Understanding California’s Community Health Worker/Promoter Workforce: A Survey of CHW/Ps

In California, one of the most culturally diverse states in the country, healthcare must bridge cultural and language differences to serve all communities equitably. As trusted community members with lived experience, community health workers and sponsor (CHW/Ps) has a long history of connecting those underserved by traditional health systems with culturally competent health and social services.

In California, CHW/Ps are increasingly recognized as an important part of the healthcare workforce. In 2019, the California Future Health Workforce Commission recommended scaling the CHW/P workforce to expand access to preventative and social support services and team-based integrated primary and behavioral health care.

It is important that CHW/Ps themselves share their experiences and express their opinions about their profession. CHW/Ps across the state and in a variety of workplace settings were asked to complete a survey between October 2021 and January 2022. This report summarizes the results and attempts to elucidate properties and perspectives of CHW/Ps. Given this timing, the survey presents data on the work of CHW/Ps during the COVID-19 pandemic.

Important Findings

The vast majority of respondents were employed full-time in a paid CHW/P position. Key takeaways from these respondents included:

  • The majority of respondents were women and Latinos/x.
  • The majority of respondents were employed in the Bay Area.
  • Nearly two-thirds of respondents’ employers required a high school diploma or less.
  • More than half of the respondents worked in a community-based organization, and a large number worked in a community clinic or health center.
  • Almost half of those surveyed were paid $20 to $25 an hour.
  • Most respondents had completed relatively short CHW/P training (40 hours or less). Almost 70% of respondents had completed CHW/P training. For most of these respondents, training was required and paid for by their employer.
  • The type of work respondents reported doing most often included identifying and referring people to community resources, as well as case management, coordination, and navigation.
  • The work of a large number of respondents did not focus on specific health conditions. Among respondents whose work focused on specific health conditions, chronic health conditions and complex health or social needs were most frequently cited.
  • The work of a large number of respondents was not focused on serving specific populations or groups of people.
  • Respondents were divided on whether they saw potential to advance in their role as CHW/P. While most respondents saw an opportunity to advance in their role, 49% said there was no opportunity or that they were unsure of their chances for advancement.
  • Documentation of services (i.e. documentation of services for clients in an electronic medical record [EHR], paper medical record or a separate recording system) was an important part of the CHW/P’s role. Almost a third of respondents spent 10 hours a week or more documenting in an EHR.
  • The COVID-19 pandemic has increased the number of CHW/P work done virtually. Due to COVID-19, most respondents assumed that computer skills, general knowledge of COVID-19 and resilience would be the most important qualities to have over the next three to nine months.

The authors caution that the results are not representative of the entire CHW/P population in California. Also, the survey could only be completed in English or Spanish.