Opinion: A clear answer to the growing needs of NH’s aging population

“I have seen first-hand the positive health and social effects of CHWs throughout New Hampshire. In Lancaster for instance, a CHW had a client whose husband had died and was dealing with a chronic illness while living alone in her home,” writes Carbonneau.

“I have seen first-hand the positive health and social effects of CHWs throughout New Hampshire. In Lancaster for instance, a CHW had a client whose husband had died and was dealing with a chronic illness while living alone in her home,” writes Carbonneau. Pixabay

By ANNETTE CARBONNEAU

Published: 05-22-2024 6:00 AM

Annette Carbonneau, director of CHW Programs, North Country Health Consortium.

The current NH State Plan on Aging estimates that by the year 2030 over one-third of New Hampshire’s population will be over 65 years old.

COVID-19 placed unprecedented stressors on state agencies and programs resulting in severe shortages in staffing and services that are only worsening. One of the populations most severely affected by this crisis are seniors, who face often unique challenges such as transportation to healthcare, social isolation, barriers to technology, and fixed incomes that cannot keep up with the rising costs of basic needs such as housing, prescriptions, utilities, and healthy food.

When we were all dealing with COVID-19, we were forced to push the growing concerns for our state’s aging population aside to deal with later. I would argue that later is now, and while New Hampshire has worked effectively to recruit and educate more Community Health Workers (CHWs), we have an opportunity to better utilize this workforce as a long-term solution to addressing the healthcare worker shortage, improve health outcomes, and decrease healthcare costs, particularly for our older population.

CHWs are frontline public health workers who are trusted members, or have an unusually close understanding, of the community they serve. CHWs act as a one-on-one resource to help meet the full spectrum of an individual’s healthcare and social service needs, including basic needs, by working in partnership with clinical providers. By being a connector between providers, community resources, and individuals, CHWs reduce the burden on primary care and social services staff, extending their impact to increase positive health outcomes, thereby reducing hospitalizations and emergency room visits.

So how much does this cost? Well, even those most fiscally conservative cannot ignore the numbers because when looking at other models around the country, the savings far outweigh the costs. In one instance, a standardized CHW intervention showed a ROI of $2.47 for every dollar invested by a Medicaid payer. Another study in New Mexico found that CHWs generated an estimated $2 million in savings over one year, suggesting close to a 4:1 ROI.

I have seen first-hand the positive health and social effects of CHWs throughout New Hampshire. In Lancaster for instance, a CHW had a client whose husband had died and was dealing with a chronic illness while living alone in her home. In addition to supporting her medical needs, the CHW worked with community organizations for free yard clean-up and shoveling to help with home maintenance. Going to church used to be a big part of the client’s life but she could no longer attend because she had no way to get there. The CHW reached out to that religious organization, and they offered to pick her up each week to take her to church. It was life-changing for her. She could now practice her faith and see her friends. She was connected to her community again.

In many instances, technology is a huge barrier to seniors and they cannot access many of the services and healthcare information available online. CHWs can connect them with free online services and devices through community and state partners. However, if a client is not comfortable with technology, CHWs bring a laptop or tablet to help find the online services and medicines they need, as well as help fill out online forms, so clients can take advantage of prescription discounts, online scheduling, and telehealth appointments, to name a few. As navigation experts, when CHWs see a need for a client, they find and reach out to resources, and see it through to conclusion.

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New Hampshire residents are known universally as hugely independent and proud, and none of us want to be a burden on the system or others. CHWs “fit” the New Hampshire culture of taking care of our own, neighbors helping neighbors, while supporting seniors to make their own choices and safely age in place. How often do we get such a clear answer to such a complicated problem?