Faculty Book Review

Bridging the Gap: How Community Health Workers Promote the Health of Immigrants


By Sally E. Findley and Sergio E. Matos

Published August 2015

Oxford University Press USA

“Almost daily, the newspapers of the world cover stories about immigrants: children riding the rails from Central America to ‘El Norte,’ Syrians fleeing to Turkey, Greece and Hungary, whole boatloads of Africans drowning, sometimes at the hands of their captains, as they attempt to cross over to Greece, Spain or Italy, Muslims fleeing persecution in Myanmar…and so on…”

So writes Sally Findley, PhD, a professor of Population and Family Health and Sociomedical Sciences at the Mailman School of Public Health, and her co-author and research partner, Sergio E. Matos, in their new book, Bridging the Gap: How Community Health Workers Promote the Health of Immigrants.

For many people, write Professor Findley and Mr. Matos, the overwhelming reaction to immigrants and their need for care “is one of distress—that the immigrant situation poses huge problems which we are all ill-equipped to solve.” Countering this misperception and offering solutions are the main reasons they wrote Bridging the Gap.

As the book illuminates, Community Health Workers (CHWs)—trusted community members who connect other individuals from their community to health care—have proven highly effective in promoting the health of immigrants in communities across the globe.

“Health is a low priority for most immigrants,” Dr. Findley explained. “These are people who are busy seeking employment, finding a place to live, and looking for work.” If they have a chronic illness, she addded, they are likely to ignore it until they face a medical emergency, at which point the cost to their own health and the healthcare system will be far higher.

While a good deal has been written about threats to immigrant health, Dr. Findley continued, there has been far less focus on the processes that help immigrants overcome health challenges. “In our two decades of work with immigrant families in New York City (NYC), across the United States, Africa, and the Caribbean, we have observed the critical role that CHWs can play in this process,” stressed Dr. Findley.

Drawing on long-term evaluations of programs tat have used CHWs to connect immigrants to healthcare services and systems in New York City and globally, Bridging the Gap provides a roadmap for individuals and organizations seeking to put this strategy into practice. At the core of the book are the authors’ experiences working with immigrants in northern Manhattan and NYC, where Dr. Findley and Mr. Matos have simultaneously nurtured and critically examined how community health workers can be engaged, trained, and supported in their work to open pathways to better health among immigrants in disadvantaged neighborhoods. They have accompanied the evidence from their studies with dozens of interviews to better understand exactly how the CHWs leverage opportunities for immigrants, adding both perspective on their own work and an engaging, grounded human dimension. The book distills best practices from their research, and offers practical lessons for building and managing immigrant-focused CHW programs in the United States and beyond.

While much of the book focuses on the impact of CHWs in helping immigrants to bridge the gap to healthcare, Dr. Findley notes there is a broader lesson to be gleaned as well.

“The larger message of the book is that CHWs can help our global community confront the extraordinary challenge of chronic disease prevention and management despite shrinking health resources,” she said.  “Community health workers are the most cost-effective addition to a health team, whether the goal is healthy children, balanced nutrition, or development of healthy lifestyles to prevent or manage chronic disease.”