The history of the community health center movement – originating in the civil rights struggles of the 1960s and inspired by global examples – is one of broad vision based on a commitment to equity and community empowerment. Today community health centers serve nearly 32 million people each year and improve access and quality for the nation’s most underserved, including people of color, the unhoused, and migrant workers. Embracing community engagement, self- determination and governance – core civil rights principles – the community health center movement has thrived, combatting decades of both under-service and justified mistrust of the health care establishment. Embedded in the health center story is a commitment to racial justice and equal rights. The nation’s first two health centers, founded in Dorchester, MA and Mound Bayou, MS as part of a federal health center demonstration, set out to end institutionalized discrimination and systemic racism in health care. The health centers of today reflect this legacy. They embody a commitment to meeting the unique needs and desires of their communities and advancing health care justice.
Columbia Point Health Center, Dorchester, MA
In Dorchester, the Columbia Point Health Center evolved from grassroots organizing to demand more and improved services. Despite being less than 10 miles from Boston’s Tufts University, the community lacked access to essential health care and services. Though in an urban area, its residents and families were systematically isolated, through segregation and lack of transportation, from the resources needed to lead healthy lives. Many families could not even access the basic healthcare services needed to register their children for school. The Office of Economic Opportunity’s (OEO) Model Cities Program – a centerpiece of President Lyndon B. Johnson’s Great Society and War on Poverty initiative – emphasized citizen participation as a key strategy in the effort to rebuild neighborhoods like Columbia Point.[i] Activists began to rally the local low-income residents to demand and plan for better social services. Access to primary and preventive health care emerged as a key issue during these grassroots conversations. The development of Columbia Point Health Center in conjunction with Tufts University responded to these needs by bringing essential healthcare resources directly into the community.[ii] Working with neighborhood housing groups, local leaders identified four apartments in a housing project that would become the site of the nation’s first health center. Reflecting the demogrphics of the community itself, the health center’s first patients were predominantly Black and minority mothers and their children.[iii]
Delta Health Center, Mound Bayou, MS
In the Mississippi Delta, the Tufts-Delta Health Center responded to the unique needs of its rural community, which were understandably quite different from those on the outskirts of Boston. Mound Bayou, the oldest independent predominantly Black community in America, was home to many descendants of slaves and sharecropper families. Despite development in the area, malnutrition, poor sanitation, unsafe living conditions, and health disparities were rampant in the early 1960s.[iv]
Meanwhile, the civil rights movement was gaining momentum, and Dr. Robert Smith, a Mississippi native and one of the few Black physicians who practiced in the state,[v] began caring for civil rights workers who were fighting against segregation and widespread disenfranchisement amidst violent resistance. Medical facilities often refused treatment not only to local, poor Blacks but to activists. In advance of Freedom Summer (1964) – a campaign to encourage registration of Black voters and fight discrimination and the intimidation of Black voters at the polls – Smith contacted colleagues in the Medical Committee for Human Rights (MCHR), organized to support and provide care to the participating civil rights workers, community activists, and volunteers. While focusing on aid to civil rights workers, together with Dr. Aaron Shirley and Dr Smith, the MCHR conceived a broader program to connect healthcare providers working in the state, and to help the underserved, poor rural Black residents get access to care locally.[vi]
Living conditions in rural Mississippi were shaped by poverty and decades of discrimination and neglect, and community needs were glaring. After the summer, some MCHR volunteers, including Dr H. Jack Geiger, were determined to work together to provide care for local Black residents.[vii] MHCR activists set up the small volunteer-run Mileston clinic inn Holmes County, supported by private funding and staffed by nurses together with Dr. Alvin Poussaint.[viii] This early clinic provided basic services in the Delta and also helped to organize local residents, but more comprehensive services were desperately needed. Volunteers and locals were frustrated by the high levels of need and lack of resources.[ix] Meeting in Greenville in December 1964, Smith, Geiger, and other healthcare justice leaders were galvanized to find a more permanent solution. Fortuitously the establishment of the OEO provided an opportunity to seek federal funding, and with the support of Dr. Count Gibson, Tufts University Medical School secured funding to set up not only Columbia Point, but a second site in the South,[x] with the Tufts -Delta Health Center ultimately finding a home in Mound Bayou.
Distinct from Columbia Point, Tufts-Delta Health Center did not begin with a focus on medical care, recognizing the community’s more immediate needs for public health and for improved nutrition, sanitation, housing and jobs to support community health. Driven by an ethos of community engagement and empowerment, sociologist Dr. John Hatch, the health center’s Director of Community Health Action, developed several programs which were led by and integrated into the community, focused on educational opportunity, food security, and sanitation.[xi] Medical services at the health clinic were initiated in November, 1967,[xii] with Dr. Robert Smith and Dr. Aaron Shirley commuting hundreds of miles from Jackson to provide care.
