1. “Champions in Communities for Improving Health and Wellness” Community Health Worker Conference Louisville KY Sept
Vivian Lasley-Bibbs, MPH
Acting Branch Manager and Epidemiologist
Office of Health Equity
Kentucky Department for Public Health

2. Health starts in our homes, schools, workplaces, neighborhoods, and communities.

3. World Health Organization
What is Health ?
“Health is a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity.”
World Health Organization
The definition has not changed since
Foundation for Healthy Generations 2014

5. Community Health Workers
Explore how programs, practices, and policies in these areas affect the health of individuals, families, and communities.
Establish common goals, complementary roles, and ongoing constructive relationships between the health sector and these areas.
Maximize opportunities for collaboration among Federal-, state-, and local-level partners related to social determinants of health.

6. CHW Core Competencies Communication Skills Interpersonal Skills
Knowledge Base
Service Coordination Skills
Capacity-Building Skills
Advocacy Skills
Teaching Skills
Organizational Skills
National CHA Advisor Study

7. Who are they?
We connect our friends, family, and neighbors to a comprehensive, integrated delivery network of health, human and social services resulting in improved access and removal of barriers to needed resources.
Community Health Workers (CHWs) are frontline public health workers who are trusted members of and/or have an unusually close understanding of the community they serve. This trusting relationship enables CHWs to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. 
CHWs also build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy. (American Public Health Association, 2008)

8. Community Health Workers must be of the people they serve
They must live with them…
Work with them…
Rejoice with them…
Suffer with them…
Grieve with them…
And decide with them…
World Health Organization

9. Who are they? Sisters Mothers Daughters Aunts Grandmothers Nieces
Friend
Vital role in Health care system
Wise investment
Evidence based approach that works

10. What is their role? Provide/increase access: “the 5 rights” Right Care
Right Time
Right Place
Right Provider
Right Payer
CHW’s afford a unique position to engage individuals and populations that professionals have difficulty reaching.

11. What do they do? Outreach Cultural mediation
Navigation: help people get the services they need
Create more effective linkages between communities and care systems
Provide culturally appropriate health education and self-management support
Advocate for underserved individuals and community needs
Informal counseling and social support
Build individual and community capacity in addressing health issues

12. How Do They Do What They Do…..
They stay current on the issues
They strategize …
They take advantage of every learning/training opportunity or they create it
Popular education
Incorporating adult learning styles
Most importantly they know how to reach the community they serve

13. Why does it work? Peer support
Status within the community and identified as someone respected
Contribution to community empowerment
Successful referrals to health facilities
Communities see visible changes
CHWs also build individual and community capacity

14. “Trust is the conduit of influence”
The trusting relationship enables the CHW to serve as a link between systems and the community to facilitate access to services and improve the quality and cultural competence of service delivery systems.
(Amy Cuddy, social psychologist)
Foundation for Healthy Generations 2014

16. Health Equity Exercise
Equal ≠ Equity

17. Making Healthy Choices the Easy Choices
Social Circumstances:
Housing
Education
Employment
Health Care
Access to services
Safety
Sidewalks
Availability of Healthy Food
Systems and Policies Matters
Foundation for Healthy Generations 2014

18. Examples of Social Determinants
Availability of resources to meet daily needs (for example, safe housing and local food markets)
Access to educational, economic, and job opportunities
Access to health care services
Quality of education and job training
 Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
Transportation options 
Public safety
Social support
Culture
Social norms and attitudes (for instance, discrimination, racism, and distrust of government)
Exposure to crime, violence, and social disorder, like the presence of trash and lack of cooperation in a community
Socioeconomic conditions, such as concentrated poverty and the stressful conditions that accompany it
Residential segregation
Language/Literacy
Access to mass media and emerging technologies, like cell phones, the Internet, and social media

19. Examples of Physical Determinants
Natural environment, such as green space (e.g., trees and grass) or weather (e.g., climate change)
Built environment, such as buildings, sidewalks, bike lanes, and roads
Worksites, schools, and recreational settings
Housing and community design
Exposure to toxic substances and other physical hazards
Physical barriers, especially for people with disabilities
Aesthetic elements (e.g., good lighting, trees, and benches)

20. What I need to know WHAT YOU WILL NEED TO KNOW: Data
Understanding community needs and assets
Representation form all sectors of the community
Impact of current policies and programs
Level of support for an issue or action
Tools and resources needed to take action
Use of multiple approaches to reach diverse audience
Share or develop the necessary resources for action and problem solving.
Recruit participants from diverse backgrounds and with diverse experiences.
Promote community-wide change through the use of multiple approaches proposed by representatives from different sectors of the community.
Improve your chances of making meaningful changes in community conditions by gaining community members’ trust in a broad-based coalition of partners.

21. Partnerships and Collaborations
Education
Urban Planning and Built environment
Faith-based
Transportation
Business Sector/Commerce
Housing
Law Enforcement
Community based organizations
State/Local/city government

22. Next Steps
Obtain professional recognition for Promotores and Community Health Workers.
Create certification process
Can result in job availability for Promotores and Community Health Workers
Utilize knowledge, experience and abilities of Promotores and Community Health Workers in the creation of policy.
Increase Advocacy presence.

23. Thank You! Vivian Lasley-Bibbs, MPH
Kentucky Department for Public Health
Office of Health Equity
ext. 4074