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Many street medics consider themselves, and their basic scope of practice to be a part of the Community Health Worker (CHW) global movement. This para-professional scope of practice was internationally recognized at the 1976 Alma-Ata Conference as a key in promoting a high standard of health and well-being for all people.

About CHWs[edit | edit source]

Community health workers—also known as community health advocates, lay health educators, community health representatives, peer health promoters, community health outreach workers, and in Spanish, promotores de salud—are "community members who work almost exclusively in community settings. They serve as connectors between health care consumers and providers to promote health among groups that have traditionally lacked access to adequate health care."(Witmer 1995, p. 1055)

One of the most important features of CHW programs is that they strengthen already existing community network ties (Israel 1985; Institute of Medicine 2002). CHWs are uniquely qualified as connectors because they live in the communities in which they work, understand what is meaningful to those communities, communicate in the language of the people, and recognize and incorporate cultural buffers (e.g., cultural identity, spiritual coping, traditional health practices) to help community members cope with stress and promote health outcomes (Wilson, Brownstein, & Blanton, 1998; Walters & Simoni 2002).

CHWs can build partnerships with formal health care delivery systems to connect people with the services they need and to stimulate social action that influences community participation in the health system and political dynamics (DiClemente, Grady & Kegler 2002). Such workers provide a community-based system of care and social support that complements, but does not extend or substitute for, the more specialized services of health care providers (Oregon Public Health Association).

CHWs also educate providers about the community's health needs and the cultural relevancy of interventions (Witmer 1995) by helping providers and health care systems build their cultural competence (Institute of Medicine 2002). Using their unique position, skills, and an expanded knowledge base, CHWs can feasibly help reduce health care and personal costs as they help improve outcomes for community members (Witmer 1995).

Core roles, competencies, and qualities of CHWs[edit | edit source]

The National Community Health Advisor Study, conducted by the University of Arizona and the Annie E. Casey Foundation (Wiggins & Borbon 1998), reached almost 400 CHWs across the country to help identify the core roles, competencies, and qualities of CHWs. The following seven core roles were identified:

  • Bridging cultural mediation between communities and the health care system;
  • Providing culturally appropriate and accessible health education and information, often by using popular education methods;
  • Assuring that people get the services they need;
  • Providing informal counseling and social support;
  • Advocating for individuals and communities within the health and social service systems;
  • Providing direct services (such as basic first aid) and administering health screening tests; and
  • Building individual and community capacity.

Notes[edit | edit source]


DiClemente RJ, Crosby RA, Kegler MC. (2002). Emerging Theories in Health Promotion Practice and Research. San Francisco, CA: Jossey-Bass.
Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Snedley BD, Stith AY, Nelson AR, editors. Washington, DC: Institute of Medicine; 2002.
Israel B. (1985). Social networks and social support: Implications for natural helper and community level interventions. Health Educ Q, 12, 65-80.
Oregon Public Health Association, Community Health Worker Committee (1999). Community Health Worker Position Paper. Portland, Oregon.
Walters KL, Simoni JM. (2002). Reconceptualizing native women’s health: An "indigenous" stress-coping model. Am J Public Health 92, 520-524.
Wilson K, Brownstein JN, Blanton C. Community Health Advisor Use: Insights from a National Survey. In: US Department of Human Services, Centers for Disease Control: Community Health Advisors/Community Health Workers: Selected Annotations and Programs in the United States, Vol III, June 1998.
Witmer A. (1995). Community health workers: integral members of the health care work force. Am J Public Health, 85, 1055-1058.
Rick Kimball. The Role of Health Care Workers in Chronic Disease Management. Becker's Hospital Review (2015).
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