← Risk register SOC 21-1094 · reviewed 2026-08-11

Community Health Workers

61,660 US workers · median $51,850/yr · Social Service

EXPOSED

The core of this job is showing up in people's homes, churches, shelters, and clinic waiting rooms to build enough trust that someone actually takes their meds, keeps the prenatal appointment, or accepts a referral — that cultural brokering and physical presence is not automatable. What is automatable is the paperwork half: intake forms, case notes, eligibility screening, resource directory lookups, appointment reminder calls, and the health-education handouts CHWs currently assemble by hand. Licensure is the weak spot — most states require only voluntary certification, so there is no legal barrier to a payer replacing outreach headcount with an app plus a smaller field team.

10-year outlook: Demand grows as Medicaid and health systems keep paying for social-needs work, but documentation and referral-matching duties get absorbed by software, so the job shifts toward more visits per worker and more clinically embedded roles.

US employment, 2019–2025+4.6%
58,95061,660 workers

Roughly flat across the period, with year-to-year wobble.

Median pay $40,360 → $51,850 +2.8% in real terms (nominal +28.5%, less ~25% US inflation over the period)

The job count is not the verdict

This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.

So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing. The marked year is 2020.

BLS projection, 2024–2034

+11.3% 65,100 → 72,500 on the projections basis

Growing, and only partly exposed

The BLS expects +11.3% more of these jobs by 2034, and at 58/100 the work is only partly exposed — some tasks are automatable, the core of the job is not. Nothing here is in tension.

Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.

~7,800 openings a year on average, including replacing people who leave.

One email if this score changes. Watch as many occupations as you like from the same address — no account, and nothing is sent on a schedule, only when a verdict actually moves.

Also known as — 24 job titles this covers

Titles reported by people doing this work, from the US Department of Labor's O*NET survey. If your job title is here, this page is about your work even though the name doesn't match.

PromoterNavigatorContact TracerGuest AdvocatePeer NavigatorWellness CoachHealth AdvocateNurse NavigatorHealth NavigatorApprise CounselorCommunity LiaisonCommunity NavigatorLay Health AdvocateOutreach SpecialistPeer Health PromoterPublic Health WorkerCommunity Health AgentHealth Outreach WorkerMental Health AdvocateCommunity Health AdvisorCommunity Health AdvocateCommunity Health PromoterBehavioral Health AdvocateCommunity Health Assistant

Score — 58/100 resistance

Holding it up: trust premium (16/20). Weakest point: liability shield (5/20).

Five dimensions, 0–20 each, summed. Higher means more protected. The arithmetic is shown so you can check it: 13 + 14 + 5 + 16 + 10 = 58. · Scored 2026-08-11, and re-examined when evidence accumulates rather than on a schedule.

Task resistance 13/20

Mixed — a routine tier and a judgment tier At 13 rather than 16, the door-knocking, motivational-interviewing, and translating-a-discharge-plan-into-a-grandmother's-kitchen-Spanish half genuinely resists software, but the other half of a CHW's week — SDOH screening tools, entering encounters into the community-care platform, running a 211-style resource lookup, calling the no-show list — is already being handed to text-message bots and eligibility engines.

Embodiment 14/20

Hands-on in uncontrolled environments 14 reflects that the work happens in stairwells, encampments, food pantries, and unairconditioned apartments where you carry BP cuffs and glucometers, do home safety walk-throughs, and drive clients to appointments — uncontrolled environments, but with fewer clinical procedures on your hands than a home health aide, which is why it sits at 14 and not 18.

Liability shield 5/20

Certification preferred, not legally required 5 is the floor-plus-one for a role where most states offer only voluntary CHW certification (Texas, Indiana, Massachusetts credentials among them), no scope-of-practice statute protects your tasks, and the nurse or care manager above you signs off on anything clinical — the credential helps with Medicaid billing pathways, not with keeping the job.

Trust premium 16/20

The human relationship is the product 16 because the entire reason payers hire CHWs is that you are from the ZIP code and the client will pick up your call after ignoring six from the clinic — that shared-language, shared-history credibility is the deliverable, though it is a bit below 20 since programs do reassign caseloads and clients transfer between workers.

Judgment & accountability 10/20

Meaningful discretion 10 sits mid-band because you decide in real time whether a home visit has become unsafe, whether the depression screen warrants an immediate warm handoff, and whether to report suspected neglect — but the protocols, escalation thresholds, and care plans are written by supervising RNs and program managers, so you carry the judgment call without owning the final clinical decision.

Confidence: medium · reviewed 2026-08-11 · how scoring works

What this job involves — and which parts are yours

The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.

AI already does these at usable quality

These still need a person

Active moats on the surviving side: trust, embodiment, physical-presence

How to future-proof this job

Training paths for your skill gaps: Khan Academy — physics, chemistry and biology from the ground up free · Khan Academy — reading and vocabulary, all levels, free free · Coursera — critical thinking and logic, audit free free to audit · Apprenticeship.gov — industrial maintenance and millwright programs paid to train · MIT OpenCourseWare — operations management free · Coursera — active listening and communication skills free to audit · Coursera — negotiation courses, audit free free to audit

All 35 skills ranked by how many jobs they open →

Where this experience transfers — occupations you could move toward

Computed from U.S. Dept. of Labor O*NET skill and knowledge profiles: high overlap with what you already do, a materially higher resistance score, no large jump in required training, and no licence you would have to start a new pipeline to get. Targets that pay meaningfully less, that are themselves COOKED, or whose own headcount is falling are excluded — a move into a shrinking trade is not an escape.

