Buoyed by mission and mandate, grassroots community leadership has been pivotal to the health center movement since its inception. In the face of formidable challenges, dedicated community leaders and advocates challenged the health care establishment to meet the pressing needs of their neighbors. The founding leaders of America’s health centers, driven by a fervent dedication to their communities' well-being, embarked on journeys marked by resilience, resourcefulness, and unwavering resolve. Their stories illustrate both the unique nature of each community and the shared values that drove the activists and founders of health centers across the nation.
The Community Founders of Delta Health Center – 1960s
Delta Health Center, the nation’s first rural health center, now serves more than 14,000 patients annually. While Dr. Jack Geiger is widely known as the co-founder of this center and its urban counterpart in Dorchester, MA, this work reflects his deep collaboration with and leadership of local Black leaders and physicians like Dr. Robert Smith and Dr. Aaron Shirley, sanitarian Dr. Andrew James, and social worker / sociologist Dr. John Hatch.
Dr. Smith, a Mississippi native, attended medical school at Howard University in the 1950s and had started his residency training in at Cook County Hospital in Chicago, IL but his training was disrupted when was called back to Mississippi by the US Army in 1961. His willingness to work in the segregated south was a sacrifice; Black doctors in the south, and particularly in Mississippi, were not granted hospital privileges and had limited practice authority. But Mississippi was always his home, and his work in the civil rights movement in the ensuing years compelled him to stay. After meeting the Mississippi civil rights leader Medgar Evers, Dr. Smith realized that his skills were deeply needed in his home state. Often called “the doctor of the movement” Dr. Smith started the Medical Committee for Civil Rights in 1963 to protest segregation and racism in the AMA and began treating civil rights workers in Mississippi in the early 60s. In 1964, Smith formed an alliance with the Medical Committee for Human Rights (MCHR, organizing as its first Southern Medical Field Director to support activists during the Freedom Summer voter registration campaign.[i] But Dr. Smith and others were also deeply committed to providing care for impoverished local Blacks. At a gathering in Greenville, MS in December 1964, Dr. Smith urged Geiger to help build the infrastructure for community-oriented primary care in Mississippi. Together with Geiger, Smith and fellow activists strategized and secured funding from the Office of Equal Opportunity to launch the community healthcare pilot in Mound Bayou. When the health center was funded, Smith recruited physician colleagues to work with him, encouraging them to join the nascent health center movement. In the early years, Dr. Smith learned to fly and borrowed a plane to ease the trip from Jackson to Mound Bayou. Smith later founded and served as CEO of Jackson’s Central Mississippi Health Services.
Dr. John Hatch, a social worker and community organizer, attended Atlanta University. He was working in Boston when he was recruited by Dr. Geiger to join the Department of Preventive Medicine at Tufts University Medical School to help develop the health center projects. Like Smith, he returned to his home in the south, arriving in the Mississippi Delta in the fall of 1965. As the Tufts-Delta Health Center’s Director of Community Health Action, Hatch spent months integrating himself into Bolivar County, where the health center would ultimately be situated, connecting with residents and leaders, learning about the community’s strength, resilience, and needs.[ii] As one of the first rural community organizers, he helped the local residents envision what a health center could look like, and nurtured community leadership. This on-the-ground, community-engaged work was foundational to the successful launch of the programs addressing food insecurity, housing conditions, sanitation, job training and employment and ultimately, medical care.
