Spotlight on History: Community Health Center Initiatives Advance Empowerment, Health Care Justice

Since their inception in the 1960s, community health centers have exemplified a profound commitment to community engagement, embracing community governance and issue-focused grassroots advocacy. Visionary leaders and local advocates have transformed their communities by engaging health centers to address broader health and social needs. From pioneering farming cooperatives to comprehensive workforce development programs, health center initiatives are beacons of community-driven change, fostering economic autonomy and self-determination. Through collaborative efforts shaped by community input, they have both improved health outcomes and catalyzed sustainable economic development, demonstrating the transformative power of local engagement to create sustainable change. Just a few of these unique efforts are profiled below, illustrating the diversity of community, strategy and experience that shape the health center program.

Aaron E. Henry Community Health Services Center, Clarksdale, Mississippi

Aaron E. Henry Community Health Services Center (AEH), founded in Clarksdale, Mississippi in 1979, explicitly identifies promoting economic development as central to its mission. Founded in honor of civil rights activist, pharmacist, and Mississippi State Representative Aaron E. Henry, the health center started in Clarksdale but soon expanded into Tunica in response to community demand. AEH is led by Aurelia Jones-Taylor who has served as CEO since 1989 and has spearheaded major expansions of health center services in the agricultural heart of the Mississippi Delta.[i]

As part of these expansions, the health center has operated Delta Area Rural Transit System (DARTS) public transportation in the surrounding counties for over 30 years. What began as transportation for medical care evolved into Delta Rides, a reliable public transport service supported by AEH and a network of non-profit organizations, and  used by hundreds of Mississippians to connect to employment, childcare, and human service agencies.[ii]  By providing reliable and affordable access to transportation, Delta Rides has facilitated access to jobs and education all along the Mississippi Delta, generating opportunities for stability and growth for all community members.

Many of the health center’s staff have been trained through their Delta Workforce Initiative, which provides workforce development training for community members and those already working in the health center. This training helps to decrease turnover, enhance trust and connectedness with the community, and contributes to economic development.[iii]  Many community members who now work in highly skilled positions as nurse practitioners or in medical billing gained their skills and educational development through participation in the Delta Workforce Initiative.[iv] Access to these opportunities not only uplifts individuals but creates generational community stability.

Building on its goal of economic empowerment, and supported by external grants, AEH started the Health & Wealth Program in 2023 in conjunction with Southern Bancorp Community Partners, a community development financial institution (CDFI). To encourage community member’s financial wellness, the program provides interested patients with resources and referrals to financial advisors and credit counselors in addition to and alongside traditional medical services.[v]

Together, this unique array of services complement the clinical program and increase financial security, employment opportunities, and overall health for the entire community.

Beaufort-Jasper-Hampton Comprehensive Health Services, Ridgeland, South Carolina

Beaufort-Jasper-Hampton Comprehensive Health Services (BJHCHS), located in South Carolina’s low country, was established in 1970 to serve a rural community that suffered the consequences of poverty, malnutrition, and substandard housing. The predominantly Black residents, descendants of former slaves, were disenfranchised, with many households earning less than $3,000 annually. Low life expectancy, poor health outcomes, and high infant mortality plagued the community, which had poor sanitary and health infrastructure, as well as little access to financial support. The health program was organized to address these pervasive social, environmental, and economic disparities.[vi]

Thomas Barnwell, the first executive director of what was then called “Comp Health,” established a program to train community health education workers on basic environmental health and sanitation needs.[vii] To address the need for potable water, Barnwell and environmental engineer Emory Campbell worked with advocates and local agencies to secure funds for a new water system.[viii] This community-led investment dramatically improved the health of local residents in just a few years and elevated the health of the county overall, earning Beaufort the distinction of healthiest county in the state of South Carolina for over ten years.

Water, sanitation, and economic investment went hand in hand with programs to improve health care quality and access, including for especially vulnerable populations. BJHCHS operates a nationally acclaimed Agricultural Worker Health Program, supporting the health and social needs of migrant farm workers and their families through community outreach and culturally and linguistically competent care.[ix] They offer a night clinic during the tomato and watermelon harvest season to better meet the needs of the workers.

The health center maintained its steady commitment to innovative community improvement under the leadership of Roland Gardner, who served as the center’s CEO for 41 years and passed the baton in 2022 to its current dedicated and transformative leader, Dr. Faith Polkey.

Delta Health Center, Mound Bayou, MS

John Hatch, Tuft’s-Delta Health Center’s director of Community Health Action, arrived in Mound Bayou in 1966, organizing health associations to engage local leaders and mobilize and empower the community from the ground up. The North Bolivar County Health Council was established in 1968 as an umbrella organization to coordinate the work of ten local health associations and serve as an advisory group,[x] helping the health center to define its goals and programs. While voting members were selected by their associations, Council meetings were open to the entire community[xi] and provided a place for people to come together and productively share ideas about their community’s challenges and potential solutions. Locally elected leaders gathered community input on everything: environmental health, civic improvement and the need for housing, transportation, legal services, and food were all on the Council’s agenda.

