The American Public Health Association defines a community health worker as:

“a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.

A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.”

How are CHWs being deployed?

In recent years, over 45 states have developed CHW education and training programs, with many incorporating core competencies, certification pathways and continuing education opportunities. Medicaid reimbursement for CHW services has expanded, with states like Minnesota and Oregon establishing long-standing reimbursement models, and Kansas recently exploring integration of CHWs into care teams through Medicaid managed care. Medicare Advantage plans in some states are also beginning to reimburse CHW services under supplemental benefits. Numerous states now have active CHW coalitions or associations — such as the Kansas Community Health Worker Coalition, the Texas CHW Association, and the Massachusetts Association of CHWs — which support workforce development, advocacy, and policy engagement. At the national level, the National Association of Community Health Workers (NACHW) plays a central role in uniting CHWs across the country, providing leadership, promoting best practices, advocating for sustainable funding, and elevating the voice of CHWs in health policy and systems change.

Clinical

Clinical Community Health Workers operate primarily within medical settings and work directly with health care professionals to support patient care beyond clinic walls. They focus on addressing medical needs such as chronic disease management, specialty care follow-up and patient navigation, ensuring continuity of care. Clinical CHWs serve as the eyes and arms of medical staff in the community, acting as a vital liaison between patients and providers to enhance care coordination. They utilize clinical and health risk assessments to develop formal medical care plans while also addressing social determinants of health that impact patient outcomes. Primarily integrated into hospital departments such as internal medicine, cardiology, oncology, and emergency rooms, as well as clinics like Federally Qualified Health Centers and rural health centers, they work closely with clinical teams while reaching out to community services as needed. Their role is centered on improving quality metrics, supporting reimbursable services and stabilizing patients by ensuring they connect with essential health care and support systems.

Community

Community-based Community Health Workers establish strong relationships within the community and provide culturally relevant support tailored to the unique needs of those they serve. Their responsibilities often extend beyond health education and care coordination, encompassing tasks such as connecting individuals to local resources, supporting chronic disease management and advocating for better access to health care services. Additionally, community-based CHWs work to address the broader social determinants of health, such as housing, education and employment, which significantly influence health outcomes. By collaborating with community organizations, churches and other local groups, CHWs empower individuals and families, reduce health disparities and foster a stronger, healthier community overall.

Global

Global Community Health Workers operate in diverse international contexts, adapting their work to meet the specific cultural, geographic and health-related needs of the communities they serve. Often serving in low-resource or rural areas, Global CHWs play a crucial role in expanding access to essential health services where formal health care and social infrastructures may be limited or difficult to reach. Their work includes conducting home visits, delivering vaccinations, providing maternal and child health education, supporting infectious disease prevention and treatment, and promoting safe water and sanitation practices. In Kenya, for example, CHWs are deeply embedded within national health strategies and are trained to provide integrated community case management (iCCM) for childhood illnesses, maternal health support and referrals to clinics. In Central and South America, Promotores de Salud are trusted community leaders who offer culturally appropriate health education, chronic disease support and mental health outreach, often in Indigenous and rural populations. These CHWs serve as critical connectors between global health systems and local realities, addressing health disparities through community-centered, grassroots efforts while strengthening trust, resilience and health equity on a global scale.

Specializations

Specializations fit the need of the community and/or the organization deploying CHWs. Examples of specialized tracks include:

• Emergency room
• Cancer care
• Diabetes and nutrition
• Health educator
• Navigator
• School-based
• Case management
• Interpreter
• Maternal and infant
• Advocacy
• Social media and campaigns