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Workforce Development, Part 2: Career Development

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Ladder going up into the sky.CHW employment should:

  • Have a career ladder for advancement options
  • Have pathways to related careers with special supports for CHWs who need it
  • Be viewed as a way into the workforce for people on welfare or formerly incarcerated


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We turn now to career development for CHWs.

Most employers do not see the CHW as a regular occupation, so they simply have not thought about career development for CHWs. The current funding structure for most positions does not provide incentive to employers to offer career development or even continuing education for CHWs, who may be laid off or moved to another program after two or three years. Until the CHW becomes a “regular” occupation with long-term employment prospects, career development for CHWs will not be on their radar. Some people assume that CHW positions are primarily steppingstones to other health-related occupations. The notion that one could actually have a career as a CHW has not occurred to most people, including many CHWs. In most states, therefore, the idea of career advancement as a CHW may not have even been discussed.

What kinds of opportunities are available for the most experienced CHWs? Pursuing another career such as nursing is generally a positive step for a CHW, and given the characteristics of people usually hired as CHWs, the decision is probably also a positive thing for society. If the CHW returns to practice her new profession in the same community, the community benefits. However, the community and the employer will have lost an effective CHW. This potential “brain drain” has not yet become a serious issue for most communities, but it may in the future as the CHW job market begins to grow and stabilize.

Many CHWs may have chosen the field out of a general interest in health-related occupations combined with a belief that they would not be able to meet the academic requirements for other health-related professions. Others who may have been drawn to a health-related career might have become CHWs because of a fear of exposure to blood, needles, and the like. Even so, many CHWs have grown in confidence and successfully pursued one of these other professions.

One argument for the “pathway” philosophy is that the same qualities that make an effective CHW would also make a community-responsive and culturally competent nurse, physician, dental assistant, or other health care professional.

We conclude this session with three specific needs for improving career development for the CHW workforce:

  • CHWs need a career ladder with advancement options
  • They need pathways to related careers and special supports in pursuing them
  • CHW employment should be viewed as a possible entry to the workforce for welfare recipients, and for people who were formerly incarcerated