It is widely known that the Black Panther Party’s rallying call was “serve the people, body and soul.” That’s exactly what they did when they developed their survival programs. These survival programs, including health care, food services, and so much more, were meant to, “meet the needs of the community…until we can all move to change the social conditions that make it impossible for the people to afford the things they need and desire.”
We don’t often associate the Panthers with the term “Community Health Workers,” but that’s exactly what they were,” says Denise Smith, Community Health Worker (CHW), prior Access Health CT Training Coordinator for the Navigator and In Person Assister Outreach program and past Director of Career and Education Initiatives and Coordinator of the Heart Strong: Disease and Stroke Prevention program for Central Area Health Education Center, Inc., and leader in the field. “Community Health Workers operate with a desire to see a need met so that someone can see a whole life.”
CHWs tend to be trusted and knowledgeable members of the communities that they serve and often work under different titles and in many different settings. Among other roles, they can educate and connect underserved communities to care, coverage, and support. They provide outreach, advocacy, patient education, navigation, and social support to community members.
“The Affordable Care Act (ACA), includes language in support of CHWs, but it can be limiting when we think about the scope of Community Health Work and the many different forms that it must take in order to meet the demands birthed by an unjust healthcare system,” continued Smith. A so-called system, that is, that privileges those that are wealthy, English-speaking, and White, and leaves much to be desired by those left out and unprotected.
“They desire to see transformation within communities and individuals, provide linkage to resources that allow for the building of competency and self-advocacy, and ultimately, reduce the barriers that prevent people from getting the care that they need. CHWs serve as a bridge,” says Smith. “Their competencies translate across many different environments.”
Serving as that bridge means addressing barriers that exist in our so-called healthcare system. “Actually, it’s not a healthcare system,” says Smith. “What we have is a disease management system. A healthcare system provides preventative care and has structures in place to address barriers of access, quality, and cost. “That’s where CHWs come in….they acknowledge those barriers,” says Smith.
One of the key features of the Panthers’ survival programs was that they were completely free. It was promised that, “survival programs will always be operated without charge to those who need them and benefit by them.” One of the main ways that CHWs advance health equity, enabling all to achieve good health, is by addressing the barrier of cost. “Often times, as volunteers, CHWs jump in and provide services where the healthcare ‘system’ does not,” says Smith.
Although a crucial part of health care, CHWs “were never really part of the healthcare system.” That means they are not confined by its limitations and can often focus their energy on what a person or community needs. “They offer true client-centered care, because that’s who they serve,” says Smith.
In addition to reducing the cost of care by providing free services, by serving as a bridge between traditionally underserved populations and needed health information, support and care, CHWs address barriers of access and quality as well.
“When Community Health Workers step in to offer free services where there is a demand for them, it begins to transform the healthcare environment,” says Smith.
Working alongside, but not within the healthcare system in an era of health reform, “Community Health Workers can be engaged now,” says Smith. “That is, until we have a truly equitable and integrated healthcare system that addresses all barriers.” As the Panthers put it “until we can all move to change the social conditions that make it impossible for the people to afford the things they need and desire,” we look to the patient-centered work of CHWs as their work is inspired by a vision of health equity for all.