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There are suggestive indications, but
no statistical evidence, of the size and
direction of change in the community health
worker (CHW) workforce. Studies in Minnesota[1]
and California [2]
suggested the growth of the CHW workforce
but could not be used to accurately predict
a growth trend. The absence of an official
definition of the CHW occupation and the
erratic, short-term funding of CHW programs
have hampered the collection of CHW data
and made estimates difficult. However,
two sources of information offer some
evidence that the CHW workforce is likely
to increase in the forthcoming years:
the Bureau of Labor Statistics (BLS) projections
of occupations that include CHWs and the
interviews of CHW employers conducted
for this study. The BLS data can be used
to make a very rough estimate of the growth
of the CHW workforce from 2000 to 2005.
Estimates of Growth
for the Community Health Worker Workforce
from BLS Data
The method used in this study to arrive
at national and State estimates of community
health workers[3]
employed data from the Census Bureau and
the Bureau of Labor Statistics for two
Standard Occupational Classification (SOC)
codes:[4]
SOC code 21-1010, Counselors, and SOC
code 21-1090, Miscellaneous Community
and Social Service Specialists. The "Social
and Human Service Assistants" (SOC
21-1093), a subgroup of Miscellaneous
Community and Social Service Specialists,
was "projected to grow much faster
than the average for all occupations between
2004 and 2014 and was ranked among the
most rapidly growing lines of work."[5]
Current estimates from the Bureau of
Labor Statistics for these two occupations,
21-1010 and 21-1090, are shown in Table
7.1.[6] BLS
expected that the number of individuals
working in these two SOC occupation codes
will increase between 2000 and 2005 by
22 and 44 percent, respectively.
Table 7.1 Percent
Change in Selected SOC Codes
| SOC
|
2000
|
2005
|
Percent
Change |
| 21-1010
|
434,130
|
530,710
|
22.2
|
| 21-1090
|
385,080
|
555,640
|
44.3
|
| Total
|
819,210
|
1,086,350
|
32.6
|
Source: Bureau of Labor Statistics.
Using the estimated proportions of CHWs
in SOC 21-1010 and 21-1090 in 2000 (1.8
and 12.4 percent, respectively) and assuming
no changes in the proportions over time,
an estimate of 9,758 (530,710 x 1.8 /
100) and 68,938 (555,640 x 12.4 / 100)
can be made to represent the total of
CHWs in these occupations in 2005. The
change in those totals from 2000 to 2005
was applied to the CHW total for 2000
(85,879) to arrive at the 2005 figure
of 121,206.
Table 7.2 Estimated
Number of CHWs in 2000 and 2005
| 2000
|
2005
|
Change
|
Percent
Change |
| 85,879
|
121,206
|
35,327
|
41.1
|
Source: Bureau of Labor Statistics and
CHW National Workforce Study Estimates
(Chapter 3).
CHW National
Workforce Study Interviews (CHW/NWSI)[7]
During "best-informant" interviews
with 36 employers in two large and two
small Northern and Southern States,[8]
a routine question was asked on future
plans relative to continuing or increasing
CHW personnel.
The majority of employers in Texas and
Arizona who participated in the interviews
were optimistic about continuing the employment
of CHWs and expanding their utilization
into health care services addressing diabetes,
mental health, and oral health. Also,
a few employers mentioned plans of involving
CHWs in future clinics, emergency rooms,
and additional geographic areas. All employers
interviewed in the four States indicated
that continued funding was the key determinant
of continued CHW employment.
[1]
Blue Cross Foundation. Critical Links:
Study Findings and Forum Highlights on
the Use of Community Health Workers and
Interpreters in Minnesota. Eagan (MN):
Blue Cross and Blue Shield of Minnesota
Foundation, 2003; Minnesota Community
Health Worker Work Force Analysis: Summary
of Findings for Minneapolis and St. Paul.
Minnesota Community Health Worker Project
in partnership and funded by the Robert
Wood Johnson Foundation and the Blue Cross
Blue Shield Foundation, 2005.
[2] Love MB, Gardner
K, Legion V. Community health workers:
who they are and what they do. Health
Educ Behav 1997; 24 (4):510-22; Cowans
S. Bay Area Community Health Worker Study.
[HED 892 - Final Report]. San Francisco
(CA): San Francisco State University,
2005. 29 p.
[3]See Chapter 3 and
detailed methodology in Appendix B.
[4]Occupational Outlook
Handbook, 2006-07 Edition, Social and
Human Service Assistants [Internet]. Washington
(DC): Bureau of Labor Statistics, U.S.
Department of Labor; 2006 [updated 2006
Aug 04/cited 2006 Oct 20]. Available from
http://www.bls.gov/oco/ocos059.htm.
[5] Ibid.
[6] Occupational Employment
Statistics. Washington (DC): Division
of Occupational Employment Statistics,
Bureau of Labor Statistics, U.S. Department
of Labor; [updated 2006 Oct 04/cited 2006
Oct 20]. Available from http://data.bls.gov/oes/search.jsp?data_tool=OES.
Note: Customized tables.
[7] Interviews with selected
candidates in the four in-depth study
States were carried out from May to July
2006 to learn more about issues unattainable
from extant data, including contributions
CHWs have made, demand for CHWs, and future
utilization of CHWs. See Appendices E1
and E2 for "workbooks" used by the research
team during the interviews.
[8] Arizona, Massachusetts,
New York, and Texas were selected as "in-depth"
studies for this report.
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