Potential Barriers to Entry into the Profession

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A CHW helping a woman fill out some forms.There are many potential barriers that may block people from entering into the CHW profession.

Some of these include:

  • Education and work experience requirements
  • Language preferences
  • Immigration policy
  • Criminal background


CHWs are hired from the communities to be served, in part because they have survived the same kinds of challenges that members of those communities have experienced. The nature of the work of CHWs makes such background an asset rather than a liability.

The conventional policies and practices of human resources, especially in large organizations, may create some problems with this criterion in hiring. It is entirely possible that good candidates will have had limited success in conventional education and limited work experience. Organizations often insist that all employees have a working command of English, and many positions require applicants to be bilingual, but many non-English-speaking people are successful CHWs. In the face of these requirements, undocumented immigrants have been known to serve successfully as volunteer promotores, receiving at most such noncash stipends as supermarket gift cards, but immigration policy prohibits them from actual employment.

The issue of criminal background is especially interesting in this context. Many organizations require criminal background checks on all new employees. However, in some programs, a CHW who has been through the criminal justice system may actually be more effective than one who has not. In recent revisions to its CHW certification regulations, Texas considered adding a background check requirement, but looking only at criminal history that might have a bearing on the actual duties of a CHW, allowing people with convictions for minor, nonviolent offenses to be considered for employment or certification as a CHW. This proposed modification was dropped, however, because it would have made the review of background checks too complex.