In my interview with Dr. John J. Green, he cited community health centers (CHCs) as one of the prime examples of the South leading the nation in innovative solutions for positive health outcomes. After our conversation, I decided to explore this history, how far this invention has come, and the modern day duress these centers are facing in the US healthcare system.
The CDC defines CHCs as “community-based and patient-directed organizations that serve populations with limited access to care.” Today, CHCs are responsible for serving as the primary source of care for over 28 million patients in over 13,000 communities all across the nation. Yet these widespread facilities originated in the Mississippi Delta as an innovative solution to the health disparities plaguing the region.
In 1965, Dr. H. Jack Geiger and Dr. Count Gibson obtained funding from the Office of Economic Opportunity to establish the Delta Health Center in Mound Bayou, Mississippi, along with an urban CHC in a housing project in Boston, Massachusetts, as the nation’s first federally qualified health center. Now, the Delta Health Center operates nine different CHCs in the Delta, providing comprehensive, affordable primary care to their patients, including dental care, family medical care, pediatric services, women’s health, nutritional counseling, pharmacy services, and more.
CHCs are distinct in that at least 51% of the board of directors membership must be individuals who use the services of the health center as their medical home; this ensures that care is patient-centered with feedback at every level of leadership. The patient-focused model has allowed these health centers to respond to the unique needs of the community, whether that is transportation needs in a rural setting or housing needs in an urban community.
Despite their vital function in under-resourced communities, these health centers have had great financial difficulty during the COVID-19 pandemic. Their service to many vulnerable populations — including the homeless, uninsured, and those in poverty — across the nation has meant that their need has only increased during the pandemic. However, budget constraints on the healthcare system forced many CHCs to layoff employees, leading to struggles meet the needs of their current patients.
These centers have been shown to reduce medical costs, saving an average of 24% per Medicaid patient, due to the integrated and preventative nature of medical care. CHCs are 501(c)(3) nonprofits typically relying on private insurance providers and Medicaid repayments to balance out the uninsured patients they serve. States’ failure to expand Medicaid, coupled with an increase in uninsured patients, has strained these centers over the past few years.
CHCs and their funding are a prime example of the role that policies and government play in creating equitable access to healthcare. They have solved many barriers to healthcare by placing care directly in communities that have historically had limited access to primary care; collaborating with patients to address specific, nuanced community needs; and integrating access to care across medical disciplines.
Raising awareness of their important work and ensuring continuity of funding is critical in protecting some of the most vulnerable populations in the South and in the nation. Many CHCs have responded to the pandemic with pop-up testing, telehealth options, and on-site vaccinations. Increasing funding for these centers, especially in a time of a crisis, is a critical step for increasing positive health outcomes, particularly for under-resourced populations.
CHCs arose out of the ingenuity of Dr. Geiger and Dr. Gibson’s compassionate recognition of the need for a community-based approach to healthcare, accessible to all. A recollection and revitalization of those values in crafting policies and allocating funding is needed for CHCs to continue fulfilling their mission.
Community Health Centers: Chronicling their history and broader meaning. Community Health Center Chronicles. https://www.chcchronicles.org/stories/community-health-centers-chronicling-their-history-and-broader-meaning. Accessed December 12, 2021.
Delta Health Center: Our History: Mississippi delta. |. https://deltahealthcenter.org/our-history/. Published September 24, 2019. Accessed December 12, 2021.
Schwartz M. A Shadow Medical Safety Net, stretched to the limit. The New York Times. https://www.nytimes.com/2020/05/06/magazine/community-health-centers-covid.html. Published May 6, 2020. Accessed December 12, 2021.
The Community Health Center Movement. Health Center Partners of Southern California. https://hcpsocal.org/the-community-health-center-movement/. Published February 1, 2018. Accessed December 12, 2021.
What is a community health center?: The Community Corner Definition. Community Health and Dental Care. https://ch-dc.org/community-corner/what-is-a-community-health-center/. Published February 10, 2021. Accessed December 12, 2021.