Pandemic Era Expansion of State Laws Governing the Professionalization of Community Health Workers

Introduction Community Health Workers (CHWs) are trusted public health workers who strengthen healthcare access, quality, and cultural responsiveness by addressing social determinants of health. While CHW services show value, professionalization policies, including certification and training requirements, remain debated. Methods To understand these policies, we conducted an empirical legal mapping study of CHW professionalism laws in 54 U.S. jurisdictions (50 states, DC, Puerto Rico, US Virgin Islands, and Guam) in effect in 2019 and 2024 following consensus legal mapping guidelines for legal research, coding, and quality control. Results We screened 2,248 relevant laws, with 31 jurisdictions modifying CHW professionalization laws. Between 2019 and 2024, the number of jurisdictions with consistent terminology (16 to 21), defined CHW roles (15 to 21), laws concerning certification (14 to 22), and laws requiring training for practice or certification (21 to 23) increased. Jurisdictions with formal education requirements declined (12 to 8), while jurisdictions requiring training programs increased (12 to 20). Conclusion CHW professionalization requires careful navigation. While increased professionalism might enhance workforce stability, it risks creating barriers to entry and undermining CHWs’ community-rooted identity. Future research is needed to identify the balance between CHW professionalism and the preservation of CHW status as trusted members of the communities they serve.