Chidinma Ibe (
Anika Hines, Virginia Commonwealth University, Baltimore, Maryland.
Health Aff (Millwood). 2023 Oct;42(10):1392-1401. doi: 10.1377/hlthaff.2023.00584.
Community health workers (CHWs) are front-line public health personnel who share common attributes with or have a nuanced understanding of the communities they serve. Their membership in marginalized communities gives them expertise in delivering contextualized interventions that mitigate their clients' social risk factors, but it also places them at greater risk for exposure to various harms. We employed the photovoice method to illuminate how the lived experiences of CHWs working, residing, or both in Baltimore City, Maryland, dovetail with facets of their jobs. In partnership with our sixteen predominantly racial and ethnic minoritized study participants, we surfaced the ways in which CHWs negotiated and subsequently leveraged experiences with social risk factors rooted in structural racism to shape their approach to intervention delivery for structurally vulnerable communities. We also uncovered several occupational hazards that participants faced as a function of their identities. Our findings underscore the need to embed antiracist principles in the fabric of policies and practices that directly affect the CHW workforce.
社区卫生工作者(CHWs)是处于公共卫生第一线的人员,他们与所服务的社区具有共同的特征或对其有细致入微的了解。他们作为边缘社区的一员,具备提供背景化干预措施的专业知识,这些措施可以减轻客户的社会风险因素,但这也使他们面临更大的风险,更容易受到各种伤害。我们采用摄影法来阐明马里兰州巴尔的摩市的社区卫生工作者在工作、居住或两者兼而有之的生活经历,如何与他们工作的各个方面相吻合。通过与我们的 16 名主要来自少数族裔的研究参与者合作,我们揭示了社区卫生工作者如何协商并利用源自结构性种族主义的社会风险因素经验,来塑造他们针对结构脆弱社区的干预措施提供方法。我们还发现了参与者作为其身份的一部分所面临的一些职业危害。我们的研究结果强调了在直接影响社区卫生工作者队伍的政策和实践中嵌入反种族主义原则的必要性。