By Charles Bruner, Ph.D., Director of the Integrated Care for Kids
The health community is saddened by Dr. Paul Farmer’s death – but also heartened by the many tributes to his life and the path he has presented for us. Although much of his work focused upon the poorest and most distressed communities in the world, his experiences have relevance to our nation’s efforts to improve our health and achieve racial equity.
At the heart of Dr. Paul Farmer’s practice and action was “accompaniment”, as reflected both in his own engagement of patients as a physician and his tireless work to enlist community health workers as frontline “accompagneurs” and valued members of the medical team.
Science and research have proved that well-resourced community health workers (family advocates, relational care coordinators, “promotores”, coaches, etc.) – particularly in low-income and medically-underserved communities – are core to improving population health and rectifying racial inequities. COVID-19 has shown how essential and yet how under-resourced such workers, primarily women and disproportionately people of color, are. Increasing investments in them is critical to our nation’s infrastructure and also creates employment and career opportunities where they are most needed. Exemplary child health programs and practices have demonstrated the feasibility, value and impact of including community health workers as part of the medical home team to optimize child health across physical, social, emotional, and cognitive development.
Both Congress and the President have proposed investments to strengthen the community health workforce that now require attention and action. President Biden has called for investments in at least 150,000 additional community health workers, valuing and resourcing them in their roles. Senator Bob Casey (D-PA), Senator Thom Tillis, (R-NC), Senator Tina Smith (D-MN), and Senator Lisa Murkowski (R-AK) have introduced bipartisan legislation to authorize such investments. Senate Health Education Labor and Pension Committee Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC) have included this legislation in the committee’s bipartisan discussion draft “PREVENT Pandemics Act”.
Enactment of the legislation and full funding would be a fitting honor to Dr. Paul Farmer and would help others following in his footsteps. Community health workers, working with primary child health practices and as part of medical home teams, are critical to advancing child health, with lifelong benefits to the children and to our society and economy.
Charles Bruner, Ph.D., is Director of the Integrated Care for Kids—InCK Marks Initiative (www.inckmarks.org) funded by the Robert Wood Johnson Foundation and a former state legislator from Iowa. InCK Marks also has shown the leading role child health can and must play in this work. The most recent powerpoint presentation, with notes that provide highlights of the presentation, is available at: RETHCIPowerpoint.pptx (live.com)
