NEIGHBORHOOD HEALTH CENTERS

Neighborhood health centers (NHCs) comprise a wide array of organizations, typically nonprofit or public entities that provide services in medically underserved areas. NHCs typically exist where economic, geographic, or cultural barriers limit access to primary health care for a substantial portion of the population. The clinics seek to tailor services to the needs of the community or special populations they serve. They do this by building a community-based primary care infrastructure and by striving to provide family-oriented, culturally competent primary care, often linked to social services. The NHCs attempt to provide accessible and dignified health services to low-income persons and others with barriers to receiving care. The centers are often created by community groups, physicians, churches, and/or hospitals. Well over fifteen million of the nation's neediest people receive primary health care through NHCs.

Many types of NHCs exist, the largest being a network of approximately 700 Community and Migrant Health Centers with over 3,000 delivery sites, funded by the Health Resources and Services Administration of the U.S. Department of Health and Human Services (USDHHS). These sites are located in federally designated Medically Underserved Areas. There are also free clinics available throughout the country. The number of free clinics grew from approximately 130 in 1992 to over 300 in 1998, according to the Free Clinic Foundation of America. Free clinics are staffed predominantly by volunteers. Significant numbers of faith-based clinics, hospital owned or affiliated clinics, clinics operated under the direction of city governments also exist, as well as some free-standing unaffiliated clinics.

Many NHCs target their service to all ages and attempt to provide comprehensive services, which can include some or all of the following: outpatient medical, dental, supplementary and/or subsidiary hospital follow-up, mental health, substance abuse, and WIC nutrition. Some even provide transportation to connect those in need with the service providers. Other NHCs target their services to specific populations, such as women, children, ethnic groups, the homeless, the elderly, residents of public housing, schools, persons with special needs (e.g. HIV positive), or runaway children.

NHCs are financed in many different ways. Support comes from government (city, county, state, or federal support or grants), foundations, philanthropy, volunteers, churches, hospitals, health plans, individual contributors, community-action organizations, and others. Most NHCs charge fees, typically using a sliding fee scale based upon an individual's income. Not all organizations charge, however. Free clinics provide services at little or no charge, relying heavily on volunteers and nonpatient financial support.

Rick Wilk

(see also: Access to Health Services; Community and Migrant Health Centers; Community Mental Health Centers; Community Organization; Primary Care; Social Medicine; Social Work; United States Department of Health and Human Services [USDHHS] )

Bibliography

Hawkins, D., and Rosenblum, S. (1997). "The Challenges Facing Health Centers in a Changing Health Care System." Access to Community Health Care: A National State Data Book. Washington, DC: National Association of Community Health Centers, Inc.

Siegal, S. (1998). "Access to Primary Health Care: Tracking the States." Health Policy Tracking Services Series. Washington, DC: National Conference of State Legislators.