Subtitle: A Movement and the People Who Made It Happen
Author: Bonnie Lefkowitz
Subject: History of Medicine / Public Policy
Paper ISBN 0-8135-3912-9
Cloth ISBN 0-8135-3911-0
Pages: 192 pp.
Series: Critical Issues in Health and Medicine
Publication Date: January, 2007

"This lyrical book offers an intimate view of the role of community leadership in the creation of health centers, one of the most important chapters in the history of U.S. health policy for the medically underserved. Bonnie Lefkowitz's examination of health centers and community leadership should be required reading in public health leadership programs everywhere."-Sara Rosenbaum, J.D., Hirsh Professor and Chair, Department of Health Policy, George Washington University Medical Center

"This chronicle of heroes of the community health center movement is a valuable resource and great read. It's an important reminder of the fragility of the nation's safety net, and the need for public policy commitment to ensuring access to quality health care for all."-Karen Davis, president of the Commonwealth Fund

"This extraordinarily well-written account of how activists and communities created a model of comprehensive, community-based health care should be read by everyone concerned about ending inequalities in health status in the U.S."-Alice Sardell, author of The U.S. Experiment in Social Medicine: The Community Health Center Program, 1965-1986

"Lefkowitz makes the politics, legislative struggles, and social conflict come alive. The tales she tells about the incidence of parasitic disease, infant mortality, and untreated hypertension and diabetes in rural US populations sound like a novel set in a developing country. These accounts are, however, carefully researched and supplemented by oral histories to give them flavor and substance. The book quickly...becomes riveting. This meritorious work is scholarly, passionate, balanced, and nonpolemical. I recommend this book to anyone who treats low-income families as part of their health care mission."-Prentiss Taylor, MD, Journal of the American Medical Association

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.

At a time when there is bipartisan support for expansion of the program, this book offers a timely analysis of failures and successes, and offers ideas on how to ensure the survival of the centers' community-based mission in today's competitive marketplace.

Bonnie Lefkowitz is a health policy writer and consultant with twenty-four years of experience as a federal researcher, administrator, and policy analyst. She lives in North Beach, Maryland.