I became a community health worker by accident. My nephew, who’d lived with us since he was born, was diagnosed with asthma at age two. Dad wanted to follow the medication protocol the doctors gave us; Mom believed in home remedies. It was hard for me to grasp what was happening. I needed to learn about the disease so I could ask the doctor questions. As I learned how to help my nephew control his asthma, I became an ad hoc community health worker. 

That was more than 19 years ago, when I lived in Peru. When I came to the United States, I had to spend a lot of time discovering how to do new things – how to maneuver the systems here – because no one else had answers for me. The health care system was so large. How did people know what questions to ask? Where did they go to find the answers? Why were they afraid to confront their doctors? It was these kinds of journeys that led me to finally become a professional community health worker, six years ago.

My first patient was a middle-aged man from Bangladesh who spoke limited English. After first talking outside his front door for 10 minutes, he invited me into his apartment where we conversed for another half hour, his wife and three children on the floor with us as I explained who I was. Finally, he showed me the boxes – two large moving boxes stuffed with thousands of sealed, never-been-opened envelopes. He asked me to read them.

The letters were from doctors and bill collectors and credit card companies. He told me to start with the medical ones. As I opened letter after letter, we quickly learned that one of his children had lead poisoning. What I did next was obvious to me but intimidating to them: I found the family a doctor, went with them to appointments, translated for doctor and patient. I was the only bridge they had to ensuring proper and accurate medical care.

I now work closely with the New York State Community Health Worker Initiative, which is launching a statewide network of CHWs and making bold recommendations on core competencies, training standards and financing streams that will allow CHWs to fan out across the state in larger numbers as frontline, trusted commissars — and to help those most profoundly in need.  

If we are to be successful in getting better outcomes overall – lower costs throughout the system and more people living longer, healthier lives – we must integrate what happens inside institutions with what happens outside, in our communities. I am a community health worker, and I do this every day.