The disruptions of COVID have accelerated the embrace of community health workers in the United States and around the world. The processes of testing, helping families quarantine, treat and recover amid the economic and social traumas dissolved the spaces between public health, healthcare, social services, work, and faith organizations. Most of this activity has happened on the other side of the sidewalk from all the institutions. Health organizations have been drawn deeply into community space, especially driven by the need to partner with groups and churches trusted in the local micro-geographies wary of big everything. One major result has been to hire a lot more community health workers (CHW). Of course, this has accelerated the need for training and credentialling of CHWs. What is a good or bad one? What is good or bad community health work? How do organizations used to functioning within their organizational model know what to expect or hope for as they cross the sidewalk into the more complex ecology of community?
An article in the NC Medical Journal noted that “CHWs’ efforts have consistently been shown to positively impact: costs , return on investment for Medicaid payers , health outcomes, and quality of life of our most vulnerable populations, particularly those experiencing chronic disease  and the sharpest edge of poverty and racism, most recently during the COVID-19 pandemic . There is no need to continue to prove that CHWs are valuable in the ecology of health that exists between the clinical space of health systems and our most distressed communities.”
Many organizations bring with them a box of tools designed to manage some disease condition, maybe connect to the medical institution. The CHW is basically doing community located work but still with a mind of fixing one individual client or patient at a time. This is nothing but good and nothing but smart. But it is still clinical and individualistic. Training this kind of CHW happens almost entirely within the clinical paradigm. A positive example recently in the news is Pathways Community Hub Institute, a model Common Spirit uses as a key into community strategy. It offers 28 paths for individuals to gain or regain or live with an array of medically defined conditions. Good. Smart. And yet, clinical.
The NCMJ article explored a complementary model, that of Community Health Weavers, especially relevant to the micro-geographies where needs are often chronic and serious. But even in the most consistently traumatized neighborhoods, unless you can see the assets and vitalities, nothing changes. It is critical to have eyes for assets and generative possibilities. What’s wrong? Everything. What’s possible? You need different training to answer that.
Community is no longer just a venue of needs waiting to be acute enough to cross over into the appropriate clinical space, nor the empty space in which we discharge or jettison patients after doing something reimbursable to them. Community is where healing happens, if those relevant to the healing process find proper relationship and alignment guided by both science and social values. CHWs are a keystone to the arch, without which the bridge collapses. But the keystone has no value without all the other parts of the bridge and without the energy to make the journey from disparity to equity. (ibid)
Future Generations University
Community Health Weaving precedes the clinically-oriented CHW movement by at least a century. It even has a university—Future Generations University (future.edu, and pictured above and below)—designed to train people to see the seeds of vitality in any community and bring them to scale by nurturing the generative capacities already there. Although Future Generations University has graduates all over the world, it has been largely invisible and unknown to the hospitals and public health institutions in the United States that need it the very most.
The founders of what became Future Generations were involved in the seminal stages of the World Health Organization vision of “health for all.” This was also closely linked to the World Council of Churches Christian Medical Commission. At Alma Atta, a key 1978 international health gathering, Carl Taylor noticed a sharp divide between medical speakers from richer countries who stood at the podium and emphasized health (for all) while those from the poor countries focused on (health) for all. You can see that identical divide in the work around CHW’s today with the field dominated by the medical mind. The first focuses on medical interventions for patients; the second on community context—weaving assets into health.
Future Generations University is led today by Carl Taylor’s son, Dr. Daniel Taylor, and his son, Luke, who have little appetite for the vastly wealthy medical institutions or, for that matter, the credal claptrap of organized religion. They have built a fully-credentialled U.S. university that offers master’s level degree and professional certificates that align perfectly with the core competencies of community health weavers. They learn to diagnose not just the problems, but the possibilities, and find the path to transcend the traumas at community scale, not just heal individuals.
Join this first learning cohort
This next fall eight members of the FaithHealth Division of Atrium Wake Forest Baptist Health will be the first cohort of CHWeavers to begin the Future Generations University certificate program. The division is paying the tuition, which is $1,500 per course. At least one person is committed to the full masters.
The normal Future Generations certificate is four courses, but we are adding a fifth led by Dr. Theresa Cutts and myself, with other FaithHealth faculty to undo the unfortunate rending of faithhealth from the taproot that became Future Generations. This class, taught in Winston-Salem, is based on the class we teach at Wake Forest University School of Divinity on the foundations of FaithHealth, which rests a great deal on the work in Memphis and Stakeholder Health.
Why would a busy professional invest this time? Why would a post-COVID health system invest the money? We need to be deeply accountable for doing the right work well. We invest in training medical doctors, chaplains, psychotherapists and all the other credentialled professionals. Communities are more complex than individuals. Future Generations’ conceptual model, called Seed-Scale, rests on a rich bedrock of research and evaluated practice, and at least two Oxford Press books by Carl and Daniel Taylor.
If you sense this call in your life, reach out to Kelli Fleming, the academic dean of Future Generations University (email@example.com). Enroll this fall and you’ll be part of the learning cohort from Atrium Wake Forest Baptist. Normal tuition is $1,800 per course.
If you are helping lead one of the Stakeholder Health partners like us, please consider sponsoring some of your best community-facing staff. Perhaps you could negotiate the same slight discount we are receiving because we are enrolling a cohort of eight.
Perhaps like us you are watching the heart-rending scale of psycho-social-spiritual trauma left by COVID and wondering what to do. FaithHealth Division has the largest network of faith-trained licensed therapists in the nation, CareNet. Yet we are overwhelmed with wait lists for women and kids measured in weeks, even a couple months. Of course, we need more therapists. And we also need Weavers with the competencies to weave the assets and webs of our communities to be resilient and even generative.
Just as urgent, just as live-and death.