The Chronic Disease Burden in Ethnic and Minority Groups: Community Health Workers as a Potential Solution for Improving American Health Care

Abstract

Despite many efforts toward prevention, the United States continues to experience high rates of chronic disease, especially among older and ethnically-diverse and minority individuals. Economic, social, and emotional factors affect not only those diagnosed, but also family members and those in the broader community around them. In particular, those from ethnic or minority backgrounds with low income and low education levels are the most likely to have undiagnosed and/or uncontrolled chronic diseases due to the lack of access to quality healthcare, limited health literacy, and scarcity of culturally-competent and relevant information and education. This dissertation examines how Latinos and other minority groups experience chronic disease and the potential inclusion of community health workers (CHWs) in the continuum of care for chronic conditions, in particular diabetes and breast cancer. Three independent studies, representing different substantive areas and methodological approaches, were conducted. First, a study reported on the construction of a brief survey to assess the status of community health workers in the Gulf coast region, including their roles and professional recognition in the public health arena. Next, a secondary analysis was performed examining existing data to understand the impact of culturally-designed self-management intervention programs in both African American and Latino populations with diabetes. Lastly, a qualitative research study was conducted to address how Latinos experience breast cancer survivorship, their perception of quality of life, and the role of CHWs in this topic. The results found that the efforts of community health workers provide benefits in the management of chronic disease among ethnic and minority populations. The two different chronic disease research studies conducted suggest the positive value to be accrued when utilizing community health workers as part of the healthcare team. Expanding the use of this vital workforce, CHW’s could elevate ethnic and minority patient’s health and quality of life due to the enhancement of cultural and linguistic best practices. Both results, along with the status report, solidify the understanding of this concept and provide validation to reduce costs in the health care system, as well as increase compliance and patient satisfaction with incremental health provider support.