Racial/ethnic health disparities are pervasive.  There are a number of factors stemming from patient-provider relationships that may contribute to the disparate rates of health conditions that disproportionately affect communities of color, including factors such as lack of trust, race/ethnic disconnect or cultural divide and patient fear of being criticized.  It is therefore critical to identify a method that will increase cultural competence and the efficiency of care.  What method can provide the means to solving such a complex problem?  The answer is simple:  Community Health Workers (CHWs), which represent an often overlooked member of the health care team that has demonstrated effectiveness in delivering prevention messages to racial/ethnic populations.

The Black Infant Mortality Reduction Resource (BIMRR) Center of the Northern New Jersey Maternal Child Health Consortium is one of many organizations that have embraced the challenge to eliminate racial/ethnic health disparities through strategies including the use of CHWs.  The mission of the BIMRR Center is to decrease death rates among infants of African descent through provider and consumer education, as well as health policy, advocacy, and promoting health disparity agendas.

“There’s a Meeting in the Village”, a CHW training program, was developed by the BIMRR Center and funded by the March of Dimes.  The program was designed to prevent adverse perinatal outcomes and to provide a model for culturally competent care among at-risk populations.  The “train-the-trainer” workshops included one-day educational sessions that enhance the knowledge base and skill level of the CHWs about the inverse relationship between stress and pregnancy for women of color.  Throughout the workshop, the CHWs learn about the increased risk of preterm birth and low birth weight among women of color, stress reduction techniques, and coping strategies.  Upon completion of the training, the CHWs are asked to share this information with 10 clients to reduce adverse birth outcomes and promote stress management and reduction techniques.

Program evaluations received from more than 150 participants have illustrated the positive effects of the training and the impact on their collective knowledge base.  The data show that 100 percent of the participants increased their knowledge of stress reduction and coping techniques and their awareness of the impact stress has on pregnancy, and 99 percent of the participants increased their knowledge of pre-term birth.  Furthermore, surveys received from approximately 600 clients showed that close to 90 percent increased their knowledge of preterm birth and low birth weight as risk factors for infant mortality and 85 percent learned the correct definition of preterm or premature birth. 

“There’s a Meeting in the Village” is a program that was developed based on the invaluable skills of CHWs and their linkage to the communities they serve.  CHWs are culturally appropriate communicators of vital health information, helping patients develop the knowledge they need to make healthy choices that can minimize negative outcomes.  In addition, CHWs typically resemble their clients in terms of ethnicity, race, language, and lifestyle, enabling them to educate providers and other health care professionals about the cultural norms of the communities they serve.  Increasing cultural understanding helps develop productive relationships between patients and providers.  Through their first-hand experience and understanding of underserved and marginalized communities, CHWs are able to tackle the socio-economic and cultural differences that often result in disparities in health and health care. (Ro et.al, 2003). 

BIMRR firmly believes that CHWs serve as a bridge in eliminating the gaps in racial/ethnic health disparities.  BIMRRC continues to value their services as community leaders.  For more information on our training program or to schedule a training workshop at your organization, please contact Kweli Walker, BIMRR Director at (201)843-5177 ext. 13.

Source: Ro, M., Treadwell, H., & Northridge, M. Community Health Workers and Community Voices: Promoting Good Health: A Community Voices Publication. National Center for Primary Care, Morehouse School of Medicine, 2003.