Clinical and Counseling Psychologists SAFE · 71/100 · you already have ~78% of the skill profile

Skills to close: Science, Reading Comprehension, Critical Thinking

Occupational Therapy Assistants SAFE · 68/100 · you already have ~78% of the skill profile

Skills to close: Science, Equipment Maintenance

Child, Family, and School Social Workers SAFE · 70/100 · you already have ~77% of the skill profile

Skills to close: Operations Analysis, Science, Active Listening, Negotiation

What would move this back up — beyond any one person

The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 76/100 — SAFE.

5 specific changes that would raise this score
  • already happening liability shield +5

    CMS's 2024 Physician Fee Schedule made Community Health Integration services billable, but only when delivered by auxiliary personnel meeting state/certification standards under a billing practitioner. If more state Medicaid agencies follow Indiana, Minnesota, Rhode Island and Oregon in making a state-issued CHW certificate (with training hours and scope) a condition of payment, an app cannot be the billable entity — a certified named human must be attached to each billed encounter and to the supervising practitioner's attestation.

  • already happening task resistance +4

    Genuine two-tier job: if intake forms, eligibility screening, resource-directory lookup, reminder calls and handout generation are absorbed by payer platforms, the residual role is the tier AI cannot do — entering an unfamiliar home, reading whether someone is lying about food in the fridge, defusing distrust of clinics. Task mix shift alone raises measured resistance without any new law.

  • plausible judgment accountability +4

    If health-plan contracts formalize CHW escalation authority — the worker's field judgment triggering an urgent clinician callback, a CPS or adult-protective report, or an ED-diversion decision under an accountable-care shared-savings arrangement — the role owns consequential calls under ambiguity with a documented trail. Some Medicaid managed-care Health-Related Social Needs contracts already assign escalation criteria to CHWs.

  • plausible liability shield +3

    If state CHW scope-of-practice rules add named-worker documentation duties for specific reimbursable acts (blood pressure self-measurement coaching, home asthma trigger assessment, closed-loop referral confirmation) such that an audit clawback lands on the individual certificate holder rather than only the agency, personal accountability attaches.

  • plausible trust premium +2

    If payers or accreditors adopt language-and-community-concordance requirements (as some state Medicaid maternal-health and doula benefits now do), buyers are explicitly purchasing a specific human's community membership rather than an outreach function.

The limit. Trust premium is already near its practical ceiling: the buyer is a payer or health system optimizing cost per engaged member, not the community member being served, and payers have repeatedly substituted app-plus-smaller-field-team when allowed. Certification-linked reimbursement is the only lever with real teeth, and it protects the certificate, not the headcount — a state could certify CHWs while plans still cut caseload-per-worker ratios.

These are conditions, not forecasts — what would have to happen, not what will. Specific rules, cases and bills are named so you can go and check whether they exist and where they stand; verify before relying on any of them. Nothing here is legal or financial advice.

Where this work is, and what it pays there

BLS metro figures for 205 areas. The verdict above does not change by city — the rubric judges what the work involves, not where it happens — but pay and headcount do, and the national median hides a very wide range.

Most of these jobs

New York-Newark-Jersey City, NY-NJ 4,790 $59,340 +14%
Los Angeles-Long Beach-Anaheim, CA 3,200 $56,030 +8%
San Francisco-Oakland-Fremont, CA 2,090 $72,710 +40%
Boston-Cambridge-Newton, MA-NH 1,940 $56,920 +10%
Washington-Arlington-Alexandria, DC-VA-MD-WV 1,600 $58,790 +13%
Chicago-Naperville-Elgin, IL-IN 1,430 $49,750 -4%
Baltimore-Columbia-Towson, MD 1,300 $49,720 -4%
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 1,230 $50,760 -2%

Best paid

Carson City, NV 100 $81,600 +57%
San Luis Obispo-Paso Robles, CA 70 $80,290 +55%
Eau Claire, WI 40 $78,090 +51%

Percentages are against this occupation's national median of $51,850. Counts are jobs in that metro, not vacancies. Metros where the BLS suppressed the cell are absent rather than shown as zero.

Who is actually doing this — nobody, on the record

We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.

That is worth saying out loud next to a score of 58. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.

Read that as a gap in the reporting we can see, not proof of absence — the dispatch runs on English-language feeds and misses plenty. If you know of a case, tell us, or add a field report from inside the job.

Quick take — do you do this job?

Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.

Self-reported and unverified — a sentiment signal, not a survey. One response per person per occupation; you can change your answer.

Field reports — what people say has changed

No field reports yet. A written account takes a paragraph rather than a tap, goes to an editor before it appears, and is the one thing on this page the rubric cannot produce on its own.

File a field report

Concrete beats general: a tool that arrived, a task that moved, a headcount decision you watched happen. Don't include anything that identifies you or your employer if that would put you at risk.

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