Community Health Workers

Efforts to assist underserved communities have been made ever since the United States was founded, but the first formal community health worker program was created in 1967 with the founding of the Community Health Aide Program by the Office of Economic Opportunity. The program aimed to improve health literacy and outcomes for Native Americans in Alaska. The Indian Health Service eventually took over the program and changed the names of the workers providing services to community health representatives. Community health programs are still popular in Alaska due to the state’s high population of Native Americans and the large number of underserved communities that are located in remote locations—some of which can only be accessed by boat or plane. In 1970, community health workers who were members of the American Public Health Association joined to create the New Professionals Special Primary Interest Group (which later changed its name to the Community Health Worker Special Interest Group). The Affordable Care Act of 2010 included provisions that increased access to preventive health services under Medicaid (via the work of CHWs and other public health professionals) and created funding for State Innovation Models, which aimed to help states improve health outcomes and quality of care while reducing health care expenditures. Some of these state-run models have incorporated community health workers. Today, community health care workers are recognized as a cost-effective way to reach undeserved communities and improve health literacy and outcomes in these places.