Durham and Cabarrus Counties

Healthiest Cities and Counties: Community Health Workers Can Make a Difference

Community health workers have been shown to be effective in helping people in underserved communities with certain health conditions improve important health measures and increase capacity to self-manage diseases such as hypertension and diabetes. Early data suggests that community health worker support may also improve appropriate and more cost-effective use of healthcare resources, by increasing the use of primary care and reducing emergency room visits.

The most important characteristic of a community health worker is that they share a lived experience with the people in communities in which they work.  This relationship is a starting point, but community health workers also receive training to assist individuals in improving their own health and training to collaborate with others in the health care system, such as social workers, certified diabetes educators, housing authorities and others.

In Durham County, where the Durham County Department of Public Health is a partner in the Healthiest Cities and Counties Challenge with Duke-Margolis and the Cabarrus Health Alliance, a 2014 study found that community health workers, collaborating with physician’s assistants and using technology to facilitate blood pressure measurement and reporting, helped 69 percent of patients in the study to achieve their targeted blood pressure or drop their baseline systolic blood pressure by 10 mm Hg or more.  Not only did community health workers visit each high-risk patient and work with physician’s assistants and the patient to create a plan for the patient to better manage their hypertension, they also hosted 100 programs promoting healthy diet and exercise.

More research is needed to translate experiences like this into solid policy recommendations and to measure the impact on healthcare costs and quality of life, but as part of the Healthiest Cities and Counties Challenge, we’re working to learn more about how community health workers can help people improve both their individual health status and the health of their communities.

man speaking in front of microphone  two men and one woman shaking hands  man smiling

Pictured Left to Right: Howard Eisenson of Lincoln Community Health Center; Susan Denzer of NEHI, Victor Dzau of National Academy of Medicine, and Eisenson; Phred Pilkington from Cabarrus Health and Robert Saunders from Duke Margolis

The Duke-Margolis Center for Health Policy held a public launch event in Washington, D.C., on Feb. 9 that featured Duke University faculty engaged in health policy research and panel discussions focusing on the fast-changing health policy environment for health care transformation and high-value biomedical innovation. U.S. Sen. Richard Burr, R-N.C., offered opening remarks.

Advisory board member Susan Dentzer, president and CEO of the Network for Excellence in Health Innovation, moderated a health care transformation panel, which included National Academy of Medicine President Victor Dzau. Advisory board members participating included: David Brailer, managing partner, Health Evolution; David Feinberg, president & chief executive officer, Geisinger Health; Michael O. Leavitt, Leavitt Partners and former governor of Utah; and Debra L. Ness, president, National Partnership for Women & Families. A panel on high-value biomedical innovation was chaired by advisory board member Peter Orszag, vice chairman of investment banking & global co-head of health care, Lazard, and included: Joseph Jimenez, chief executive officer, Novartis; David P. King, chairman and chief executive officer, Laboratory Corporation of America; Jessica Mega, chief medical officer, Verily (formerly Google Life Sciences); and Dan Mendelson, president, Avalere Health.

Learn more about Duke-Margolis

Location: Durham and Cabarrus Counties, North Carolina, population 497,714

The Problem: Adults over the age of 18 are consuming less than five servings of fruits and vegetables each day, reporting low levels of physical activity and using tobacco and vapor products.

man and woman smilingHealthiest Cities & Counties Approach: The North Carolina Healthiest Counties Cross-Sector Team is partnering with several community-based programs underway in both counties led by Duke University School of Medicine and Duke University to improve population health and payment reform. The goal is to improve population health and health equity through addressing nutrition/food insecurity, physical activity, tobacco use, integrating physical activity “prescriptions” into clinical care and piloting healthcare delivery and payment reform via community health workers.

As Innovator Counties in the Healthiest Cities & Counties Challenge, Durham and Cabarrus Counties are enhancing the health of their residents by focusing on healthy eating, nutrition education, physical activities and preventive wellness education. In addition, through a diabetes management program, Duke University aims to build upon community collaboration to improve health outcomes. #healthiestcitieschallenge

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