When it comes to fighting the barriers of healthcare in rural areas, community knowledge and empowerment continue to be two of the most beneficial tools. Connecting those who have the knowledge with the resources, and sharing to bridge stronger connections, is at the heart of NMU Center for Rural Health’s mission. An asset to improving this issue is a role in healthcare itself: the Community Health Worker (CHW). Shannon Lijewski, NCHW MBA, CHCEF, Principal & Chief Executive Officer at Everyday Life Consulting in lower Michigan, is a champion for supporting the expansion of CHWs statewide, particularly in rural areas.
“Increasing the number of community health workers is hands down one of the most critical ways to improve health in rural areas,” Lijewski said. “They are an extender of the resource base system that is often very far apart or fragmented. By connecting resources you are able to use them more effectively, and then help build a self-empowered community.”
According to the American Public Health Association (APHA), a community health worker (CHW) is “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.”
Community health workers have a vital and direct impact on the communities they work in. CHWs help to build self-management skills and instill hope in individuals who may be struggling navigating resources or have just fallen on hard times. Often, CHWs are working with individuals who are Asset Limited, Income Constrained, Employed (ALICE), which means they are working but not always able to make ends meet or they have a situational issue that impacts their ability to successfully navigate day-to-day needs.
After years of working as a CHW, Lijewski founded Everyday Life Consulting in 2010 with the mission of partnering with organizations to help drive improvements in healthcare service and delivery. In her role as principal and CEO, Lijewski serves in a leadership capacity, driving all business and operational functions of firms committed to improving universal health conditions. She specializes in providing project management services, developing CHW programs, and strengthening clinical community linkages (CCL). Everyday Life works with nonprofit and for-profit hospitals, organizations, and government contracts.
“I’ve always been drawn to help others. I am great at connecting people and finding what can’t be found,” Lijewski said. “What gave me the passion that led me to becoming a community health worker was when I experienced trouble navigating the healthcare system first-hand. I had some conditions that were quite complex and I kept wishing there was somebody to help me through the process. That is what led me deeper into the work”.
In the Upper Peninsula (U.P.), entities and organizations are far apart, which means resources are not densely available. This makes it difficult to coordinate and address social determinants of health at the community level. As a result, individuals have to do a lot of work themselves. The U.P. also holds a low population, which means funding is less available. Data determines funding, and more densely populated communities in Michigan receive more financial support.
“There is this theory that if there are more people, more money is needed, when in reality urban populated areas have the ability to better coordinate with actually fewer resources,” Lijewski said. “For me to go from one entity to another in a rural area, I could be driving two hours. If you’re living in a more urban-based environment, that commute may only be one hour. That is a barrier that has a large impact on social determinants of health in a rural area, things take more time and it’s hard to quantify that and therefore pay for it.”
Lijewski added that a crucial piece to improving social determinants of health in the U.P. would be increasing the number of CHWs in the region. This would localize work, as CHWs are an extender of the resource base system that is often very fragmented. More CHWs would lead to a more connected, effective way of using these resources. It would also mean a self-empowered community with individuals who are able to identify a crisis before it happens.
“Instead of waiting for my utility bill to shut off my electricity, I know in advance that I’m not going to have enough money at the end of the month to pay the bill, so the resource navigation process begins sooner,” she said. “Using moms and babies as an example, instead of waiting until your second trimester to get into a provider, that community health worker might have already updated the family on healthy lifestyle practices, so they are at least getting connections to resources like Women Infant and Children (WIC) staff for nutrition counseling and more.”
In order to bring more CHWs to the U.P., localized training needs to exist in the region. Without local training entities and employers understanding how best to utilize CHWs, it’s challenging to recruit the position into the region. Part of the current recruitment and retention strategy is “home-growing.” This means helping people within the community understand that they may already be a CHW and connecting them to a network so they can grow where they are. In order to make this happen, there has to be a local entity coordinating and educating the community on identifying CHWs who are already in the community.
Adding localized CHW training will help increase economic mobility in the U.P. Less than 50% of Michigan adults have post-secondary certificates or credentials, meaning they have a high school diploma or less. Further skill-trade or college-based work increases brings money to the region and to families. This impacts everyday life and helps to bring in more vibrant communities.
Currently, supporting CHW expansion in the Upper Peninsula is a high priority for the NMU Center for Rural Health. Everyday Life Consulting is one of several organizations that has partnered with the NMU Center for Rural Health on a grant that would empower the Center to be developed and recognized as the CHW training facility throughout the U.P. region. The grant application was submitted in mid-May and grant partners expect to learn about their application status in late July. If awarded, the three year project would begin in August 2022.
Lijewski is also invested in this mission, and is contributing to CHW work on the regional, state, and national levels.
“As a community health worker myself and a longstanding stakeholder nationally in elevating the workforce, my partnership with the NMU Center for Rural Health is beneficial because it helps to inform me of the local and regional needs. As I’m having conversations across the country and most recently with a group at the Whitehouse, it helps keep me informed and provides me the ability to share relevant information with others.”
For more information on Lijewski's work and community health work in general, visi everydaylifechw.com.
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The Northern Michigan University Center for Rural Health seeks to improve the health and well-being of Upper Peninsula residents and communities by developing collaborative partnerships that enhance the access and availability of affordable, quality healthcare services. For questions or comments related to this story, contact ruralhealth@nmu.edu.