Community Health

Community Health Worker Yvonne Lacey Shares Her Experiences in Health Education

Yvonne Lacey coordinates the Black Infant Health Program for the City of Berkeley, California’s Department of Health and Human Services. Last month, she was honored by the Community Health Worker Special Primary Interest Group of the American Public Health Association for her longstanding commitment to community health. Yvonne’s dedication makes her a respected leader among her peers and the countless individuals she has helped over the course of 33 years of service. Recently, we had a chance to speak with her about the value that community health workers (CHWs) have in reaching traditionally underserved families.

Q. What are CHWs, and what makes their health promotion efforts unique?

A. At one point, I had a list of over 100 titles held by individuals whose work defined them as community health workers! We are referred to as outreach workers, community health educators, health advocates and/or health advisers. Different cultures have their own terms, too. In the Latino community, the role is held by promotoras. I use the term “foot soldiers” because it reflects how CHWs are at the front line. They are outreach workers who advocate, educate, mentor and counsel. CHWs live in the communities they serve and are a trusted resource for health information to help individuals access services. The amount of time we spend with families is probably the most distinguishing factor about CHWs. That makes a difference to people, now more than ever.

Q. What are some of the challenges faced by CHWs?

A. CHWs are still working hard to be recognized, trusted and called upon by other professionals in the health care system. Short term, this can translate into families not getting services. Long term, it means that valuable input is lost on the solutions to some of the problems out there. The National Healthy Mothers, Healthy Babies Coalition was the first organization at the national level to acknowledge CHWs as key players in the health care field, and bring them to the table where comprehensive strategies are being discussed. Job security and salary remain consistent challenges for us because the nature of the job makes it dependent upon funding. Also, the personal safety issues that some of us have working in low income neighborhoods are unique. But that’s what we need to do for people who aren’t going to go seek out care – we bring health information to them. But it’s not always easy, and I have many, many stories I could tell about it!

Q. Does any one story stand out in your mind?

A. There are so many, it’s too difficult to put my finger on one in particular. We deal with families that are non-compliant in every way–meaning you may walk into a household where there are issues of domestic violence, substance abuse or any number of unsafe, unhealthy factors that put children at risk. Plenty of the single mothers that I have seen are completely without a support system–without one single friend or relative to which they feel they can turn. In some instances, our work might have to start with the purchase of diapers or food. Something like that builds trust, and it allows us to connect people to other resources available to parents and children. At the end of it all, our reward is seeing everything turned around. Through education, we can convince a mother or a father to get their kids’ immunizations up-to-date, see that they get a physical exam and a visit to a dentist. It’s an incredible thing to be a part of that, and it’s something that I wish every health care provider could experience.

Q. What is the Community Health Worker Special Primary Interest Group and why is it so important?

A. The Special Primary Interest Groups are known as SPIGs, and they give members of the American Public Health Association (APHA) a place where they connect with others in a particular area of role in health care. The SPIG provides a chance to share experience and contribute to the field. In the case of CHWs, the SPIG has been extremely critical in bringing us together and identifying how, collectively, we can have a stronger voice. It’s also extremely important to individuals to know that they have resources out there. It wasn’t too long ago that there were just a few of us making and attending the presentations. But we have worked hard to identify individuals out there who may not have considered themselves a “community health worker” prior to their connection with us. Several of this year’s sessions at this year’s APHA were standing room only, and our reception was a fantastic event that showed so much diversity. As a former Chair of the CHW SPIG, I feel very proud to have been able to build us up to this point. I also feel confident that the leadership will continue that growth.

Congratulations on your recent acknowledgement by your colleagues in the CHW SPIG!

Thank you. It’s quite a feeling to be rewarded by your peers for something you love doing so much. However, I have to say that I didn’t get here alone. I had a lot of mentors along the way and a lot of people who helped me accomplish what I set out to do.

For more information about the Community Health Workers SPIG of the American Public Health Association, contact