Community health workers improve health and well-being through, most notably, health education, advocacy, and building individual and community capacity. In spite of these contributions to the health care landscape, these workers are not well integrated within the professional workforce throughout much of the United States. Building on the lens of medical citizenship, I introduce the concept of professional citizenship, which elucidates the belongingness of a group within a professional workforce. Drawing on this framing, I detail the lack of professional belongingness among community health workers in Indiana and the emergent issues that arose via professionalization including: the potential creation of a hierarchy, changes to core roles, and the (in)accessibility of the position due to the requirements for the community health worker certification course. Additionally, I situate these issues within race, ethnicity, gender, and class in examining their effects on the professionalization of these workers. The findings presented in this article can be utilized by policymakers, public health programs, and other employing organizations as community health workers undergo professionalization. Given the poor health outcomes in Indiana, these workers are poised to make significant contributions to the health of their communities—with careful consideration for potential ramifications via professionalization.

中文翻译：

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职业化是一把“双刃剑”：评估中西部社区卫生工作者的职业公民身份

社区卫生工作者通过健康教育、宣传以及建设个人和社区能力来改善健康和福祉。尽管对医疗保健领域做出了这些贡献，但这些工人并没有很好地融入美国大部分地区的专业劳动力中。基于医学公民的视角，我介绍了专业公民的概念，它阐明了一个群体在专业劳动力中的归属感。在此框架下，我详细介绍了印第安纳州社区卫生工作者缺乏专业归属感以及通过专业化产生的紧急问题，包括：等级制度的潜在创建、核心角色的变化、以及由于社区卫生工作者认证课程的要求而无法获得该职位。此外，我将这些问题放在种族、民族、性别和阶级中，以检查它们对这些工人职业化的影响。随着社区卫生工作者的专业化，决策者、公共卫生计划和其他雇佣组织可以利用本文中的发现。鉴于印第安纳州的健康状况不佳，这些工人准备为他们社区的健康做出重大贡献——并仔细考虑通过专业化可能产生的后果。随着社区卫生工作者的专业化，决策者、公共卫生计划和其他雇佣组织可以利用本文中的发现。鉴于印第安纳州的健康状况不佳，这些工人准备为他们社区的健康做出重大贡献——并仔细考虑通过专业化可能产生的后果。随着社区卫生工作者的专业化，决策者、公共卫生计划和其他雇佣组织可以利用本文中的发现。鉴于印第安纳州的健康状况不佳，这些工人准备为他们社区的健康做出重大贡献——并仔细考虑通过专业化可能产生的后果。