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Rural Health Information Hub

Community Health Workers in Rural Communities

Community health workers (CHWs) are also referred to as community health advisors, lay health advocates, promotor(a)s, outreach educators, community health representatives, peer health promoters, and peer health educators, among other titles. According to the Bureau of Labor Statistics, in 2019, there were over 58,000 CHWs employed in the U.S. The Health Resources and Services Administration estimates that the demand for CHWs in rural communities will grow by 13% by the year 2030.

The Standard Occupational Classification for CHWs, created by the Department of Labor Bureau of Labor Statistics, defines CHWs as workers who:

“Promote health within a community by assisting individuals and communities to adopt healthy behaviors. Serve as an advocate for the health needs of individuals by assisting community residents in effectively communicating with healthcare providers or social service agencies. Act as liaison or advocate and implement programs that promote, maintain, and improve individual and overall community health. May deliver health-related preventive services such as blood pressure, glaucoma, and hearing screenings. May collect data to help identify community health needs. Excludes 'Health Education Specialists.”

CHWs most often work in underserved communities, including communities in urban and rural areas and tribal lands. CHWs often work with individuals who:

  • Have limited financial resources
  • Have limited or lack of transportation options
  • Do not speak English fluently
  • Have specific health conditions
  • Lack access to quality healthcare services

CHWs can help to address the shortage of health professionals in rural and underserved communities, and act as a liaison between providers and patients.

According to the Health Resources and Services Administration (HRSA) Allied Health Workforce Projections, 2016-2030: Community Health Workers, CHWs provide a range of services including:

  • Care coordination
  • Case management
  • Health coaching
  • Health education
  • Health assessment and screening
  • Resource linking
  • Medication management
  • Remote care
  • Patient follow-up
  • Social and literacy support

In rural communities, CHWs may work in a variety of settings, including:

  • Patients' homes
  • In the community
  • Schools
  • Workplaces
  • Faith- and community-based organizations
  • Healthcare systems
  • Community health centers/Federally Qualified Health Centers
  • Other healthcare settings
  • State, local, tribal, and territorial governmental public health agencies

Resources to Learn More

Community Health Worker Resources
Provides reports, websites, and education materials about CHWs and their roles and services addressing the following topics: asthma, cancer, cardiovascular disease, diabetes, infectious disease, injury prevention, obesity, physical activity, and general resources.
Organization(s): Centers for Disease Control and Prevention, Center for State, Tribal, Local, and Territorial Support

APHA: Community Health Workers
An APHA member section promoting opportunities for members to share their knowledge and strategies in promoting the CHW field of practice.
Organization(s): American Public Health Association (APHA)

Community Health Worker Resource Directory
An online resource directory containing free resources in English and Spanish supporting CHW programs in underserved and rural communities.
Organization: MHP Salud

Community Health Workers: Health System Integration, Financing Opportunities, and the Evolving Role of the Community Health Worker in a Post-Health Reform Landscape
Provides background information about the CHW workforce and its unique role in health promotion. Summarizes the structural elements influencing the integration of CHW programs. Presents case studies, discusses the evolution of CHW competencies, and identifies opportunities for funding.
Author(s): Malcarney, M., Pittman, P., Quigley, L., et al.
Organization(s): George Washington University Health Workforce Research Center
Date: 10/2015

Community Health Workers National Workforce Study
Reports on a national study of the CHW workforce and the factors affecting its utilization and development in urban and rural settings.
Organization(s): Health Resources and Services Administration
Date: 3/2007

I Am Who I Serve - Community Health Workers In Family Planning Programs
Discusses the roles of CHWs in family planning programs and the current issues affecting their efforts.
Author(s): Benson Gold, R.
Citation: Guttmacher Policy Review, 13(3)
Date: 8/2010