Community Health Centers (CHCs) play a central role in the Patient Protection and Affordable Care Act, but CHCs are not new. CHCs have delivered primary and preventive health care for free or reduced cost to disadvantaged and uninsured Americans since 1965. CHCs were first funded under the 1965 Economic Opportunity Act and expanded under the 1975 Special Health Revenue Sharing Act. In 1990, the Omnibus Budget Reconciliation Act created the now well known designation, "federally qualified health centers" (FQHCs).
Since 2000, the CHC program has grown under both the G.W. Bush Administration and the Obama Administration. Today, there are more than 8,000 CHCs. They are located in every state and serve over 20 million Americans. Forty percent of their patients are uninsured; 70 percent are in poverty; 50 percent are minorities (Adashi et al. NEJM 2010). Visit our history page to learn more about the history of the program in the US.
This project constructs quantitative measures of CHC availability over the program's history.
For early CHCs (1965-1980), the blue shading shows the first year a community health center was established by county of service delivery. The darker shading indicates a center that was funded later. Today, many counties have more than one CHC. In 2011, counties in light blue had at least one CHC and counties in dark blue had more than one CHC. Comparing the two maps shows the dramatic geographic expansion of the CHC program since 1980.
The project also aims to examine the effects of CHC availability on the use of care, health care expenditures, and health outcomes from the mid-1960s to the present. To this end, we are assembling new data and linking CHC information to existing health data (e.g., National Health Interview Surveys and Vital Statistics). Our first set of findings have been published at the American Economic Review and can be found here.