Community Health Workers Rise to the Occasion to Help Address Racial Inequities

I personally became aware of the acronym CHW (Community Health Worker) in 2014 when I was sent an email to apply for the State of Illinois Community Health Worker Advisory Board. At first, I deleted the emails because I didn’t know that breastfeeding peer counselors fell under the umbrella of the CHW title.

Illinois has been one of the states to pioneer a way for CHWs, because its stance is that a law can and should be used as a tool to create sustainability for CHWs. Other states already using CHWs in an instrumental way are California, Texas, New York, Minnesota, Massachusetts, and Michigan.

The Illinois CHW bill (HB5412), was signed into law on July 31, 2014, creating the CHW Advisory Board. The Board is unique in that of its 15 total voting members, eight are CHWs from across the state. The remaining seven members are stakeholders representing health care and social services, health workforce policy development, institutions of higher education, and employers of CHWs. I am honored to be currently serving as one of the Advocacy Board members.

The Board’s responsibilities are to advise the Illinois Governor and legislature on all matters that impact the success of CHWs and their work, including: training and certification processes, and recommendations for reimbursement options to ensure sustainable funding.

The development of the Board’s recommendations will ensure an infrastructure that supports the role and the work of CHWs by identifying them as a part of the team, within the evolving health care workforce. The establishment of finance models will enable CHWs to achieve greater results over the long term.

Although my initial introduction to the term CHW was as a result of the Illinois application process, I became more familiar with the CHW role on a national and international level from the keynote speech given by Yvonne T. Maddox, then acting Director of the National Institute on Minority Health and Health Disparities at the Institute’s 2014 Conference in Washington DC. She explained how CHWs were mentioned in the Affordable Care Act (ACA) multiple times (approximately 13), as a way to help reduce costs. She also reminded the states that were at the forefront of this endeavor that, in order to be successful with CHW implementation, CHWs should be included on the ground floor of boards, planning committees, and roundtable discussions to prioritize inclusion of their input and experience.

I was filled with pride that Illinois had already begun this very process! Bottom line: the work of the Illinois CHW Advisory Board will expand the availability of breastfeeding assistance to the moms in our state that need it. Ask anyone in the lactation field and they will tell you that we need more people on the front lines supporting families.

With the Surgeon General’s “Call to Action” and the Illinois Breastfeeding Blueprint launched in 2011, the Illinois Hospital Feeding Act (HB 4968) passed into law in 2013 aiming for 100% breastfeeding initiation in Illinois hospitals, and the percentage of babies born in Baby-Friendly Hospitals on the rise, we have many new moms breastfeeding and seeking assistance to meet their goals. As our communities of color experience greater access to these breastfeeding supports, we also need to ensure an increase of racial diversity in the workforce. Community Health Workers will act as a perfect solution to reduce health inequities in breastfeeding and diversification of the workforce in the African American and Latina populations.

Recently, the Illinois CHW Advisory Board scheduled listening sessions throughout the state with the purposes of eliciting feedback, ensuring transparency, and garnering support from a large array of stakeholders. We went over the recommendations from the four committees of the board which are: Core Competencies and Skills, Training and Certification, Financing and Reimbursement, and Workforce Development. For those that could not attend we emailed out a survey to complete the feedback process before working on our final report, currently in its final stages, before being sent to the Governor’s Office and State Legislature.

Although the CHW Board has received a lot of feedback, there are many actions that breastfeeding moms, members of breastfeeding organizations, and people that employ breastfeeding support frontline workers can do to help further this movement and keep its forward momentum.

First, you can survey the breastfeeding community that you are a part of and request “breastimonies: stories that show how a breastfeeding counselor helped you with a breastfeeding barrier by creating a solution that helped you achieve your goals.”

Secondly, you can seek stories from breastfeeding counselors as to why they are a valuable part of the health care team.

Lastly, you can seek statements from organizations that have worked with breastfeeding counselors and can attest to their experience and success with clients. It would be appreciated, but not mandatory, that names and contact information be included with your stories. These stories can be forwarded to my email at

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