Dr. Andrew James was also recruited to work at the Tufts - Delta Health Center, initially as the director of the health center’s environmental health division, and was subsequently named the health center’s first director. An environmental engineer by profession, he conducted research to identify the causes of the area’s high maternal and infant mortality and found that lack of access to clean and safe drinking water was at the root of the elevated mortality rates and many of the region’s health problems. Dr. James worked with local authorities to add water wells and sanitary privies, providing clean water and vastly improved sanitation. He also established an environmental internship for aspiring sanitarians and environmental engineers[iii] and a job training program that trained community members to address sanitation and living conditions. His work strengthened the community’s overall health, improving the living and working conditions while also fostering greater economic empowerment for its members and. After completing his doctorate at the UTHealth Houston School of Public Health, Dr. James would go on to advocate for public health improvements through the practice of environmental engineering and community development across the south, from Mississippi to Texas.[iv]
Dr. Aaron Shirley, another Mississippi native, was also central to the early years of Delta Health Center and the broader health center movement. As an active member of the MCHR during Freedom Summer, Dr. Shirley worked with Dr. Smith and Dr. Geiger to treat civil rights workers. He cared for patients in Mound Bayou in the Delta Health Center’s early years, commuting twice a week from Jackson. In 1970, despite rampant racism and fierce social and political objections from the state government and locals, Shirley founded Jackson-Hinds Comprehensive Health Center (JHCHC), Mississippi’s second health center. [v],[vi JHCHC prioritized nutrition and housing for elderly Black community members as well as medical care. Later in his career, Dr. Shirley established the innovative Jackson Medical Mall[vii] in an abandoned shopping center. Opened in 996, Jackson Medical Mall transformed the area witth the pioneering concept of a multidisciplinary ambulatory care hub providing medical care and fostering local economic development.
In the annals of community and public health history, the story of Delta Health Center stands as a testament to the remarkable efforts of visionary Black clinicians and lay leadership who worked tirelessly and strategically to address pressing health needs. Driven by a deep commitment to service and social justice, and working with Dr. Geiger, Dr Count Gibson, and like-minded clinicins and health and social justice activists, physicians Dr. Robert Smith and Dr. Aaron Shirley, environmental engineer Dr. Andrew James, and sociologist Dr. John Hatch laid the foundation for accessible healthcare in the Mississippi Delta and pioneered models of community empowerment and resilience. Their enduring legacy leaves an indelible mark on the health care landscape, inspiring future generations to continue the fight for inclusive, equitable and accessible healthcare for all.
The “Founding Mothers” of Health Centers in the Northeast – 1970s
Edward M. Kennedy Community Health Center
The Great Brook Valley Health Center in Worcester, Massachusetts, known today as Edward M. Kennedy Community Health Center (Kennedy Community Health), was founded in 1972 by a group of seven local women. As residents of the city’s largest low-income public housing project, which was geographically isolated and lacked public transportation, they and their families had no access to basic health services and relied on the emergency room to obtain medical care.[viii] These women knew that their families and community needed more services. Together they negotiated with the Worchester Housing Authority to secure funds and start a clinic staffed by one Nurse Practitioner. Ms. Angel Hampton was one of the early Great Brook Valley advocates involved in developing the health center, and later, served on the health center board for over 30 years. These grassroots beginnings, originating with seven mothers deeply concerned not just for their own children and families, but the entire community, launched a network with community-based care at its center. Today, while 13% of its patients are residents of public housing, Kennedy Community Health has expanded far beyond its original home, and provides comprehensive medical, dental and behavioral health care to residents of Worcester, Framingham, Milford, and the surrounding communities of MetroWest and Central Massachusetts. Its locations include a flagship across the street from its earliest public housing site, and 6 school-based health locations.[ix]
Sun River Health
New York State’s Sun River Health is another widely recognized example of a community health center started by a group of strong, community-minded women. The health center was founded in 1975, through the efforts four “Founding Mothers” - the Reverend Jeannette Phillips, Mary Woods, Willie Mae Jackson, and Pearl Woods. They worked with community and religious leaders to address the need for affordable health care in Peekskill, NY, one of the poorest cities in New York’s Hudson Valley region. The Founding Mothers were instrumental in securing a grant from the Office of Economic Opportunity to open the Peekskill Area Ambulatory Health Care Center, the predecessor of Sun River Health, in 1975. Obtaining this vital funding was just the beginning of how these dynamic women shaped community health care.[x]
Alongside long-time CEO Anne Kauffman-Nolon, who first came to the area as a Vista volunteer, community leaders including the Founding Mothers worked to address health and health-related social needs, expanding the health center’s reach to more than 40 sites operating today across the Hudson Valley, New York City, and Long Island.[xi] Especially in the early years, they relied heavily on grass roots funding sources to meet their community’s needs: think community bake sales, not donor benefit galas. They understood that the success and longevity of their efforts were intricately tied to their community’s own empowerment. Navigating continued poverty, housing crises, and gentrification of once-beloved cultural hubs, the Founding Mother’s vision of intentional, community-led services drove the development of one of the largest community health centers in the nation. Sun River Health invests in housing, nutrition, preventive healthcare, and education and keeps the community at the center of its work through programs like Community Health Action[xii] and the Alamo Community Center, offering agricultural worker and family support.[xiii] Forever inspired by the Founding Mother’s vision, the health center has built a robust and responsive network tailored to its community’s needs.
