O10 Community health workers: solving health issues and improving wellbeing

As the U.S. health care system continues to face a myriad of challenges due to political uncertainty, cost, lack of reform, and financial insecurity, many individuals and communities throughout the U.S. will continue to encounter barriers to accessing care. Among the most vulnerable groups include black, immigrant, refugee, and low-income communities. These groups encounter significant barriers in the form of social determinants of health – such as lack of financial security, education level, and transportation. One type of non-clinical worker, commonly known as a community health worker (CHW), provides one means of addressing these issues. However, in many states, CHWs are not well integrated within the workforce and/or are treated with ambivalence. Their strengths include belonging to the community they work within, emphasizing community outreach, health education, and advocacy. Their strengths address vital gaps in care for marginalized communities.This paper explores key findings from a dissertation project that documented the lived experiences of CHWs. The aim of this paper is to present the practical and theoretical findings regarding these workers as they are integrated into the workforce in the state of Indiana. The theoretical framing of this project includes moral economy and anthropological framings of health care. The project utilized a collaborative approach with a local CHW organization and drew on participant observation (>300 hours), semi-structured interview (n=50 interviews), focus groups, and photovoice. The results demonstrate similar yet diverse experiences among these workers, disparities in the vision of the CHW model between stakeholders and CHWs, and the vital role of advocacy in promoting health and wellbeing. Overall, this project demonstrates that social scientists can play a crucial role in infusing social theory in conceptions of health and wellbeing in addition to fostering collaborative research relationships with community partners.