The role of childhood experiences in shaping career choices as a Community Health Worker serving agricultural workers in rural Texas

Community Health Workers (CHWs) have historically bridged gaps between public health systems and rural, hard-to-reach communities. Many CHWs have personal connections to the communities and populations they serve. Yet, there is limited understanding of how these formative experiences influence CHWs’ career decisions, particularly those who serve agricultural workers. A cross-sectional study was conducted among CHWs (n = 15) who provide outreach services to Texas agricultural workers. Data was collected through structured phone interviews using standardized survey tools: Adverse Childhood Experiences (ACEs), acculturation and language use (SASH), anxiety (GAD-7), depression (PHQ-9), and open-ended questions focused on professional and lived experiences. Descriptive statistics and thematic analysis were conducted. Participants were predominantly bilingual Hispanic females (87.0%). Mean ACEs score was 2.3, reflecting moderate exposure to adversity, and mean SASH score was 2.6 suggesting bicultural tendencies. Participants reported low levels of anxiety and depression. Many shared that their parents had worked in agriculture and recalled that their own experiences mirrored systemic barriers faced by agricultural workers, including lack of transportation (48.7%), health insurance (40.0%), and health access (28.7%). Thematic analysis revealed that CHWs expressed a deep emotional connection to agricultural workers, rooted in their shared personal experiences. There is a need to invest in CHW programs to ensure their lived and field experiences inform public health strategies. Future work should develop comprehensive, ongoing training for evolving issues, and establish a statewide network for CHWs to share field experiences, resources, connect with peers, access trainings, and alert public health agencies on emerging issues.