The COVID-19 pandemic has laid bare exactly how devastating years of under-investment in our public health infrastructure can be. Now more than ever, health experts across the country are criticizing the manner in which public health funding ebbs and flows in the US. This instability prevents health departments, hospitals, NGOs, and other public health entities from maintaining a sustainable workforce and adequately responding to public health emergencies. In response, GHJP has engaged in various partnerships to increase the availability of sustainable funding for the public health workforce and eliminate structural barriers to workforce entry such as criminal background checks and low wage, and lack of support for community health workers.

 

Public Health Jobs Now 

In fall 2021, GHJP joined Public Health Jobs Now!, a coalition of labor unions, public health experts, and advocates. PHJN has worked to  call for the creation of a Public Health Jobs Corps (PHJC) to create 1.6 million permanent public health jobs, including 540,000 permanent Community Health Worker positions, to address health disparities and rebuild our capacity to address current and future crises. 

PHJN advocates for jobs that offer a prevailing wage, plus benefits, the right to organize and a pathway to joining a union, the right to a safe workplace, with training, pathways for advancement, and access to wraparound support services that will enable workers stressed by pandemic caregiving needs to serve in these jobs, such as childcare and flexible scheduling. Employers should receive incentives for adopting high-road labor practices.

Some of these goals have materialized in the Biden administration’s recent announcements to increase funding for the public health workforce

 

Health Justice: Theory to Practice, Spring 2021

Students in GHJP’s spring 2021 seminar, Health Justice: Theory to Practice, worked closely with PHJN to develop reports, toolkits, and recommendations to support a sustainable public health workforce infrastructure. 

  1. Confronting A Legacy of Scarcity: A Plan for America’s Reinvestment in Public Health 
    The students on this team interviewed over 20 public health experts, scholars, and practitioners to assess how we may begin to reverse the course of continued disinvestment in our public health infrastructure. The resulting report highlights the need for a mandatory public health funding stream made available to states and localities and insulated from attempts to shift funding away from public health and explores various routes to achieve that end. 
  2. How to Advocate for Good Jobs to End the COVID-19 Crisis and Address Health Inequity with Recent Federal Funding
    This student team created an in-depth toolkit for community-based organizations looking to access federal funding and bolster their community health workforce. The toolkit highlights the need for a community and public health workforce explicitly structured and supported to address new and existing health inequities, provides helpful talking points when advocating for these positions, and discusses in detail federal funding opportunities that may be used to strengthen our public health infrastructure. The toolkit is also featured on the website of our project partner, the Public Health Jobs Now coalition. 
  3. COVID Is the Sprint, Equity Is the Marathon
    The students on this team drafted a set of recommendations for federal policymakers on how to overcome common barriers to scaling up a public and community health workforce and ensure that funds from the American Rescue Plan Act will be used to build a workforce responsive to the health and economic needs of marginalized communities and built on racial equity. The white paper recommends building the community and public health workforce by hiring directly from communities most impacted by COVID-19, allowing for community-based organizations to directly apply to up-front funding grants, and building processes for local community input and buy-in. 

 

Supporting the CHW Movement with NACHW

GHJP has worked with the National Association of Community Health Workers (NACHW) to help support power-building and organizing among community health workers.  Community health workers (CHWs) are frontline public health professionals who have a deep and close understanding of the community in which they work either from shared lived and/or cultural experience, and thus a vital segment of the country’s public health infrastructure. 

In spring 2022, the Global Health Justice Partnership (GHJP) researched  the prevalence of criminal record check requirements in CHW certification processes across the United States. 

Students in this project, Akshat Agrawal, YLS, LLM ‘22;  L Britton, YSPH, MPH ‘23; Laura Hallas, YLS ‘24; Jenna Hoskison, YLS ‘24, conducted a 50-state policy analysis of criminal background check requirements, and based on trends identified in their analysis, created a typology in which CHWs can readily classify and assess their state’s policies. Students used this typology to provide policy recommendations to increase transparency, eliminate barriers to workforce entry, and improve overall equity in the certification process.

As Denise Smith, Executive Director of NACHW, has noted “Through this valuable research, we now know that this issue is one faced by many CHWs who are often called to serve our community’s toughest populations but may be unable to reach them due to the criminal background check barrier. Through this incredible research completed by Yale Law Students, NACHW can now take steps to provide resources to justify those CHWs affected by this challenge and NACHW is proud to continue our collaboration into the coming semester and hopefully beyond.”