Through their visionary leadership and unwavering advocacy, women transformed the healthcare landscape and inspired empowerment, resilience, and social justice. These narratives underscore the enduring legacy of women as catalysts for change, architects of community-driven healthcare solutions, and guardians of collective well-being. Their stories serve as beacons of hope, reaffirming the transformative power of grassroots leadership in advancing health equity and fostering inclusive, accessible healthcare for all through community health centers.
This article was published in 2024.
[i] Student Nonviolent Coordinating Committee (SNCC). (n.d.). Medical Committee for Human Rights. Retrieved March 8, 2024, from https://snccdigital.org/inside-sncc/alliances-relationships/mchr/
[ii] Schader Rogers, J. (Director). (2018) Out in the Rural [Film]. Retrieved from https://dcr.lib.unc.edu/record/883feeb3-762a-4676-954e-b9b77de48eeb
[iii] Ward, Thomaas . Out in the Rural ( 2017) Oxford University Press.
[iv] Fairman, J. A. (2024). Dr. James Tribute. Retrieved March 8, 2024, from https://deltahealthcenter.org/wp-conten,t/uploads/2024/02/dr.-james-tribute.pdf
[v] Jackson Hinds Community Health Center. (n.d.). Home. Retrieved March 10, 2024, from https://www.jackson-hinds.com/
[vi] Walker, A. (2021). Dr. Aaron Shirley: Health Care Innovator. Retrieved March 10, 2024, from https://www.nachc.org/dr-aaron-shirley-health-care-innovator/
[vii] Jackson Medical Mall. (n.d.). Home. Retrieved March 10, 2024, from https://jacksonmedicalmall.org/
[viii] Edward M. Kennedy Community Health Center. (n.d.). About Us. Retrieved March 10, 2024, from https://www.kennedychc.org/about-us/
[ix] Schwann, H. (February 16, 2022). ‘It’s breathtaking’: Kennedy Health Center in Worcester hits half-century mark. Retrieved March 8, 2024, from https://www.telegram.com/story/news/2022/02/16/healthcare-ted-kennedy-community-health-worcester-framingham-milford/9199284002/
[x] Palmer, J. (September 14, 2023). Community Health Center Movement Mourns Leading Advocate, Rev. Jeannette J. Phillips, Founding Mother of Sun River Health. Retrieved March 8, 2024, from https://www.sunriver.org/community-health-center-movement-mourns-leading-advocate-rev-jeannette-j-phillips-founding-mother-of-sun-river-health/
[xi] CHC CHroniCles. (n.d.). Sun River Health. Retrieved March 10, 2024, from https://www.chcchronicles.org/explore/hudson-river-healthcare-inc
[xii] Sun River Health. (n.d.). Community Health Action. Retrieved March 8, 2024, from https://www.sunriver.org/other-supports/programs/community-health-action-staten-island/
[xiii] Sun River Health. (n.d.). Alamo Community Center. Retrieved March 8, 2024, from https://www.sunriver.org/other-supports/programs/alamo-community-center/
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