A Community health center in the United States
is a Community health center
A health center or community health center is a clinic staffed by a group of general practitioners and nurses.Community health centers in the U.S...
(CHC) in the United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
Community Health Centers are unique in that at least 51 percent of all Governing Board Members must be patients at the CHC. Access to care is improved by decreasing the cost of care with a sliding fee scale based on income. Grant programs are typically available to provide the broadest opportunity for health care.
Integration of health care services is a major focus. Administrative and health care personnel sit down regularly to focus on location health care needs. Multiple services are provided that vary depending upon the site including primary care, dental care, counseling services, women's health, health promotion and education, podiatry, physiotherapy, case management, advocacy and intervention. The mission of Community Health Centers depends upon creating collaborative relationships with industry, government, hospitals and other health services.
Community Health Centers that receive federal funding through the Health Resources and Services Administration, HHS
, are also called "Federally Qualified Health Centers." Today, there are more than 1250 federally-supported community health centers with more than 8000 service delivery sites. They are community health centers, migrant health centers, health care for the homeless centers and public housing primary care centers that deliver quality primary and preventive health care to more than 20 million people in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, and the Pacific Basin. Through the years, health centers have built an impressive track record delivering high quality prevention and primary care to millions of low-income residents in inner cities and isolated rural areas.
In 2002, President Bush launched the Health Centers Initiative
to significantly increase access to primary health care services in 1,200 communities through new or expanded health center sites. Between 2001 and 2006, the number of patients treated at health centers has increased by over 4.7 million, representing a nearly 50 percent increase in just five years. In 2006 the number of patients served topped the 15 million mark for the first time. By 2010, with the help of funding received through the American Recovery and Reinvestment Act (ARRA, or the "stimulus" law), health centers had expandede to serve more than 18 million people. and with new funding provided through the Affordable Care Act of 2010 (aka, health reform law), health ceners will grow to serve almost 40 million people by 2015 [National Association of Community Health Centers, www.nachc.org].
Approximately two-thirds of health center patients are minorities, and 9 out of 10 have incomes below 200 percent of the federal poverty line. Four in 10 health center patients have no health insurance.
The health center program’s annual federal funding has grown from $1.16 billion in fiscal year 2001 to $2.59 billion in fiscal year 2011 [House Appropriations Committee, www.house.gov/appropriations].
A large number of Community Health Centers also exist in Canada, although they are planned at the provincial level currently.
The concept of community health centers in the United States, according to historian John Duffy, can be traced to infant milk stations in New York City in 1901. In November, 1914, the first district health center in New York was established by the city at 206 Madison Avenue, serving 35,000 residents of Manhattan's lower east side. The staff consisted of one medical inspector and three nurses stationed permanently in the district who through a house card system developed a complete health record of each family. The system was expanded to Queens in 1915 with four district centers. Wartime and political pressures brought this development in New York City to an end, but privately-funded clinics through the New York Association for Improving the Condition of the Poor
The Association for Improving the Condition of the Poor was a charitable organization in New York City, established in 1843 and incorporated in 1848 with the aim of helping the deserving poor and providing for their moral uplift...
were started in 1916 (Bowling Green Neighborhood Association), 1917 (Columbus Hill Health Center), 1918 (Mulberry Street Health Center) and in 1921 the Judson Health Center
Judson Health Center, founded in 1921, was an early New York City Community Health Center inspired by the Rev. Alonzo Ray Petty of the baptist Judson Memorial Church located at 55 Washington Square South. Petty appealed to fellow baptist and physician Eleanor A...
founded by Eleanor A. Campbell in Greenwich Village, which became by 1924 the largest health center in the U.S.
Under the modern definition, the first community health center in the United States was the Columbia Point
Columbia Point, later referred to as Harbor Point, in the Dorchester neighborhood of Boston, Massachusetts sits on a peninsula jutting out from the mainland of eastern Dorchester into the bay.-History:...
Health Center in Dorchester, Massachusetts
Dorchester is a dissolved municipality and current neighborhood of Boston, Massachusetts, United States. It is named after the town of Dorchester in the English county of Dorset, from which Puritans emigrated and is today endearingly nicknamed "Dot" by its residents. Dorchester, including a large...
. It was opened in December 1965 and served mostly the massive Columbia Point public housing complex adjoining it. It was founded by two medical doctors, Jack Geiger who had been on the faculty of Harvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...
then later at Tufts University
Tufts University is a private research university located in Medford/Somerville, near Boston, Massachusetts. It is organized into ten schools, including two undergraduate programs and eight graduate divisions, on four campuses in Massachusetts and on the eastern border of France...
and Count Gibson from Tufts University. Geiger had previously studied the first community health centers and the principles of Community Oriented Primary Care with Sidney Kark and colleagues while serving as a medical student in rural Natal
KwaZulu-Natal is a province of South Africa. Prior to 1994, the territory now known as KwaZulu-Natal was made up of the province of Natal and the homeland of KwaZulu....
, South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
. The Columbia Point Health Center was funded by the federal government's Office of Economic Opportunity
The Office of Economic Opportunity was the agency responsible for administering most of the War on Poverty programs created as part of United States President Lyndon B. Johnson's Great Society legislative agenda.- History :...
(OEO) and was needed to serve the community living in the Columbia Point Public Housing Projects which was on the isolated peninsula far away from Boston City Hospital. It is still in operation and was rededicated on its twenty-fifth anniversary in 1990 as the Geiger-Gibson Community Health Center.
At about the same time, Geiger and Gibson also had set up a rural community health center, The Delta Health Center, which was located in Mound Bayou
Mound Bayou is a city in Bolivar County, Mississippi. The population was 2,102 at the 2000 census. It is notable for having been founded as an independent black community in 1887 by former slaves led by Isaiah Montgomery. By percentage, its 98.4 percent African-American majority population is one...
, Bolivar County, Mississippi
-Demographics:As of the census of 2000, there were 40,633 people, 13,776 households, and 9,725 families residing in the county. The population density was 46 people per square mile . There were 14,939 housing units at an average density of 17 per square mile...
serving Bolivar, Coahoma, Sunflower, and Washington counties, where poverty was widespread. It was also set up in conjunction with Tufts University and with a grant from the OEO. It was a rural model whereas the Columbia Point center was an urban setting.
Newer developments in Community Health Centers include integration of health professional education with CHC sites for training. Numerous liaisons have been developed across the nation. New models also exist. The National Association of Community Health Centers
encouraged the development of the physician assistant
, and osteopathic medical student
training with A.T. Still University at the Arizona campus. Those with experience working with CHCs are encouraged to pursue Hometown status
to improve probability of admission.
- Eula Hall
Eula Hall, is a prominent Appalachian activist and healthcare pioneer who founded the Mud Creek Clinic in Grethel in Floyd County, Kentucky.-Biography:...
, Founder of the Mud Creek Clinic
A clinic is a health care facility that is primarily devoted to the care of outpatients...
- Community Health
Community health, a field of public health, is a discipline that concerns itself with the study and betterment of the health characteristics of biological communities. While the term community can be broadly defined, community health tends to focus on geographic areas rather than people with shared...
- Federally Qualified Health Center
A Federally Qualified Health Center is a reimbursement designation in the United States, referring to several health programs funded under the Health Center Consolidation Act...
- Free clinic
A free clinic is a medical facility offering community healthcare on a free or very low-cost basis in countries with marginal or no universal health care. Care is generally provided in these clinics to persons who have lower or limited income and no health insurance, including persons who are not...