Community Health Centers in US Inner Cities: From Cultural Competency to Community Competency

James Jennings


This paper critiques the idea of multiculturalism in the delivery of public health to low-income and communities of color as incomplete and limited. Health activists, and very importantly, community health centers in these places must become more involved with struggles against structural inequalities. Using the theory of social determinants of health, it is proposed that the leadership of community health centers consider how spatial inequalities impact directly on the particular health needs of low-income groups and people of color. Until public health addresses inequality, higher rates of ill health and health disparities will continue to plague economically distressed urban neighborhoods in the US. Based on an earlier study for the Robert Wood Johnson Foundation, including a literature review and interviews with key informants, the author argues that public health is a key venue for the empowerment of inner city neighborhoods. Therefore, community health centers should be perceived and supported as community actors involved directly or indirectly with a range of economic and political issues, rather than simply the place - albeit quite multicultural - where poor and working-class people go when they are sick.

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Copyright (c) 2009 James Jennings