Each April, National Public Health Week offers a reminder that public health is not only about programs or policy. It is about the systems, relationships, and infrastructure that help communities stay healthy in the first place.

Many of the protections we rely on every day come from public health. These are not always visible, but they shape health in powerful ways, such as:

• Clean water and sanitation
• Seat belt and car seat laws
• Food safety regulations
• Smoke-free indoor air laws
• Laws against drinking and driving

Today, healthcare systems face ongoing challenges with access, affordability, fragmentation, and trust, making it difficult to consistently support healthy communities and improved outcomes. At the same time, many communities continue to experience a gap between how systems are designed and how people actually live, seek care, and make decisions. Closing that gap requires a stronger connection to community experience, priorities, and real-world conditions. This is where Community Health Professionals (CHPs) play a critical role.

CHPs include community health workers, promotores, doulas, peer support specialists, patient navigators, and other trusted, community-based professionals. Through lived experience, cultural understanding, and trusted relationships, they often have a level of insight that traditional systems cannot easily replicate. CHPs are experts in:

• Community values and priorities
• The barriers people face when accessing care and services
• How trust influences participation in healthcare, programs, and research
• How systems can better align with community needs

CHPs offer an essential perspective and play many roles in strengthening communities and systems. They support access, build trust, improve continuity, help people navigate complex services, and create stronger connections between institutions and the communities they aim to serve. They also have an important role to play in shaping how evidence is generated and applied.

This is one of the pathways being explored through the Responsive Trust Network, led by CHPs and supported by Texas Health Institute and the University of Houston’s Community Health Worker Initiative. Through this effort, we are learning with CHPs about what meaningful engagement can look like across multiple dimensions of community and system change, including research. One area of focus is how CHPs can be more intentionally integrated into community-informed research and engagement efforts from start to finish. That includes learning directly from CHP leaders with deep expertise in trust-building, community partnership, and real-world system navigation, and engaging a core group of CHP experts as co-designers in shaping what meaningful integration can look like in practice.

This also matters for the broader systems that rely on evidence to make decisions. When the people closest to community realities help shape what questions are asked, how information is gathered, and how findings are interpreted and shared, the result is often evidence that is more relevant, more actionable, and more grounded in real life. That has broader implications for health system transformation. If health systems are to become more responsive, effective, and trusted, they must be designed with a clearer understanding of how people experience care, services, and support in their everyday lives. CHP engagement helps create that bridge between community experience and system design.

Health system transformation depends on more than clinical redesign alone. It requires better alignment across healthcare, community services, public health, and policy in ways that reflect how people experience health and care. Many of the public health protections we rely on today work quietly in the background, built into the systems around us. There is an opportunity to apply that same thinking more intentionally across healthcare and community systems: designing supports that are more coordinated, trusted, and responsive, rather than fragmented and difficult to navigate. CHPs are uniquely positioned to help make that possible.

We also recognize the CHPs who are actively helping shape this work through the Responsive Trust Network. Their leadership, expertise, and lived experience are helping inform how this effort is designed and carried forward. We are grateful for the contributions of the following CHP leaders who are serving as co-designers in this work: Joie Hernandez Caston, CHW, Doula; Luz Cruz, CHW; Kizzey Demease, CHW, CWP, PSS, CFP-S; Abraham Medina, CHW; Natieli Pazdra, CHWI, CHW; Michelle Presley, CHWI, CHW, Patient Navigator; Rosario Ramírez, CHW; Lynita Robinson, CHW; Tori Williams, CHWI; and Tasha B. Wilson, MLA, CHW. 

About Texas Health Institute

Texas Health Institute (THI) is an independent nonprofit public health institute dedicated to advancing the health of all Texans. THI helps communities and decision-makers navigate complex health challenges by serving as a nonpartisan, trusted convener, and data-driven analytic partner. By bringing together policymakers, health system leaders, clinicians, researchers, philanthropy, employers, and communities, THI translates evidence into insight and advances effective systems-level solutions across the state.

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