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Community Health Centers

A Movement and the People Who Made It Happen

Bonnie Lefkowitz

Publication Year: 2007

The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race.

This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960s, community health centers have served the needs of the poor in the tenements of New York, the colonias of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment.

Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.


Published by: Rutgers University Press

Title Page, Copyright

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pp. v-vi

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pp. vii-x

This book is about a groundbreaking approach to health, a program that by all rights should never have survived, and people with rare foresight and commitment. For forty years or more, men and women have been working in the tenements of New York, the colonias of Texas, the working-class neighborhoods of Boston, ...

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pp. xi-xii

The first people I want to thank are those who were convinced I should write this book and were there in the beginning to read outlines and early proposals and bug me to get on with the next steps. They include Dorree Lynn, who literally poured her enthusiasm into me and shared ideas, contacts, and all the agonies of trying to publish; ...

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Chapter 1: Heroes of Community Health

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pp. 1-28

Community health centers appeared on the national scene in 1965, offering a new way of providing preventive and primary care combined with consumer involvement and cross-sectoral action to address the underlying causes of disease. Most observers gave them little chance of surviving. ...

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Chapter 2: Mississippi: Where It All Began

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pp. 29-49

Driving northwest from Jackson into the Mississippi Delta everything is quiet and green, a lush fertility the only reminder that this place gave birth to an extraordinary period in U.S. history. Explosive and violent, inspiring and redemptive, the civil rights years are still a touchstone of uncommon valor and long overdue change. ...

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Chapter 3: Boston: The Way Democracy Ought to Work

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pp. 50-74

It’s early morning in East Boston, a polyglot peninsula surrounded by water and cut off from the rest of the city by Logan Airport and its feeder roads. Jack Cradock is standing at the entrance to the health center he runs, along with medical director Jim Taylor. ...

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Chapter 4: The South Carolina Low Country: A Homegrown Black Power Structure

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pp. 75-90

The stretch of Atlantic coastline from Charleston, South Carolina, to Savannah, Georgia, is a favorite of artists and writers. In what is known as the Low Country, dark trees and brush contrast starkly with wheat-colored marsh grass and wide-open skies. ...

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Chapter 5: New York: Health Care Is a Right

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pp. 91-115

A golden day in Central Park, sun shining on autumn leaves. Enormous medieval pennants hang over the Bethesda Fountain plaza. The rainbow of people includes roller bladers, acrobats, families on outings, dog walkers, and one lone reader sitting yoga style on a glacial rock. ...

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Chapter 6: The Rio Grande Valley of Texas: Steps from the Third World

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pp. 116-134

Down where the Rio Grande splits southernmost Texas from Mexico, rich soil and a subtropical climate have always attracted year-round crops and the poor people who work them. In recent decades hundreds of thousands more have been drawn to the region by some 250 maquiladoras—large U.S.-owned manufacturing enterprises ...

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Chapter 7: The Health Center Legacy

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pp. 135-150

Paula Gomez’s advice to the young volunteers is a perfect introduction to this final chapter. We are constantly admonished to learn from history, but as I have traveled around the country I’ve also seen a jarring disconnect between the rich, emotional legacy of health centers and their need to compete in a modern marketplace as sophisticated providers. ...


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pp. 151-162


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pp. 163-166


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pp. 167-177

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About the Author

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Bonnie Lefkowitz grew up in and around Washington, D.C., and then spent fifteen years in New York City before moving back to the D.C. area. She spent her early career as a reporter for Newsweek, a medical writer, and a political activist. ...

E-ISBN-13: 9780813541310
E-ISBN-10: 081354131X
Print-ISBN-13: 9780813539119

Page Count: 192
Publication Year: 2007