The Promise of Community Health Workers for Addressing Structural Drivers of Inequities Among Hospitalized Patients.

Community health workers, trained health professionals from the community they serve, hold promise in their ability to combat structural racism affecting Black patients in the hospital. Structural racism leads to downstream, adverse effects on patient care, including lack of trustworthiness of health care institutions, impaired communication, and limited access to adequate pain control. To address these challenges, we launched a Health Advocate program integrating a community health worker into our hospital's medicine wards. The program sought to improve communication, patient experience, and quality of care for Black patients. In the patient case reported in this article, the Health Advocate program assisted with communication with care teams and patient advocacy, improving the patient's experience of their care. We suggest that the Health Advocate program demonstrates the promise of community health workers to strengthen trust and communication and address other downstream effects of structural racism affecting Black patients in the hospital. The Health Advocate program also encountered challenges, including integration into the health system, sustainable financing, and longitudinal support. Insights from implementation can help address these challenges, which future community health worker programs will need to navigate in order to advance equitable, high-quality care for patient populations affected by structural racism.