Potential Policymakers

Potential policymakers include CHWs and CHW allies who are members of the CHW section of APHA and/or CHW leaders who are involved with other national and state CHW programs such as the National CHW Association, CDC, and the Community-Based-Workforce Alliance. Multiple stakeholders (i.e. about eighteen individuals) across Community-Based Organizations, healthcare systems, payers, and government officials have convened to co-write this policy proposal. Endorsers include the APHA sections of Health Administration, Maternal Child Health, Black Caucus, and the Community Heath Planning & Policy Development.

Policy Solution

CHWs have historical lived experience of racism faced by HMCs and were incepted for racial equity interventions in the late 1960's to help HMCs when healthcare systems were not able to do so, and thus, this workforce has historical lived experience of racism faced. Our policy proposal, "CHWs as Racial Equity Advocates and Pathways for Training" will promote this workforce to be identified and advocate for their work in racially motivated systems leading to structural violence. This policy proposal applies the Socio-Ecological model where each of the policymakers are co-writing the problem statement and justification cross-walked with the levels of influence (i.e. intrapersonal, interpersonal, community, organizational, and systems/policy). The Life Course Theory is being applied to show that CHWs are able to be Racial Equity Advocates throughout an individual's "life course." A Health-in-all-Policies (HiAP) approach will be applied for implementation within regions and states. The Office of Minority Health, Department of Health & Human Services, and the NC CHW Association are all interested to pilot the first implementation using a HiAP approach for "CHWs as Racial Equity Advocates and Pathways for Training" in North Carolina. This policy proposal will be sent to APHA Executive Board the Joint Policy Committee as a late breaker by September 14, 2021.

HOPEI Definition

Historically Oppressed and other Peoples Experiencing Inequities (HOPEI) is defined as historically oppressed populations including those brought from Africa and enslaved in America as well as Indigenous First Nations whose lands were colonized by Europeans (including descendants of those groups who trace their genealogy back to Indigenous Mexicans, Aztecs, Mayans, Incas, etc.); in addition, HOPEIs include other populations experiencing inequities caused by structural racism.

The term HOPEI is designed to shift erroneous practices of attempting to define diverse ethnic communities with racial groupings that do not reflect how these people consistently define themselves. "Historically Oppressed" establishes an unprecedented historical presence of racial inequities and oppression among certain populations. "other Populations Experiencing Inequities" include but are not limited to: Muslims, Immigrants, LGBTQ2I and others. These inequities are primarily the consequence of systemic racism and unhealthy dynamics within the dominant culture.