Eastside Family Health Center, Denver, CO
Across the country, in Denver, CO, another health center was born: Eastside Family Health Center. Within days of the OEO grant to Tufts, Denver’s Department of Health and Hospitals was funded to start the first health center west of the Mississippi River.[xiii] The goal in Denver was, again, unique – to establish a network of sites across the city as part of the City's own War on Poverty. The first of these sites, Eastside Family Health Center, was established in the Five Points neighborhood which had high rates of poverty and poor housing. The neighborhood was emblematic of the racial and ethnic disparities in acute and preventive care access. For many decades, Five Points was a hub of Black culture in Denver with a thriving jazz and blues entertainment district, despite segregation which bounded the community.[xiv] Five Points was also home to a large Hispanic community of primarily Mexican and Mexican-American seasonal agricultural workers.[xv] In its first year, Eastside Family Health Center’s patients represented this community: 36% of those served were Black, while and 42% were Hispanic.[xvi]
The stipulations of their OEO grant encouraged employment of the neighborhood residents. Accordingly, functioning as both a healthcare center and a jobs engine, Eastside Family Health Center was a vehicle to greater prosperity for the neighborhood.[xvii]
Seeing “health as a social justice phenomenon,” health center leaders in Denver prioritized community input at board meetings, even as these meetings got heated during the height of the civil rights movement.[xviii] The neighborhood’s commitment to civil rights and community activism contributed to the success and resilience of the health center, even through subsequent years of tumultuous population shifts.
Despite their different communities and origins, the earliest community health centers were deeply invested in the thread of community engagement and empowerment. Today’s health centers keep these principles at their center, addressing local needs and fostering resilience and collaboration among and within communities. This community-based, citizen-led formula remains central to the health center mission. Health centers today follow in the footsteps of the first health centers, building on this history while reflecting the specific local needs and desires of those they serve.
[i] Young, J. T. (2006). Model Cities Program. Retrieved March 10, 2024, from https://encyclopedia.federalism.org/index.php/Model_Cities_Program
[ii] Massachusetts League of Community Health Centers. (n.d.). History of Community Health Centers. Retrieved March 10, 2024, from https://www.massleague.org/CHC/History.php
[iii] Dorchester Atheneum, (n.d.). Geiger Gibson Health Center, Columbia Point. Retrieved March 10, 2024, from https://www.dorchesteratheneum.org/project/geiger-gibson-health-center-columbia-point/
[iv] Student Nonviolent Coordinating Committee (SNCC). (n.d.). Medical Committee for Human Rights. Retrieved March 8, 2024, from https://snccdigital.org/inside-sncc/alliances-relationships/mchr/
[v] John Dittmer, “The Medical Committee for Human Rights.” retrieved May 16, 2024, from https://journalofethics.ama-assn.org/article/medical-committee-human-rights/2014-09
[vi] Student Nonviolent Coordinating Committee (SNCC). (n.d.). Medical Committee for Human Rights. Retrieved March 8, 2024, from https://snccdigital.org/inside-sncc/alliances-relationships/mchr/
[vii] Alondra Nelson. “African American Responses to Discrimination Before 1960” Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination. University of Minnesota Press, 2011. Retrieved May 16, 2024, from https://ebookcentral.proquest.com/lib/gwu/reader.action?docID=819528&ppg=42&pq-origsite=primo
[viii] Student Nonviolent Coordinating Committee (SNCC). (n.d.). Medical Committee for Human Rights. Retrieved March 8, 2024, from https://snccdigital.org/inside-sncc/alliances-relationships/mchr/
[ix] Thomas J. Ward Jr, Out in The Rural: A Mississippi Health Center and Its War on Poverty. “ Oxford University Press. 2017.
[x] Ibid.
[xi] Schader Rogers, J. (Director). (2018) Out in the Rural [Film]. Retrieved from https://dcr.lib.unc.edu/record/883feeb3-762a-4676-954e-b9b77de48eeb
[xii] Ward, p. 65
[xiii] Denver Health and Hospital Authority (Denver Health). (2010). Denver Health: 150 Years of Level One Care for ALL. Retrieved from https://www.denverhealth.org/-/media/files/about/annual-reports/150-years.pdf?la=en&hash=E0ED46BD363EF75FAEA2B6F5A27C1F5F88C1913C
[xiv] Denver Public Library. (n.d.). Five Points-Whittier Neighborhood History. Retrieved March 10, 2024, from https://history.denverlibrary.org/neighborhood-history-guide/five-points-whittier-neighborhood-history
[xv] Denver Public Library. (n.d.). Five Points-Whittier Neighborhood History. Retrieved March 10, 2024, from https://history.denverlibrary.org/neighborhood-history-guide/five-points-whittier-neighborhood-history
[xvi] Denver Health. (2018). Who Was Bernard Gipson? Retrieved March 10, 2024, from https://www.denverhealth.org/news/2018/02/who-was-bernard-gipson
[xvii] Denver Health. (2020). How Health Care Became a Right in Denver in the 1960s. Retrieved March 10, 2024, from https://www.denverhealth.org/blog/2020/06/how-health-care-became-a-right-in-denver-in-the-1960s
[xviii] Denver Health. (2020). How Health Care Became a Right in Denver in the 1960s. Retrieved March 10, 2024, from https://www.denverhealth.org/blog/2020/06/how-health-care-became-a-right-in-denver-in-the-1960s
Create a customized profile.
© Copyright 2025, The George Washington University
