Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review

Authors: Ilona Verhagen, Bas Steunenberg, Niek J de Wit and Wynand JG Ros

The health status of most ethnic minority groups in Western countries is poorer than the health status of the majority population. This is especially applicable for ethnic minority older adults. Limited access to health care services has been reported to be an important factor for these disparities in health and is in part caused by limited knowledge about health care facilities, language problems, and financial barriers. Intercultural differences in the perception of health needs and reasons for consultation may be other important contributing factors.

Culturally sensitive interventions such as the introduction of community health workers (CHWs) have been used to address health disparities among ethnic minorities. CHWs share the same ethnic background, speak the same language, are aware of the health beliefs and understand the barriers to health care that ethnic minority adults experience. CHWs have been demonstrated to be effective in increasing health knowledge, changing health behaviour, and increasing access to care in this target group. However, an overview of CHW benefits for older adults is lacking in the literature.

The authors aimed to investigate whether CHWs are also effective in providing the aforementioned benefits to ethnic minority older adults. The number of older adults from ethnic minorities is increasing rapidly in Western countries, and their utilisation of health facilities has been reported to lag behind. Better access to health care would optimising their health and enable them to maintain independence, improve societal participation, and diminish existing disparities. Therefore, the authors systematically reviewed the literature on the implementation of CHW programmes in ethnic minority older adults in Western countries.