Strengthening community health centers: Combating staffing challenges for health equity

female healthcare worker,  sitting in hospital hallway with a mask on

By Cassie Kearney

Master’s Student, Health Behavior and Health Education

For many Americans, especially those in underserved communities, Community Health Centers (CHCs) and other Federally Qualified Health Centers (FQHCs) are more than just medical facilities—they are lifelines. These centers strive to offer equitable healthcare, with services provided to all, irrespective of their ability to pay. Affordable sliding scale fees ensure that individuals without insurance can still access necessary healthcare. CHCs also play a broader role in their communities, fostering health issue awareness and community pride and serving as a touchstone for social support.

While the COVID-19 Public Health Emergency (PHE) era has ended, the pandemic continues to fester in healthcare access and quality of care in CHCs. CHCs have grappled with severe staffing shortages that impair their capacity to deliver quality care. Financial instability and burnout have led to a significant exodus of healthcare professionals, leaving a scenario reminiscent of healthcare deserts, particularly in rural areas

What has led to CHC staffing shortages?

Several elements contribute to critical staffing shortages at CHCs. These include enticing financial prospects with better pay at urban healthcare systems, elevated burnout due to pandemic pressures, and the challenges of finding childcare while maintaining a work-life balance. A staggering 70% of CHCs have reported workforce losses between 5 and 50% in recent times, inviting concerns about reliable healthcare access for some of the nation's most vulnerable populations.

What are the implications for patient care?

Staffing shortages directly affect care delivery, exacerbating medical errors, prolonging waiting times for appointments, and reducing visit lengths. This can result in a deterioration of the patient-provider relationship and potentially adverse health outcomes, as early intervention and treatment are often delayed.

What are ways in which CHC workers can be better supported?

The complex and multifaceted problem of staffing shortages and burnout will require a similarly multifaceted solution:

Wellness Programs: Allocating resources to wellness initiatives could benefit 60% of CHC staff, enhancing their ability to cope with the job's demands. This could include flexible work hours, subsidized gym memberships, and support groups for staff facing workplace burnout. In addition, revising workplace sponsored loan repayment and forgiveness programs could alleviate financial stress and incentivize retention.

Childcare Resources: Given the family responsibilities of many healthcare workers, providing on-site childcare solutions could significantly relieve the burdens they face, helping to retain current staff and attract new talent.

Salary Increase through Federal Funding: A proposed 10% raise in salaries, backed by increased federal funding, could bridge the wage gap between CHCs and other health institutions. By providing competitive compensation, CHCs could better retain staff and ensure they are sufficiently rewarded for their expertise and hard work.

To uphold the mission of CHCs in providing top-notch, equitable care to all individuals, it is vital that we commit to policies and practices that support and strengthen the workforce. The sustainability of these centers hinges on our ability to creatively and effectively respond to their needs. Through a balance of enhanced wellbeing, compensation, and federal backing, CHCs can continue to serve as the bedrock of accessible healthcare for those who need it most, readying the nation for any future public health challenges.

About The Author

Cassie Kearney headshotCassie Kearney is a 2024 graduate from the University of Michigan School of Public Health (SPH) with a Master of Public Health in Health Behavior and Health Education. Her main interests include family health, maternal and child health and nutrition, youth social media/technology use, adolescent mental health, and community prevention efforts. Cassie holds an undergraduate degree in Psychology with a minor in Global Health from Middlebury College in Vermont. Outside of the classrooms at SPH, Cassie can be found frequently running around campus! She is a student-athlete on the cross country and track and field teams at U of M as well. After graduating with an MPH, she will be a Research Assistant focusing on research translation, health education, and communications on Michigan Medicine’s team for the American Academy of Pediatrics (AAP) Center of Excellence on Social Media and Youth Mental Health.