The Yale Undergraduate Research Journal


Since their formal inception in the 1960s, Community Health Worker (CHW) programs have been revered as a panacea by some and critiqued as a delusion by others (R. N. Labonte et al., 2017; R. Labonte & Saunders, 2015). CHW programs can yield up to a 10:1 return on investment, mobilising communities to take preventative actions to tackle some of the most overwhelming diseases of our time (Earth Institute at Columbia University, 2013; WHO, 2015). However, when carried out without appropriate support or integration into broader health systems, CHW programs cease to be comprehensive tools for resilient preventative health and, instead, become structures that exploit CHWs, leaving them distressed and disillusioned within roles they are unequipped to fill and so fail to meet the needs of the communities they serve (Campbell et al., 2008; R. N. Labonte et al., 2017; Rifkin, 1996). The vital role CHWs are playing in the global COVID-19 pandemic requires us to highlight the failings of such scale-ups in the past and the key lessons we can take from this history.

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