In response to malnutrition and a loss of agricultural employment, the Council helped establish, in 1967, the independent North Bolivar County Farm Cooperative, a county-wide agricultural co-op that produced high-quality vegetables and fruit, providing essential food for its members. The co-op was dedicated to building community autonomy, and by the end of its first year in operation, served nearly 1,000 families. Its investments not only decreased malnutrition but also spurred community self-determination and economic development through innovation and job creation. The co-op eventually produced so much food that the community was able to sell its excess produce to others, stimulating the local economy.

Decades later, a commitment to addressing food insecurity continued. Delta Health Center has partnered with United Healthcare to provide fresh and locally grown produce to plan members. In 2022, the heath center partnered with the Friedman School of Nutrition Science and Policy at Tufts University, Tougaloo College's Reuben V. Anderson Insitute for Social Justice, and the Center for Science in the Public Interest (CSPI) on a Food as Medicine initiative. With a $6.6 million grant from the National Institutes of Health [xii][xiii] the project, Delta GREENS, aims to increase the production and consumption of nutritious produce in Bolivar, Washington, and Sunflower counties and reducing the risk of obesity and diabetes. The collaborators partnered with local farms that deliver food to the health center for distribution to enrolled patients participating in the program, who have diabetes and struggle with food insecurity.[xiv] Short for Growing a Resilient, Enriching, Equitable, Nourishing food system, Delta GREENS could be a model for building a sustainable food system and improving health.

Urban Health Plan, New York, New York

Urban Health Plan (UHP) was established in 1974 in the South Bronx by local physician Dr. Richard Izquierdo and now serves communities in the Bronx, Central Harlem, and Northwest Queens, New York.[xv] Izquierdo, a family practitioner and pediatrician, opened a solo practice in 1962, serving a predominantly Hispanic and medically underserved community. Committed to the residents of the community and seeing that they needed more comprehensive services than he alone could provide. Izquierdo, known to the community as “Doc,” developed a group practice that offered care in a more consistent, cost-effective, and managed manner. This practice later became Urban Health Plan (UHP). Today, under the leadership of Doc’s daughter Paloma Izquierdo-Hernadez, this dedication to providing quality care and improving the health of the community continues and multiplies. UHP provides comprehensive primary, diagnostic, and specialty care for adults and children, including LGBTQIA+, teen- and elder-focused services, as well as ancillary services such as case management, insurance navigation and enrollment, nutritional and WIC education, and educational and workforce development programs.[xvi]

Dr. Izquierdo was committed to advancing educational opportunities and job readiness for residents of the Bronx. His vision is embodied in the Dr. Richard Izquierdo Health and Science Charter School, the first charter school in New York City to offer a career and technical education program geared toward preparing students for jobs in the healthcare sector. UHP’s Workforce BX program empowers community members with the education and training needed to participate in the workforce. The program provides training and education in market-driven job skills, resume writing, career planning, and job search techniques. It also  offers job placement to connect participants with local businesses, helping to create a growing local economy of skilled, local workers who support their families’ future success and contribute to a thriving local economy.[xvii] Rooted in its historic mission and community, and driven by its deep understanding of the social, environmental, and economic dimensions of community health, UHP has developed a holistic vision, and deepened its commitment to fostering healthy and vibrant communities.

Yakima Neighborhood Health Services, Yakima, Washington

Founded in 1975, Yakima Neighborhood Health Services (YNHS), located  in an agricultural region of Washington state, has grown steadily over the decade. Once a small, prevention-oriented clinic, YNHS is now a large, responsive hub of comprehensive community health and social care. The health center operates mobile medical clinics and utilizes community health workers to best serve its unique community members, many of whom are agricultural workers. Its mission is explicitly focused on “improve[ing] the quality of life and equity in our communities by providing accessible and integrated health and social services, ending homelessness, and offering unique learning opportunities for students of health professions.”

Until 2020, YHNS was helmed by Anita Monoian, who has consistently observed that he success of the health center is deeply rooted in committed staff who understand and respond to the community’s unique needs.[xviii] Many of the staff are themselves community members who have seen generations of families cared for by the health center.[xix]

Now led by Rhonda Hauff, Yakima Neighborhood Health Services upholds this core mission. Responding to the county’s call to increase care for people experiencing homelessness, Yakima Neighborhood Health engaged with community organizations to meet homeless individuals where they were at and let their needs guide the health center’s investments. This led to the successful development of transitional and permanent supportive housing, mobile clinics, and case management services which are well-utilized by the community.[xx] In 2023, more than 13% of the patients they served were experiencing homelessness.[xxi] “Neighborhood Apartments,” opened in 2023, provides 58 units of permanent supportive housing for chronically homeless individuals and families. Starting in March 2024, YNHS also offers Neighborhood Showers, a mobile hygiene unit designed to serve those experiencing homelessness.[xxii]

Other populations supported by the health center incude  rural, seasonal agricultural workers. In 2022, more than 30% of YNHSpatients were agricultural workers or their families.[xxiii]  YNHS has tailored its services, outreach programs, and hours to better serve its diverse Yakima Valley community, helping elevate their health and their lives.

These health centers, among many others, have continuously invested in advancing and strengthening their communities.  Driven by community governance and the lived experience of community members, Board and staff, they foster community development while advancing health equity. By championing community-driven initiatives, health centers serve as powerful catalysts for empowerment and social change. Their unique services, programs and investments often go beyond clinical care and allow the strength and wisdom of communities to shine.

This article was published in 2024.