How Far We Have Come: Reflections on a Half Century of Health Centers Care

Posted: August 7, 2015

by Dan Hawkins, Senior VP, Public Policy and Research

danhawkinstightheadshot_webTo measure how far our nation has come in terms of progress in healthcare access, it is important to look back at where Community Health Centers started 50 years ago. It began with a cause — and then an opportunity. The cause, undertaken by community activists and reform-minded doctors, was to bring needed health services into poor and neglected communities nationwide. From Mississippi to Watts, communities rose up around the cause of health equity. President Lyndon Johnson’s War on Poverty was the opportunity we needed to respond to this demand.

50 Years of Trail Blazing Commitment to Serving Vulnerable Communities

Last summer, I had a very special opportunity to participate in an extraordinary event – the dedication of the brand new, beautiful H. Jack Geiger Medical Center building at the Delta Health Center in Mound Bayou, Miss., one of America’s very first Community Health Centers. Jack, who is now approaching his 90th birthday, was there – and I was fortunate to be able to sit with him as he met with several long-time friends and colleagues, many of whom were part of the original staff of the Delta Health Center back in the 1960s. These brave souls, who were the true “fire-starters” of what has become a national movement for better health and social justice in underserved communities all across America, looked back on those perilous times with a sardonic chuckle, and marveled at how their humble beginnings had grown to become such a powerful force for good health – and for good jobs and economic benefits – in thousands of poor and minority communities in every state in the union.

As I listened to the reminiscences and banter among these veterans of our movement’s earliest and most difficult days, I was reminded that people like myself – who came along just a few short years later – had it so much easier than these early pioneers, precisely because they had blazed a trail for us, forging a clear path in the health care wilderness amidst great peril so that we could carry this movement forward, to the benefit of millions who had never known either good health care OR good health. What was, to me, most remarkable was that, while many of those early trail-blazers had moved on to other places and other challenges, they all have, in one way or another, remained faithful to the beliefs that brought them to Mound Bayou in the first place, and the commitment to make life just a little bit better for others.

Today, health centers serve more than 25 million Americans, including seven million children, 260,000 veterans, and many other vulnerable populations, in more than 9,200 communities.

That first investment in community-based solutions began as a modest demonstration program in 1965 to break the cycle of illness and poverty. It evolved 50 years later into the largest and most successful primary care system in the country. Today, health centers serve more than 25 million Americans, including seven million children, 260,000 veterans, and many other vulnerable populations, in more than 9,200 communities.

More than Health Care Delivery: It’s About Improving Community Lives As Well

CCALAC-Website-National-Health-Center-WeekOver the course of their five-decade existence, health centers have demonstrated impressive results in reducing infant mortality, improving immunization rates, developing programs for early screening and treatment of cancer, and managing chronic conditions such as hypertension and diabetes. Studies have shown that the care a health center patient receives is every bit as good or even better that what one finds in a private physician practice. Yet health centers are about more than simple healthcare delivery.

By mission, they are community problem solvers, and have been ever since Dr. Geiger wrote out “prescriptions” for groceries to the mothers of malnourished children in rural Mississippi. Today their approach is a new twist on a longstanding mission: provide services that not only prevent illness, but address the factors that cause it – such as nutrition, homelessness, lack of exercise, joblessness, etc. In addition to a range of primary care services that can include dental, pharmacy, mental health and substance abuse counseling, vision, pediatric, geriatric, and obstetrical care, health centers frequently offer services not commonly offered by traditional medicine in order to confront the social determinants of health. There are farmer’s markets and food pantries, community gardens, exercise programs and cooking classes. Some health centers are even partnering with organizations to open grocery stores with fresh produce in poor neighborhoods. There are also health centers that offer job training or legal services. The aim is to reach beyond healthcare delivery and improve the quality of life in communities. And it is working.

Numbers alone never tell the full story when it comes to measuring success. But in the case of health centers, the evidence is significant: health centers save the U.S. healthcare system $24 billion a year in reduced hospitalizations and visits to the ER – a figure that dwarfs the amount of the federal investment to sustain the program.   Health centers also lower the mortality rates of patients over 50 by 13 percent, and lower total Medicare spending by up to 30 percent.   They are also an economic shot in the arm. Health centers create jobs and generate $11 in total economic activity for every one dollar investment. For those of us who are part of the Community Health Center Movement, we recognize that the compounding impact that health centers have on the communities we serve is beyond measure. Our community-based model of care did not set out to change healthcare delivery generally, but did so anyway. It did not aim to be an innovator in primary care, but it became so anyway – and our model has been hailed by the Institute of Medicine as “stellar models” of primary care practice to be emulated across the nation. Health centers did not set out individually to build a nationwide community-based health system, but they did anyway, earning the admiration and respect of the nation.

This year, as we celebrate National Health Center Week, we celebrate enduring legacy and to thank the thousands of current health center staffers who keep this movement going and the many current policy-makers whose efforts support their continued operation and expansion into the future.
Coauthored by Amy Simmons, National Association of Community Health Centers

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