Community health centers offer one-stop services and help stop the spread of disinformation. They also offer an opportunity to reshape health care and improve outcomes.
“You know I have insurance.” I look up towards my patient. “I’ve been coming here for years, though, because you treat me like family.”
I nod and smile. And then, it clicks. It’s no secret that as a free student-run clinic, we lack resources to meet all our patients’ complex medical needs. However, community members choose to receive care at Paul Hom Asian Clinic because we treat them as family, centering our patients’ medical and non-medical needs and speaking to them in their native tongue.
At Paul Hom, we view having staff who share language and cultural concordance with our patients as a right, not a privilege. Undergraduate volunteers serve as community health workers (CHW) and interpret for patients, coordinate social service and complex care management, and give insights that enrich providers’ understanding of patients’ clinical pictures. Too often, we see patients who experience setbacks in care due to lack of English proficiency. As health care prices soar and complexity of the health care landscape ticks upwards, we must seek to narrow gaps in health care through integration of the CHW model throughout health systems.
Community members choose to receive care at Paul Hom Asian Clinic because we treat them as family.
Community health workers are care navigators, preventive care providers, interpreters, and patient advocates all in one. As health educators and interpreters, they combat disinformation circulating in their communities and bridge language and cultural divides between patients and physicians. As primary care provider burnout persists, they also offer health systems opportunities to redistribute, and thus reduce, work burden.
Lifestyle modifications can prevent the onset of heart disease, diabetes, and several types of cancer. Yet, as many can attest to, improving one’s behaviors is no easy task. Social and behavioral changes remain elusive yet crucial in efforts to reduce the burden of disease on communities, but community health workers offer breakthrough solutions. Several lines of evidence have demonstrated that community health workers can make great strides in improving preventive care and chronic disease management. A study conducted across the Kaiser Permanente Northern California health system found that patients’ glycemic and LDL values improved by 10% and 9%, respectively, upon switching to a language concordant provider.
As health care expenditures rise to staggering heights, community health workers offer an opportunity to optimize care provision. Researchers at the University of Pennsylvania found that a CHW intervention called IMPaCT resulted in a return of $2.47 for every dollar invested. Similarly, a Mayo Clinic study found that integration of CHWs into their primary care system reduced the number of inpatient admissions and emergency department visits among patients.
Physicians and health systems can re-envision a new health care system, one that elevates language and cultural concordance and reduces medical costs through sustainable, community-centered solutions. In my past work interviewing CHWs, many have identified innovative opportunities to integrate CHWs in clinic flow. One Connecticut-based CHW shared that a provider had reached out to them to collaborate on “expanding telehealth communications” and “assessing readiness levels of certain patients, particularly sickle cell patients.”
In medicine, physicians wear an overwhelming number of hats. With the steadily increasing prevalence of chronic diseases in our communities compounded by community members’ complex care needs, it is no surprise that health systems are strained by large expenditures, high physician turnover rates, and poor and inefficient utilization. In this context, community health workers offer more than just a helping hand. They represent an opportunity to reshape health care into a dynamic entity rooted in, and responsive to, the diverse communities that physicians serve daily.
