CONTRIBUTIONS OF COMMUNITY HEALTH
CENTERS:
A SYSTEMATIC REVIEW OF THE LITERATURE
TARA HANCOCK
CALIFORNIA STATE LONG BEACH
SCHOOL OF SOCIAL WORK
MAY 2012
Introduction
 Results of the Systematic Review of Literature
showed that current research indicated:



The proximity and availability of Community Health Centers
(CHCs) was correlated with higher rates of healthcare access
by underserved populations
A reduction of healthcare disparities related to race/ethnicity,
gender and socioeconomic status was noted in comparison to
other healthcare settings
A high quality of care that includes medical treatment, health
education, patient satisfaction, self-reported health, provider
skills and internal policies on quality is upheld even when
serving underserved populations
Social Work Relevance
 There are needs in providing better quality of care among
gender, race and socioeconomic status that are not present
in our healthcare system.
 It is important for CHCs to be better known about and
better funded allowing a safety net to further remain in
place for millions of people until something on a national
scale is potentially implemented
 CHCs are an excellent platform for social workers to use as
an example of how healthcare availability for everyone
could be beneficial to us as a nation
Cross-Cultural Relevance
 CHCs place emphasis on eliminating disparities in
healthcare by the incorporation of culturally competent
practices including hiring bilingual staff, making
community residents a part of their board and being
located within specific cultural communities.
 Medical social workers can use the multicultural services
implemented by CHCs to provide better care for patients.
 The findings from CHCs that demonstrated the benefits
of culturally sensitive services can further encourage
social workers about the benefits of the services they
provide and the true need for multicultural practices.
Literature
 CHC federal requirements for funding and operation also make up their
core framework. These requirements include:




Being located where there are impoverished areas or people
Integration and coordination of high quality patient care in-house and off-site
Solicitation of community involvement by requiring residents on the board of directors
Delivery of healthcare services regardless of ability to pay (Deye & Duncan, 2006; NHPF, 2004; USDHHS, HRSA,
BPHC, 2011b)
 The majority age range for CHC clients is between the ages of 19 to 64, making up
65% of its clients (NHFP, 2004; USDHHS, HRSA, BPHC, 2011a)
 In 2007, CHCs serviced 1 in 7 of every uninsured person in the United States and 1
in 5 of the low-income uninsured (NACHC, 2009). Also, in 2007, 1 in 3 of the
clients they served live in poverty and 1 in 4 was a minority living in poverty
(NACHC, 2009)
 The most recent data shows that nationally CHCs serviced approximately 35%
White non-Hispanics, 35% White Hispanics, 25% African American and 10%
Asian/Pacific Islander/Native American/multiracial (USDHHS, HRSA, BPHC,
2011a)

CHCs predominantly service the low-income and uninsured within a specific
neighborhood but they also service Medicare and Medicaid recipients along with some
privately insured persons (NHPF, 2004).
Methods
 A total of 34 articles related to community health centers were
found by using numerous library databases at California State
University, Long Beach.
 These articles were reviewed and selected based on their relevancy
to the focus of community health centers contained in this proposal.
 The articles were systematically analyzed based on author and year
of publication, purpose statement, research design, sampling
method, data collection method, sample size, source of sample,
setting of study, demographics of community health center clients,
enrollment correlation with disease management, effect of
enrollment to access to medical care, results on the community with
community health center presence, quality of care measurements
and affects and impact of community health center on disparities in
healthcare.
 These results were then presented in narratives and in four tables.
Findings
 CHC impact on access to healthcare:
 CHCs more likely to accept new patients, take publicly insured
patients, have evening and weekend hours, and allow sameday appointments when compared to office-based doctors
 Low-income populations were found have better access to
primary care needs when there is the presence of a CHC
 Obtaining preventative services, such as cervical and breast
cancer screenings, were found to be closely associated with
access to a CHC and to decrease the prevalence of their
associated cancers among CHC patients Presence and
availability of CHCs were found by studies to decrease patient
visits to emergency rooms and admission to hospitals
Findings
 Factors associated with high quality care deliver at CHCs:
 CHC met or exceeded rates of quality care when compared to similar settings—
such as hospital outpatient centers and physician offices
 Through ingrained quality care policies, CHCs allowed clients to increase checkup visit and immunizations rates
 CHC users had an increase in levels of delivery and comprehension related to
information—such as, smoking, exercise, sexually transmitted diseases and drug
use—than similar patients nationally
 CHC patients reported more positive primary care experiences than those
nationally
 CHC role in reducing healthcare disparities:
 CHCs had significantly higher rates of minorities accessing their clinics than in
other, similar outpatient settings
 Studies identified increases in women’s health to female CHC patrons for PAP
smears, mammograms, other preventative cancer screenings and obstetrician
and gynecological visits in general than national averages, especially among the
uninsured
 CHCs have few differences among its patient income brackets indicating greater
socioeconomic equality
References
National Association of Community Health Centers. (2009). Chartbook: A sketch of community health
centers. Retrieved from http://www.nachc.com/client/
documents/Chartbook_Update_20091.pdf
National Health Policy Forum (NHPF). (2004, August 31). The fundamentals of community health
centers. Retrieved from http://www.nhpf.org/library/ background-papers/BP_CHC_08-3104.pdf
U.S. Department of Health and Human Services (USDHHS), Health Resources and Services
Administration (HRSA), Bureau of Primary Health Care (BPHC). (2011a). Uniform data
system manual 2010. Retrieved August 13, 2011, from
http://bphc.hrsa.gov/healthcenterdatastatistics/index.html