Community health care workers (CHWs), lay community members with basic health care training, have been charged with providing appropriate care for vulnerable populations, addressing social determinants and improving population health. Frequently, CHWs lack the economic or cultural capital to accomplish these goals. Through analysis of 17 semi‐structured interviews with CHWs and supervisors at a CHW programme in the United States, we draw on Bourdieu's theory of practice to examine how the exchange of cultural and social capital impact CHW effectiveness. We found that CHWs’ reliance on bonding capital was perceived to effectively build social networks and mutual trust among marginalised communities. But, over‐reliance on embodied cultural capital and bonding capital reduced integration into the health care field; limited access to bridging capital; and limited social standing. We highlight how the exchange of cultural to bonding and bridging capital presented structural limitations. Overall, the demonstrated tension demarcates and reinforces longstanding divisions between social issues and health care issues. Future efforts should focus on promoting the unique skills of CHWs within health care settings to avoid compromising CHWs’ ability to advance population health.

中文翻译：

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美国社区卫生工作者之间文化和社会资本的交流和利用

社区卫生保健工作者 (CHW) 是接受过基本卫生保健培训的非专业社区成员，负责为弱势群体提供适当的护理、解决社会决定因素和改善人口健康。通常，CHW 缺乏实现这些目标的经济或文化资本。通过对美国 CHW 项目中 CHW 和主管的 17 次半结构化访谈的分析，我们借鉴 Bourdieu 的实践理论来研究文化和社会资本的交流如何影响 CHW 的有效性。我们发现 CHW 对债券资本的依赖被认为可以有效地在边缘化社区之间建立社交网络和相互信任。但是，过度依赖具身文化资本和结合资本减少了对医疗保健领域的整合；获得过渡资本的机会有限；和有限的社会地位。我们强调了文化与纽带和桥接资本的交流如何呈现结构性限制。总体而言，所表现出的紧张局势划定并加强了社会问题和医疗保健问题之间的长期分歧。未来的努力应侧重于在卫生保健机构内推广 CHW 的独特技能，以避免损害 CHW 促进人口健康的能力。