Recognizing the diverse roles of community health workers in the elimination of health disparities: from paid staff to volunteers.

The community health worker (CHW) model has been successfully used to promote health and reduce adverse health outcomes in underserved communities. Although there is a general consensus that involvement of natural helpers from the targeted communities is a promising approach in the elimination of health disparities, there is less agreement on their responsibilities, scope of work, and reimbursement for their services (ranging from paid staff to unpaid volunteers). These differences in pay structure stem from philosophical differences, programmatic needs, and financial realities. Based on our experience with both the paid and volunteer approaches, we provide some lessons learned on how the CHW model can be integrated in our efforts to eliminate health disparities.