"Of the Poor, By the Poor, or For the Poor": Community Health Centers and the War on Poverty

Abstract

In early 1965, Dr. Jack Geiger, a physician with a history of civil rights activism, approached officials in the newly-created Office of Economic Opportunity (OEO) and proposed a plan to create a community health center in the South. The OEO, which had been charged with directing President Johnson’s War on Poverty, was then in the midst of searching for community-oriented solutions to poverty. OEO officials seized Geiger’s proposal and what they saw as the opportunity to tackle health and poverty in tandem, and a new federal program was born. Over the next few years, the OEO funded community health centers across the country.

This dissertation looks at how the ideas of “community,” “community health,” and “community control” came to form the basis of a federal program. The community health center program was the result of interactions between federal officials, medical reformers, medical schools, health radicals, and the patients themselves. Drawn together by the appeal of “community,” these groups soon realized that their interests did not always align. This dissertation will explore these tensions and conflicts, shedding light on how the competing definitions of “community” shaped the implementation of the community health center program. In the process, it attempts to integrate the community health centers into the larger history of the War on Poverty and reconcile the split between bottom-up and top-down approaches.