During the COVID-19 pandemic, community health workers like Hmongshee Khang were on the front lines focusing on an equitable response to reducing the disease’s spread.
People of color, those living in rural areas and elderly community members in Wisconsin and throughout the United States were impacted more severely by COVID-19, according to data from the Centers for Disease Control and Prevention and the Wisconsin Department of Health Services.
For example, in Wisconsin, Hispanic or Latinx residents had 1.4 times greater case rates, Black residents had 1.6 times greater hospitalization rates and American Indian residents had 1.2 times greater death rates compared to white residents, according to DHS data.
Khang, who works in the central Wisconsin city of Wisconsin Rapids, provides health information, screenings, vaccinations and other health care assistance to medically underserved people in the area.
Challenges with health care system interactions largely created a disproportionate pandemic impact on underrepresented populations in Wood County and the surrounding area, she said.
“In some cases, there is a language barrier, in addition to the fact that they are not familiar with the health care system generally,” Khang said.
Other factors like substandard housing, low income and lack of insurance also disproportionately impact the health of the populations she works with, she said.
Khang often meets with people at the local YMCA or community centers to help them navigate the health care system and spread the word about healthy habits and practices.
During the height of the COVID-19 pandemic, Khang and other community health workers in Wood County helped manage pop-up community vaccination clinics.
“Really, it’s about letting them know the health care system is there to keep you healthy, not just for when you need it in an emergency,” she said. “Community health workers are also often people they know and can trust with health information.”
In 2021, the UW Population Health Institute at the University of Wisconsin School of Medicine and Public Health received $4 million in funding that was awarded to DHS by the CDC. The funding helps train professionals like Khang in Wisconsin and across the country to address health disparities that were amplified by the COVID-19 pandemic.
The funding consists of two separate grants, one for an online training center that supports 67 entities across the U.S. and a second grant for Wisconsin community health worker training and support.
The new program created to carry out this work is called Envision, which is a partnership consisting of the UW Population Health Institute, DHS, the University of Southern Carolina and Louisiana State University Health Sciences Center-New Orleans. Envision provides training and technical assistance to state and local municipalities and tribal and territorial health departments to develop and sustain their community health worker programs and train other community health workers and their programs in their areas.
Envision also provides guidance on how to plan for long-term funding for community health workers at the local, county and state levels, according to Sherri Ohly, outreach program manager at the UW Population Health Institute and co-director, development, Envision.
“While this program may have been initiated to address the fallout from the COVID-19 pandemic, it could have a much bigger impact on community health workers in the future,” she said. “We want to grow the workforce and continue to address health disparities and underlying risk factors, like chronic disease prevention and control and social determinates of health, long after the pandemic is over.”
Three pillars of the program’s training include monthly webinars, communities of practice where community health workers from around the country can share ideas, and communities of transformation that provide workshops, tailored technical assistance and community-of-practice-style learning.
Marcia Morales Villavicencio, community health worker and outreach coordinator at the UW Population Health Institute, works in partnership with DHS to support Envision programming in the state and nationally.
The state’s Latinx, Black and Hmong populations have always faced these disparities and the pandemic exacerbated these issues, but community health workers can be a strong tool to reduce them, she said.
“Because CHWs work in the community, building trust and sharing credible information, we can begin to improve the health of our friends and neighbors around the state,” Morales Villavicencio said.
Khang is also a training coordinator with Envision and helps train other community health workers in Wood County, including professionals in larger municipalities like Marshfield, Port Edwards and Nekoosa in addition to many smaller rural communities. Khang also trains community health workers across the nation.
The training Envision provides is essential to creating a strong community health worker workforce, she said.
“With effective community health workers, we can make a difference in the lives of the people we serve, and this training makes us the best we can be to help raise the collective well-being of our communities,” Khang said. “It also teaches the tools community health workers need for long-term sustainability as a valued part of the health care system.”