Expanding Detroit’s health care workforce

Ben Montgomery, Jr. never planned to become a community health worker. After graduating from Renaissance High School in Detroit, he earned his bachelor’s in business administration and accounting online from Maryville University in St. Louis, Missouri, then held various roles in accounting and human resources. When the Community Health Awareness Group began recruiting people to become community health workers to increase the number of people who received COVID vaccines and to educate the community about COVID-19, HIV/AIDS, diabetes, and other health conditions, Montgomery answered the call.

“I feel like I have come full circle,” he said. “I was trained in community outreach about 15 years ago, and I thought getting my community health worker certification would strengthen my skills. I learned how to empathize with and advocate for others, and I fell in love with serving the community.”

Detroit has long struggled with significant health disparities compared to neighboring and more affluent Michigan communities, with lower life expectancy and higher rates of chronic diseases. The COVID-19 pandemic further exposed gaps in health outcomes and the health care system.

“Detroit and its neighbors lack sufficient primary care options,” said Nate McCaughtry, Ph.D., assistant dean of the Division of Kinesiology, Health and Sport Studies and director of the Center for Health and Community Impact in the Wayne State University College of Education. “Even when residents access primary care opportunities, the region lacks coordinated after-care approaches that address broader social determinants of health often contributing to health conditions. Residents need more supports and services to ensure access to adequate housing, heathy foods, safe drinking water, toxin-free environments, medications, employment, transportation and behavioral health services.”

The pandemic also revealed health care workforce gaps in the United States. One report indicates a shortage of 38,000 front-line health care workers, particularly those directly engaged with the community. This deficit is especially noticeable in Detroit, where health care, managed care, public health and community-based agencies face challenges in recruiting sufficient staff.

In collaboration with university colleagues and a network of regional health care-focused partner agencies, McCaughtry and his team launched the Community Health Worker Academy in 2021 to advance health equity and improve the effectiveness and cost efficiency of optimizing population health by recruiting, certifying and providing professional development for community health workers (CHWs) employed in health care, managed care, public health and community-based organizations. In September 2022, the academy received a $2.6 million Community Health Worker Training Program grant from the Health Resource and Services Administration (HRSA) to expand the CHW health care workforce in Southeast Michigan.

“Research shows that CHWs improve community health outcomes,” said McCaughtry, who directs the academy. “As members of integrated care teams, they help health care organizations reduce costs and enhance chronic disease management, use of primary care services, patient satisfaction, social service engagement, vaccination rates and food access.”

Recognized as front-line public health workers by the American Public Health Association, CHWs are trusted community members. They act as intermediaries, bridging the gap between health and social services, facilitating access to services and improving cultural competence. Through outreach, education, counseling and support, CHWs enhance health knowledge and self-sufficiency, provide coaching, and facilitate capacity building.

“Community health workers reach people in a way that other health professionals simply cannot,” said Phillip Levy, M.D., professor of emergency medicine and associate vice president for translational science at Wayne State University and director of the Wayne Health Mobile Unit program. “The CHW Academy that Dr. McCaughtry and his colleagues have developed takes this one step further by advancing knowledge and creating opportunities for upskilling that don’t exist anywhere else. By working with their team, the Wayne Health Mobile Unit program has been able to build our capacity, meeting people on their terms to help identify and address social determinants that contribute to worse health outcomes.”

Initially, the academy certified and trained CHWs to staff local health care facilities, mobile health units and large-scale federally funded health reform initiatives led by multidisciplinary research teams across Wayne State. The HRSA grant has expanded the program’s possibilities.

“The award was instrumental to the academy’s growth,” said Cheryl Somers, Ph.D., associate director. “More agencies became interested in replenishing and scaling their health care workforce. The academy is part of the community’s health care fabric and fills a much-needed void.”

Academy staff develops CHW trainee cohorts within organizations interested in integrating CHWs into their operations, hiring additional CHWs, or providing specialized training for employees. Participants complete the Michigan Community Health Worker Alliance certification program, 25 hours of job-specific training from the academy’s CHW Education Catalog, and either a one-year paid apprenticeship or 400-hour internship. They also earn certification in Mental Health First Aid, Narcan, Mandatory Reporting and U.S. Department of Labor Registered Apprenticeship.

In less than a year, the academy launched six cohorts with more than 60 CHWs from nine organizations. Its training program was well-received by initial trainees.

“I enjoyed my experience in the CHW training cohort,” said Montgomery, who earned his certification in June. “Dr. Porsche Fischer was a fantastic instructor and made the class engaging and educational. I liked learning other trainees’ perspectives, and the class complemented my existing knowledge. I’m ready to create change in my community and advocate for those who have no voice.”

Local agencies are pleased with the quality of training and its potential to help them improve health outcomes.

“We are thrilled to have the opportunity to send our staff to the Community Health Worker Academy at no cost to our nonprofit organization,” said Cindy Bolden Calhoun, Executive Director and CFO of the Community Health Awareness Group. “This training will not only benefit our staff members’ professional development but also enhance our organization’s ability to serve our community’s various health needs.”

McCaughtry is excited about the academy’s progress, impact and future. The staff is working with 25 organizations to form a dozen new cohorts and expects to train more than 100 new CHWs in the coming year.

“The past few years have felt pretty serendipitous,” said McCaughtry. “When we began having conversations with local agencies about attracting and training Community Health Workers, I didn’t anticipate how quickly things would evolve. The HRSA grant propelled our efforts forward in ways we never imagined. We’ve built an amazing team, and I feel grateful to be part of a collective effort to improve health equity in the city where I’ve worked for over two decades.”

Montgomery, who helps low-income individuals with HIV/AIDS find affordable housing, agrees that the academy is making a difference and CHWs are vital members of the health care community, particularly in metro Detroit.

“To see myself reflected in the people that we serve makes me feel like this work is even more important,” said Montgomery. “If I can get young Black men off the streets and housed, empower them, and help them access resources, navigate life successfully, and become productive citizens, I will have accomplished my goal. This work will always be at the forefront of what I do.”


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