Thomas J. Ward Jr. is a professor of history and Dean of the School of Arts and Sciences at Farmingdale State College (SUNY). He is the author of Out in the Rural: A Mississippi Health Center and Its War on Poverty (Oxford University Press, 2017) and Black Physicians in the Jim Crow South (University of Arkansas Press, 2003).
On December 11, 1965, the Columbia Point Health Center opened in a 1,200-unit public housing project in Boston, forever changing health care delivery in the United States. A product of both the Civil Rights Movement and the War on Poverty, Community Health Centers (CHCs) originated with activist physicians from the Medical Committee for Human Rights (MCHR) who volunteered to treat civil rights workers during Freedom Summer but were so shocked by the health conditions that they found among impoverished Black Mississippians that they vowed to find a way to expand care to the dispossessed.
Earliest Community Health Centers funded by the U.S. Office of Economic Opportunity
“I understood for the first time what it truly meant to be Black in Mississippi, and underprivileged, and poor and without medical care,” remembered Robert Smith, one of the founders of the MCHR, and a native Black Mississippian himself. In response, two MCHR veterans, H. Jack Geiger and Count Gibson, wrote a grant proposal for the Office of Economic Opportunity (OEO) to fund demonstration community health projects, one in the urban North and one in the rural South.
Columbia Point: The first Community Health Center
In June 1965, the OEO approved a $1.3 million grant to fund the two centers, both to be administered by Tufts Medical School. “That there was a major, quality medical school” in charge of the grant, according to Geiger, was crucial in convincing OEO leaders to go along with the plan. Less than six months later Columbia Point (now the Geiger-Gibson Community Health Center) opened.
A dozen apartments were donated by the Housing Authority for its operation, which included an emergency room, labs, x-ray facilities, and a pharmacy. Tufts medical students assisted the center’s professional staff of physicians, nurses, and social workers. OEO leadership was so impressed by the progress at Columbia Point that funding was allocated to open CHCs in Denver, Los Angeles, and New York City. Senator Edward Kennedy became an invaluable ally of the health center movement, securing $50 million from Congress to expand the program in 1966. The rural Southern center, in the all-Black town of Mound Bayou, Mississippi, however, faced numerous challenges.
The challenge of building a Community Health Center in the rural South
Geiger had identified Mound Bayou as an ideal location because of its history of Black leadership and the presence of two private, but struggling, Black-run hospitals in the town. The OEO grant for Mississippi provided needed funding to renovate the hospitals into a new community hospital that would partner with the health center.
While Geiger saw only advantages to this arrangement—the struggling hospitals would get a needed financial boost, the health center would have access to hospital facilities, and the state government would see federal funds revitalize needed health care facilities—the proposal faced opposition from many quarters, both Black and white. Hospital administrators opposed both sharing control and being unable to charge their previous fees; Mound Bayou’s civic leadership wanted to control the federal funding coming into their town, and not be beholden to Northern whites like Geiger; finally, both the state government and the (all-white) state medical association vehemently opposed the proposal, arguing that federal aid was both unwanted and unneeded.
Undeterred, Geiger enlisted John Hatch, then working as a community organizer in Boston, to go to Mississippi to garner support for the center. As a native Black Southerner, Hatch was able to build relationships with Black leaders in the Mississippi Delta, and by the end of 1966 there was local support for its establishment. For his part, Geiger went to work tamping down opposition from the state’s white physicians, convincing them that the center was not an instrument of “socialized medicine,” and that the treating poor, Black Delta residents was no threat to their practices.
A strategic grant and the opening of Tufts-Delta
The answer to the state government’s opposition was in the ingenious manner that Geiger and Gibson wrote their grant. White Southern politicians had fervently opposed most OEO programs, viewing them as little more than extensions of the civil rights movement. In order to enlist needed Southern votes, a provision was made that governors would be able to veto OEO funds for their state, unless those funds were administered by a university. Because Tufts was the administrator of the grant, the Mississippi governor had no control over the funds.
In late-1967, almost two years after the opening of Columbia Point, the Tufts-Delta Health Center began operations in Mound Bayou. As Geiger envisioned, its services included not only basic health services, but a vast array of other community programs, including also environmental services such as well drilling and vermin control, and a variety of nutritional programs, including the establishment of a farm co-op.
Now known as the Delta Health Center, Inc., it operates 17 locations, providing much needed care throughout of the most impoverished regions of the U.S. Nationally, what began in Boston six decades ago has grown into the largest health care delivery system in the United States, with over 1,500 community health centers treating 34 million Americans annually.