Today’s health care landscape would have been almost unrecognizable 50 years ago. Miracle drugs and medical devices have changed how we approach everything from diagnostics to treatment. But one of the most fundamental differences is an approach that helped spark the entire progressive health care reform movement, and it started right here in Massachusetts, where its practitioners are continuing to lead the state and the nation.
In 1965, physician activists H. Jack Geiger and Count D. Gibson Jr. developed a new model to provide accessible, affordable and high-quality health care. They founded two community health centers, the first in the Columbia Point section of Dorchester, and the second in Mound Bayou, MS.
This new model — a community health center — introduced concepts that form the very foundation of health care today: prevention and wellness, chronic disease management, patient-centered care and community health. We see these concepts playing out today at The Dimock Center and Whittier Street Health Center in Roxbury.
The innovative model of health care launched by health centers seeks to improve the overall health of entire neighborhoods by approaching care holistically, by understanding the specific cultural, social and economic conditions affecting their patients. It has succeeded in 1,200 health centers across the U.S. serving nearly 28 million Americans in urban, suburban and rural communities, including the Boston communities of Roxbury, Jamaica Plain, Roslindale, Hyde Park, Mattapan and Dorchester.
A hallmark of the community health center model, now at The Dimock Center, provides comprehensive substance abuse treatment and integrated behavioral health and primary care services to patients. Dimock directs one of only two detox facilities in Greater Boston and has specialized, on-campus addiction treatment services that are sought out by individuals from more than 200 Zip codes across the state. In addition to its inpatient detox facility, outpatient addiction services and residential recovery homes, its holistic patient-centered medical home fully integrates behavioral health and primary care for children and adults. This model empowers patients to take control of their physical and mental health with a team of doctors and social workers. We work to share these models by participating in research projects and networking with our colleagues from across the city, state and country.
The burden of chronic diseases like diabetes, hypertension, asthma and obesity falls heavily on communities of color. In response, Whittier Street Health Center has developed specialized programs for the management of chronic illnesses that place wellness and prevention front and center. More recently, in response to the lack of fitness and wellness facilities in the Roxbury area, Whittier raised funds to construct a 6,800 square foot medical fitness center and community wellness garden, both of which opened in June 2015. The fitness center offers a broad array of services and activities, including physical fitness, exercise machines, classes in aerobics, yoga and Zumba, and access to a pediatric healthy weight coordinator. In addition to offering a relaxing green space, the Center’s new community garden is tended to by volunteers from the neighborhood and will help improve residents’ access to fresh fruits and vegetables. In combination with Whittier’s Boston Health Equity Program, a primary care delivery model that combines care coordination, community outreach and wellness support, these nation-leading initiatives are helping to redefine health care delivery in underserved communities.
Health centers across Massachusetts have made impressive gains, particularly with high-risk populations. Recent data from the U.S. Health Resources and Services Administration show that Massachusetts health centers continue to score higher than the national average on federal quality, outcomes and disparities measures related to childhood immunizations, assisting prenatal patients, reducing the incidence of low birth weight babies, and helping patients manage diabetes, hypertension, and other chronic conditions.
The challenge for the immediate future will be to sustain health center innovation through the radical economic transition that health care is undergoing. Competition for health care workers, particularly primary care providers, is intensifying. The Massachusetts League of Community Health Centers is leveraging support from state and federal policymakers, business, philanthropy, and health care industry partners to address this need. From public-private loan forgiveness programs for health center primary care providers, to health-center-based residency training programs, to community leadership programs designed to cultivate the next generation of physician and administrative leaders, health centers continue their hallmark grassroots efforts to lead the industry forward.
Dr. Myechia Minter-Jordan and Frederica Williams are President and CEO of The Dimock Center and Whittier Street Health Center, respectively.
