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We reviewed data from the electronic health data system used by Community Health Workers (CHWs) in the Richmond/Henrico Health District of the Virginia Department of Health from January 1 st 2013 to December 31st 2020, to map the Community Health Workers’ impact on Social Determinants of Health. We also interviewed the CHWs to obtain demographic information and information about the challenges their communities face. Most referrals were for Healthcare Access (48.7%) and Economic Stability (38.3%), while Neighborhood and Built Environment (0.09%) was the least used referral in the Social Determinants of Health during the time under review. Community Health Workers also carried out 1367 and 565 Blood Pressure and Blood Sugar measurements respectively during the period. The Community Health workers were all women and their education ranged from High School graduate to Master’s degree graduate and they served as Community Health Workers for time ranging from 1 to 8 years. We found their answers to the questions on the issue plaguing the community they serve to indicate empathy and understanding of the issues of low-income communities. Having CHWs working as part of the public health system to deliver health promotion and provide referrals for social determinants of health could serve as a model for improving health access and impacting Social Determinants of Health positively for low-income populations across the country.

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