Community health workers aim to bridge gaps.

• Position: Dialogue with Julie Smithwick - Interview

A Midlands mother of four had a good job and provided for her children. But when she learned she needed a hysterectomy and didn't have insurance, she found herself out of work.

After exhausting her options, with an outstanding medical bill, unable to get surgery and finding it difficult to feed her children, she was at her wit's end.

Then she turned to a community health worker: Julie Smithwick.

"She had this constant bleeding and couldn't work. She didn't know what to do," Smithwick said.

Smithwick was able to help the mother navigate the often-complicated world of health care and public assistance to help her find a food source, a payment plan for her medical bill and a low-cost program for the surgery she needed.

"She was able to pay off these bills and go back to work after the surgery to provide for her family," Smithwick said. "She wanted to go back to being a productive citizen, and she couldn't because of these health issues. She didn't want to be on public assistance if she could help it. She kept trying to do it on her own, but it's frustrating even for people not dealing with what she was going through."

The Midlands mom's illness was also potentially hurting the economy, with an able-bodied worker out of a job and having to go to the emergency room, Smithwick said. She needed a helping hand she could trust.

Community health workers are meant to be that helping hand, Smithwick said, stepping up in their communities as leaders to educate neighbors on healthy living, help connect them to health care providers and even help get them to their doctor's appointments.

Smithwick, formerly the director of PASOs, an organization of community health workers and providers charged with creating healthier Latino communities in South Carolina, is now the director of a newly formed program aimed at establishing a statewide network of community health workers. The Community Health Worker Institute at the University of South Carolina's Arnold School of Public Health, funded in part by Blue Cross and Blue Shield of South Carolina, launched March 1.

Community health workers are not necessarily highly trained or educated medical professionals, though they can be, said Lee Pearson, associate dean of operations and accreditation at the Arnold School. They're often people from marginalized communities who already have a trusting relationship with their neighbors who can help in a more organic way than a health care provider might.

"We have a large...