"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

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.