Measurable Impact, Lasting Change
Tracking the real-world outcomes of evidence-based community health infrastructure investment across Baltimore's neighborhoods.
Health Disparities Outcomes
Rigorous evaluation of CC Health Dev programs demonstrates measurable reductions in health disparities across our service areas.
Chronic Disease Management
In a 2024 evaluation conducted with Johns Hopkins Bloomberg School of Public Health, patients enrolled in CHW-supported chronic disease management programs showed a 22% improvement in hemoglobin A1C control among diabetic patients, a 19% improvement in blood pressure control among hypertensive patients, and a 31% reduction in emergency department visits for ambulatory care-sensitive conditions over a 12-month follow-up period.
These findings were consistent across racial and ethnic subgroups and were statistically significant after controlling for age, insurance status, and comorbidity burden. The evaluation was published in the Journal of General Internal Medicine and has been cited in HRSA's evidence base for CHW integration in primary care settings.
Healthcare Access
Our mobile clinic program reaches patients who report having no other regular source of primary care at a rate of 67%, significantly higher than the national FQHC average of 24%. Among mobile clinic patients who received CHW navigation services, 78% established a medical home within 6 months, and insurance enrollment rates among previously uninsured patients increased from 14% to 61% through CHW-assisted Medicaid and Marketplace enrollment support.
Transportation barrier reduction through our mobile model eliminated the most commonly cited access barrier in our Neighborhood Health Needs Assessment surveys, where 43% of respondents in target neighborhoods reported missing or delaying care due to transportation difficulties.
Maternal & Infant Health
In neighborhoods where CC Health Dev operates maternal health home visiting programs staffed by trained CHWs, preterm birth rates declined by 18% over a three-year period compared to demographically similar neighborhoods without CHW home visiting programs. Early prenatal care initiation (first trimester entry) improved from 54% to 73%, and breastfeeding initiation at hospital discharge increased from 48% to 69%.
These outcomes are consistent with the evidence base for community-based perinatal health programs documented in systematic reviews published by the National Academy of Medicine and the American College of Obstetricians and Gynecologists.
Return on Investment
An independent economic evaluation conducted by the Maryland Health Care Commission estimated that CC Health Dev's CHW programs generate $3.42 in healthcare cost savings for every $1.00 invested, primarily through reduced emergency department utilization, decreased hospital readmissions, and improved chronic disease management that prevents costly acute care episodes.
When broader social return on investment (SROI) factors are included, such as employment income generated by CHW workforce development, reduced public assistance dependency, and community economic multiplier effects, the estimated return increases to $5.18 per dollar invested. These findings have informed Maryland's policy discussions regarding sustainable Medicaid financing mechanisms for CHW services.
Selected Peer-Reviewed Publications
Our research team has contributed 18 peer-reviewed publications to the community health infrastructure evidence base.
Community Health Worker Integration in Urban Primary Care: A Mixed-Methods Evaluation of Clinical Outcomes and Implementation Fidelity
Asante, K.O., Williams, T.R., Chen, M.L. — Journal of General Internal Medicine, 2024
Neighborhood-Level Health Needs Assessment as a Foundation for Health Equity Planning: A Community-Participatory Methodology
Asante, K.O., Rodriguez, S.M., Jackson, D.E. — American Journal of Public Health, 2023
Mobile Health Clinics as Primary Care Safety Nets: Patient Demographics, Service Utilization, and Medical Home Establishment in Medically Underserved Baltimore Neighborhoods
Patterson, A.J., Asante, K.O., Nguyen, H.T. — Journal of Health Care for the Poor and Underserved, 2023
Economic Evaluation of Community Health Worker Programs in Maryland: Cost-Effectiveness, Social Return on Investment, and Policy Implications
Asante, K.O., Miller, R.D., Thompson, C.A. — Health Affairs, 2022
Training Community Data Collectors for Participatory Health Needs Assessments: Curriculum Design, Fidelity Evaluation, and Data Quality Outcomes
Williams, T.R., Asante, K.O., Davis, L.K. — Progress in Community Health Partnerships, 2021
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