This article also details the challenges they face at each level. CHWs participate in three ‘levels’ of advocacy, the micro, the macro, and the professional. Building on previous studies, this article proposes a new framework for conceptualising CHW advocacy, depending on the intended impact level of CHW advocacy. These frontline workers are more vital than ever to address disparities and are a critical force in overcoming structural vulnerability and inequities in health in the United States.Ĭommunity health workers (CHWs) participate in advocacy as a crucial means to empower clients in overcoming health disparities and to improve the health and social well-being of their communities. Finally, we describe how CHWs became especially critical in addressing disparities among rural populations in the wake of COVID-19, using their advocacy-as-caregiving role that was developed and well-established before the pandemic.

Our primary contribution to existing scholarship on CHWs is the elaboration of advocacy as a form of caregiving to improve individual health outcomes as well as provoke structural change in the form of policy development. Drawing on ethnographic, qualitative data-including interviews, photovoice, and participant observation-we analyze how CHWs connect structurally vulnerable clients in rural areas to resources, health education, and health and social services. In this article, we compare community health workers in the states of Indiana and Texas, based on the results of two separate research studies, in order to (1) investigate the unique role of CHWs in rural communities and (2) understand how their advocacy efforts represent a central form of caregiving. Community health workers (CHWs) and their Spanish-speaking counterparts, promotores de salud, are well-equipped to address rural health access issues, provide education, and ultimately assuage these disparities. Rural populations in the United States are faced with a variety of health disparities that complicate access to care. The findings and recommendations from participants found within Boundaries of Care can inform and shape CHW programs both in the United States and abroad. Told through first-hand accounts and interwoven with theory, Logan presents the key challenges facing this workforce and their potential to foster even greater well-being within their communities.

Logan examines the boundaries of and barriers to care present in the experiences of CHWs, their relationships with clients, issues of professionalization, impacts of burnout and self-care, and the critical impacts of CHW advocacy. These workers participate in nonclinical services to enhance the health and well-being of their communities outside the walls of the clinic and social service agencies.

Logan details the lived experience of community health workers (CHWs) – a present yet often invisible facet of the healthcare workforce.

Csustanislaus student assistant