Two Steps Forward, Three to the Side: Social Image and the Dance for Community Health Center Survival

This book offers a systematic analysis of the community health center program’s success since its establishment as a War on Poverty program.
Initially, the program served as a means for strengthening communities by ameliorating the poverty-related causes and consequences of limited access to health care. Today, the program is situated as an entry point and safety-net solution, shoring up gaps in the larger healthcare system. Against the backdrop of persistent health disparities and calls to return to its anti-poverty roots, the goal of this book is to both celebrate and caution against administrative strategies that primarily align programmatic outcomes with macroeconomic standards of success. Chronologically structured by its legislative authorization history and presidential administrations, Two Steps Forward, Three to the Side employs a sociological lens to trace the transformation of social narratives created by administrators and advocates about the program for the purpose of fortifying legislative support over more than six decades. The examination uncovers the gradual de-emphasis of social justice as a core tenet of the community health center program in favor of messages about programmatic efficiency and cost savings for the larger healthcare system in response to challenging funding environments.

Danielle N. Gadson is professor in the Department of Public Administration at Villanova University and a part-time lecturer and DEI consultant in the Philadelphia metropolitan area.