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  • Improving Medical Education and Patient Care Through Community-Academic Health Center Partnerships
  • David M. Levine, MD, MPH

The development, implementation, and effective use of community–academic health center partnerships continues to be a most significant and challenging issue, with vast implications for the health of the public, medical education, research, and patient care. Considerable past research and policy proposals addressed this issue. They provided examples of how mutually developed community–academic health centers are instrumental to improving the health and functional status of communities in need.1–4 Simultaneously, the academic health center has benefited from enhanced community support, use of community resources, and the bringing of community-based participatory approaches into medical education, research, and patient care. Despite this, Boutin-Foster, Palermo, Phillips-Caesar, and associates5 forcefully and appropriately reminds us that much work needs to be done to achieve the full benefit of community–academic health center partnerships. This article highlights that although, "Academic health centers and community organizations are structurally and philosophically different, they share a common mission, which is to provide a greater public good."

The authors present informative examples from their work, demonstrating the mutual benefit to communities and academic health centers of a true partnership approach. Of particular note is their model, "The Harlem Community and Academic Partnership (HCAP), a diverse partnership of community residents, community-based organizations and service providers, academia, and public health institutions." This partnership utilized the principles of community-based participatory research to develop initiatives that mutually benefit both the community and the academic health center in regard to community enhancement, improved health care, medical education, and research at the community level. Medical and public health students are now gaining important clinical and research experience in the community. Community members and academic partners launched novel community-based research studies. Research projects hired community members as liaisons, addressing major problems such as obesity among women of color. Academia and specific communities developed increased linkages and partnerships in order to prioritize health issues so they could be mutually addressed.

This article, furthermore, emphasizes the beneficial contributions of a community-based participatory model and the role of community health workers, community leaders, and organizations. Simultaneously, the authors remind us that there are continuing barriers to further development and dissemination of the community–academic medical center model. Among these are continuing skepticism by communities of the depth and sustainability of these partnerships by the academic health center, and skepticism by the academic health center of this type and degree of community involvement, and the implication of this for scholarship, training, and research. To address this, the authors conclude that a paradigm shift is necessary for academic health centers, in which they add another fundamental component to their mission-building strong community partnerships. This effort would be a strategic goal.

The authors are to be complemented for this work and the conclusions they present. A community–academic center approach is fundamental to addressing continuing disparities in health care in the United States. The majority of academic health centers are physically located in communities with excess premature morbidity, disability, and mortality. Although our current academic health centers were frequently founded to and have historically committed themselves to addressing the health care of communities and populations most in need, a community–academic center model has much to offer to enhance this societal role. [End Page 1]

David M. Levine
The Johns Hopkins School of Medicine, Department of General Internal Medicine


1. Remington RD, Axelrode D, Bingham E, Boyle J, Breslow L, Citrin T. et al. The future of public health. Washington, DC: Committee for the Study of the Future of Public Health, Division of Health Care Services Institute of Medicine, National Academy Press; 1988. Institute of Medicine Publication 88-102.
2. Health Professions Education for the Future. Schools in service to the nation. San Francisco: Pew Health Professions Commission;1993.
3. Miles SH, Lunie N, Fisher ES, Hauger ID. Academic health centers and academic reform. Acad Med 1993;68:648-53.
4. Levine DM, Becker DM, Bone LR, Hill MN, Tuggle II MB, Zeger SL. Community-academic health center partnerships for undeserved minority populations: One solution to a national...


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