LEARN It! Challenge 2, Topic 1
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The Three Foundations of the CHW Training Program

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The 3 Foundations of CHW Training Program are: 

1. Understanding Health Care Challenges

2. Understanding Workforce Challenges

3. Understanding Health Disparities

1. Understanding Healthcare Challenges

The nation is undergoing the most sweeping health care changes in decades. These changes hold the promise for improving healthcare outcomes for patients, as well as lowering costs and making the delivery of care more efficient. With the changing dynamics of the health care system, we are now presented with an opportunity to re-imagine the practices and teachings of health care and its delivery. This conversion must be rooted at all levels of the community to ensure a value-driven, asset-based, and interdisciplinary practice of education for the modern healthcare workforce.

2. Understanding Workforce Challenges

According to the Association of American Medical Colleges (AAMC), the nation will have a shortage of 91,500 doctors by 2020, with a shortfall of 31,000 specialists and over 60,000 primary care providers. For the first time since the 1930s, the per capita number of physicians is projected to drop. Estimates suggest that the US will see severe shortages in health care professionals over the next 20 years. A shortage of 46,000 primary-care physicians is projected by 2025 (Association of American Medical Colleges, 2008; Dill & Salsberg, 2008; Newton & Grayson, 2003). Similar shortages are predicted in STEM professions (Building Engineering and Science Talent, 2003), many of which support health care through discovery and innovation. One new and innovative approach to reducing the impact of physician shortages is the use of CHWs. Community health workers are in a unique position to facilitate access, as well as improve knowledge and engagement of the healthcare system.

3. Understanding Health Disparities 

In addition to the above mentioned projected shortages, a key determinant of successful health care is the status of the underserved and the consequences of their experiences. Despite leading the world in medical care spending, Americans have poorer health and shorter lives than people in many other prosperous countries (National Research Council, 2013). The United States ranks below all or most other wealthy nations on a varied set of health indicators including: life expectancy, rates of low birth weight and premature birth, mortality rates among people aged 50 years and younger, as well as prevalence and mortality rates for heart disease, diabetes, respiratory disease, and infectious diseases. (National Research Council, 2013).Access to resources, community organization, education and knowledge about health, and income create the foundation for many of the disparities. Health varies based on where people live in the United States; it has been pointed out that in this country, your ZIP code can tell more about your health than your genetic code (Mark, 2009). You don’t have to be poor to be affected by disparities; populations considered to be middle-class have significantly worse health outcomes than those with higher levels of income or education (CDC, 2012).