Many developments in public health and medical care billed as new and innovative are, in fact, often old and sometimes forgotten. These trends include everything from more community participation, more attention to larger social context, and more collaboration across sectors, among others — much of it central to Robert Wood Johnson Foundation’s Culture of Health initiative.
[Photo: Dr. Merlin Chowkwanyun]
In particular, the War on Poverty, launched by President Lyndon Johnson more than 50 years ago had a great influence on widening the health care safety net and facilitating community involvement in the leadership of larger health care organizations, bequeathing such programs as Head Start and AmeriCorps, and community health centers.
In a commentary published online in the January issue of the journal Health Affairs, Dr. Merlin Chowkwanyun, assistant professor of sociomedical sciences at the Columbia University Mailman School of Public Health, examined the health legacy of the War on Poverty long attacked as a failure, or at best, a severely limited endeavor by critics on both the right and the left.
“While there has been a recent effort in the past 10 years, to rehabilitate the War on Poverty and accentuate its successes and achievements, people still rarely think of its broader banner and the idea of an ambitious government program to eliminate poverty,” noted Dr. Chowkwanyun.
In Dr. Chowkwanyun’s evaluation of the program he looked at two on-the-ground case studies of early community health centers, one in the Lower East Side of New York City, the other in the Watts neighborhood of Los Angeles, by analyzing the challenges of these new models of care and the important role played by skilled facilitators and community organizers in resolving conflict. At the time, both of these centers were severely deprived of health care resources. Dr. Chowkwanyun’s paper shows how these centers not only addressed the access issue but also fostered community governance of centers and attempted to address larger social context affecting health.
The source base for the article was also quite unusual. To conduct his analysis Dr. Chowkwanyun relied on personal papers retained by participants over many decades that they shared with him.
“Given the political climate, for many months, I thought this was not really the right time to write about the War on Poverty’s potential — some realized, much not — given that nothing like this is in the cards soon,” said Dr. Chowkwanyun. “However, now I believe that is especially why it is important to write about it: its memory helps us cling to possibility and optimism even in somewhat less than bright times.”