CHWs often do outreach, health education, prevention support, referrals, care navigation, and communication that fits the local context. They work in many settings, including clinics, hospitals, public health departments, schools, nonprofit organizations, disaster response programs, and community-based organizations. CHWs are different from doctors and nurses because they usually do not provide advanced clinical care, diagnose illness, or prescribe treatment. Rather, their work focuses more on community-based skills, such as health education, outreach, trust-building, care navigation, referrals, and recognizing when someone needs professional medical or mental health support. 

The training and certification of CHWs differ from region to region and depending on the organization. In the United States, some states have formal certification procedures which require a certain number of approved training hours, verified work or volunteering experience, or further education, whereas in other states the emphasis is placed on training provided by the employer, certificates awarded by nonprofit organizations, or programs offered at community colleges. Since certification requirements vary from state to state, CHWs may also get training in the local and state rules concerning credentials, how to navigate the healthcare system, and how to work with healthcare professionals.

Recent global health discussions describe CHWs as key connectors between communities and health systems because they can help identify local risks, share health information, support prevention, and connect people to care. Their role becomes particularly crucial as climate change leads to a greater number of health risks that span human, animal, and environmental systems, as described in the One Health framework. The fact that CHWs have this global presence indicates that they are already in a position to help with climate-related health preparedness, provided that they receive proper training, supervision, supplies, and institutional support.

Community health workers play a key role in climate preparedness and response. They can translate complex climate and health risks into practical, locally meaningful advice. For example, CHWs may help people learn how to stay safe during heatwaves, limit exposure to wildfire smoke, prepare for flooding or find local support after disasters. They can also help create the community and neighbor connections that are needed around climate events. 

CHWs are not a substitute for mental health professionals. By providing health education, basic psychosocial support, chronic disease monitoring, and referrals, CHWs can also reduce the burden on overstretched health systems. They can provide important early support, especially in communities where formal mental health services are limited, hard to access, or not fully trusted. CHWs may help reduce stigma, recognize signs of distress, provide basic psychosocial support, offer a listening ear, connect people to formal care, and identify community members who need urgent assistance.

Research suggests that CHWs can help fill mental health service gaps when they receive appropriate training and supervision. For instance, CHW-delivered mental health interventions have been used with underserved populations in the U.S. and in low- and middle-income countries, with many studies showing reductions in mental health symptoms. CHWs can also provide psychosocial support during public health emergencies.

At the same time, many CHWs live in the same communities they support, meaning they may be supporting others while facing their own stress, caregiving responsibilities, safety concerns, and financial pressures. CHWs are therefore at high-risk of burnout. This means CHW programs should include not only mental health training for CHWs, but also emotional support, supervision, fair compensation, manageable workloads, and protection from burnout. 

Rural communities and those with chronic illnesses also experience increased climate health risks. Extreme weather can damage infrastructure, disrupt transportation, and reduce access to clinics, particularly in rural or remote locations. Climate events can worsen physical and mental health conditions. Since CHWs can aid in managing chronic diseases and extend the reach of health systems, they may assist people in preparing for interruptions like power outages, issues with accessing medication, transportation needs, cooling plans, and post-disaster referrals. 

Nevertheless, CHWs should not be viewed as an easy solution to climate inequity, since many CHWs experience inequities themselves. Many CHWs face job insecurity, low pay, unstable grant-based funding, limited training opportunities, and not enough support in the field. Some also experience the same socioeconomic challenges as the communities they serve. Their role may also be misunderstood by employers, leading to underuse or assignment to tasks that do not fully use their community knowledge and skills. Their ability to reduce disparities depends on receiving sustainable funding, fair pay, training, supervision, supplies, referral systems, and recognition for their essential role. 

Research on CHWs and climate-mental health is still evolving, but emerging research demonstrates how CHWs can aid in climate preparedness, disaster response, mental health care, and community resilience. 

A case from Pakistan illustrates how CHWs can assist in climate-related mental health care during disasters. Rabbani et al. describe the mPareshan project, a digital mental health initiative run by Pakistan’s Lady Health Workers during the 2022 floods in Sindh. The project provided app-based psychosocial counseling for adults with mild to moderate anxiety and depression. Since Lady Health Workers were already part of their communities, they continued to reach people even when flooding hindered transportation, clinic access, internet connectivity, electricity, and household stability. However, the project also revealed challenges, such as limited pathways for referrals to specialists, increased workloads, emotional stress, and the fact that many workers faced their own displacement and losses. 

Across different settings, CHWs are already helping communities respond to climate-related health and mental health challenges related to climate change. In Los Angeles County, community health workers trained as Heat Ambassadors carry out door-to-door outreach during heat waves. They identify residents at high risk, offer heat safety education and cooling supplies, and connect people to cooling centers and other resources. These trusted relationships reduce social isolation and strengthen community resilience during extreme heat. 

Similarly, in the Bolivian Amazon, promotores make home visits, monitor chronic conditions, provide psychosocial support, and help residents access care when floods and other climate-related disasters disrupt transportation and health services. Together, these examples show how CHWs can improve climate adaptation and community resilience by providing reliable community-based support before, during, and after climate-related emergencies.

1. Integrate community health workers into climate adaptation and disaster planning. CHWs should be part of planning, implementing, and evaluating climate-health programs because they know local communities, cultural practices, and barriers to care. 

2. Expand climate and mental health training. CHWs should get training in climate hazards, emergency preparedness, psychological first aid, trauma-informed communication, and referral pathways. Programs like the Climate Care Champions Program train CHW to recognize climate-related health risks, communicate extreme weather safety, support disaster preparedness, and strengthen community resilience.

3. Support innovative approaches to care during disasters. Digital tools can help maintain services when transportation and clinics are disrupted. For instance, the mPareshan program in Pakistan trained Lady Health Workers to provide app-based psychosocial support for people facing anxiety and depression during the 2022 floods.

4. Protect and support the community health workforce. Many CHWs experience the same climate-related events as the communities they serve. They need fair pay, supervision, mental health support, manageable workloads, and safe working conditions to reduce burnout and continue their work. 

5. Invest in long-term partnerships. We need sustainable funding and cooperation among health systems, public health agencies, emergency responders, and community organizations to strengthen CHW programs and improve community resilience.

Community health workers have a significant role in building climate-resilient communities, but they cannot succeed without support. More research and expanded training are needed for CHW-led climate efforts. Importantly, CHWs should receive training, fair pay, proper supervision, necessary supplies, protection, and inclusion in decision-making. 

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Published: October 26, 2026
Author: Yilin Ma, MPH Candidate
Editor: Colleen Rollins, PhD
Acknowledgements: With gratitude to McKenna Parnes, PhD for her mentorship and insightful comments.