The Transformative Role of CHW/Ps in Texas
Community Health Workers and Promotores (CHW/P) are trustworthy individuals who share life experiences with the people they serve and have fi rsthand knowledge of the causes and impacts of poor health. They bridge the gap between communities and health care services. Evidence shows that CHW/Ps can improve health for the individuals they serve and can reduce costs.
Since emerging in the 1960s, the Texas CHW/P workforce has grown signifi cantly, numbering 10,800 across 194 counties as of 2026. Despite this expansion, systemic barriers limit the reach of this workforce, and many Texans who would benefi t from CHW/P services still lack access.
Goal of This Report
The Episcopal Health Foundation (EHF) recognizes the CHW/P workforce as a key part of a community-based approach to improving health outcomes and reducing preventable health diff erences in under-resourced communities. In order to realize this promise in a state as large and diverse as Texas, stakeholders across the state will need to take coordinated action to build capacity and address systemic barriers.
To inform a strategy and action plan, we review the CHW/P landscape within Texas and nationally to identify promising practices, barriers and the system level factors critical to long-term CHW/P sector sustainability. This report lays a foundation through:
- an examination of evidence of CHW/P impact,
- a review of the Texas CHW/P landscape, informed by 13 interviews with CHW/P leaders, allies, and policy experts,
- a review of the national landscape based on the literature and IMPaCT’s experience working across 20 states, and
- a draft systems-level framework.