Enacting Justice in Community Health Centers

Started in the 1960s with a commitment to justice, the community health center (CHC) movement emphasized that everyone deserves respectful, quality health care and that addressing social drivers of health is within the remit of health-care organizations. Sixty years on, the network of federally funded community health centers that developed from this movement remain committed to serving vulnerable populations in America as they set the standard for high-quality, wraparound primary care services. This essay draws on the authors' qualitative study of moral uncertainty in community health to show how CHC providers enact a commitment to justice as they both improve access to care and services and recognize their patients' humanity in a society where too many of them are "chewed up and spit out." CHCs' ability to enact justice, however, is limited in the US's fractured health-care system and profoundly unequal society, and their success and financial viability are not assured. In order for CHCs to fully enact their mission, it will take appreciating the key role they play in advancing health justice in America, and strong, savvy advocacy efforts.