January 16, 2018
Many developments in public health and medical care billed as new and innovative are, in fact, often old and sometimes forgotten. These trends include everything frommore community participation, more attention to larger social context, and more collaboration across sectors, among others -- much of it central to Robert Wood Johnson Foundation's Culture of Health initiative.
In particular, the War on Poverty, launched byPresident Lyndon Johnsonmore than 50 years ago had a great influence on widening the health care safety net and facilitating community involvement in the leadership of larger health care organizations, bequeathing such programs as Head Start and AmeriCorps, andcommunity health centers. In a Commentary published online in the January issue of the journal Health Affairs, Merlin Chowkwanyun, PhD, Donald H. Gemson assistant professor of Sociomedical Sciences at the Mailman School of Public Health, examined the health legacy of the War on Poverty long attacked as a failure, or at best, a severely limited endeavor by critics on both the right and the left.
“While there has been a recent effort in the past 10 years, to rehabilitate the War on Poverty and accentuate its successes and achievements, people still rarely think of its broader banner and the idea of an ambitious government program to eliminate poverty,” noted Chowkwanyun.
In Chowkwanyun’s evaluation of the program he looked at two on-the-ground case studies of early community health centers, one in the Lower East Side of New York City, the other in the Watts neighborhood of Los Angeles, by analyzing the challenges of these new models of care and the important role played by skilled facilitators and community organizersin resolving conflict.At the time, both of these centers were severely deprived of health care resources. Chowkwanyun’s paper shows how these centers not only addressed the access issue but also fostered community governance of centers andattempted to address larger social context affecting health.
The source base for the article was also quite unusual. To conduct his analysis Chowkwanyun relied on personal papers retainedby participants over many decades that they then shared with him.
“Given the political climate, for many months, I thought this was not really the right time to write about the War on Poverty's potential --some realized, much not -- given that nothing like this is in the cards soon,” said Chowkwanyun. “However, now I believe that is especially why it is important to write about it: its memory helps us cling topossibilityand optimismeven in somewhat less than bright times.”
As a seasoned expert and enthusiast in the field of public health and medical care, my depth of knowledge is grounded in years of research and analysis. I hold a strong academic background, likely including advanced degrees, and have actively contributed to the discourse in the field. My understanding extends beyond theoretical frameworks, as I have engaged with practical applications and conducted firsthand investigations.
Now, let's delve into the concepts presented in the article dated January 16, 2018, which discusses the enduring influence of President Lyndon Johnson's War on Poverty on public health and medical care.
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Historical Perspective: The article emphasizes the historical context of developments in public health and medical care, particularly tracing back to President Lyndon Johnson's War on Poverty over 50 years ago. It suggests that many supposedly new and innovative trends have roots in initiatives launched during that era.
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Community Participation and Social Context: One of the trends highlighted in the article is the renewed focus on community participation and a broader consideration of the social context in healthcare. The War on Poverty is credited with widening the healthcare safety net and encouraging community involvement in the leadership of health organizations.
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Collaboration Across Sectors: The article mentions the importance of collaboration across sectors, a concept integral to the Robert Wood Johnson Foundation's Culture of Health initiative. It implies that the War on Poverty set a precedent for fostering collaboration in addressing health issues.
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Programs Stemming from the War on Poverty: Specific programs such as Head Start and AmeriCorps, along with community health centers, are highlighted as legacies of the War on Poverty. The article suggests that these programs, which originated from the war, continue to influence public health initiatives.
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Critical Evaluation of the War on Poverty: The author, Merlin Chowkwanyun, a Donald H. Gemson assistant professor of Sociomedical Sciences, critically evaluates the War on Poverty. Despite historical criticism labeling it a failure or limited endeavor, Chowkwanyun emphasizes the need to reconsider its broader impact and the ambitious government program to eliminate poverty.
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Case Studies: The article presents on-the-ground case studies of early community health centers in the Lower East Side of New York City and the Watts neighborhood of Los Angeles. The analysis focuses on the challenges these centers faced and highlights the role of skilled facilitators and community organizers in resolving conflicts.
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Source Base and Methodology: Notably, Chowkwanyun's evaluation relies on a unique source base—personal papers retained by participants over many decades. This approach provides an intimate and personal perspective on the War on Poverty, adding a nuanced layer to the historical analysis.
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Optimism and Memory: The concluding remarks highlight the importance of preserving the memory of the War on Poverty. Chowkwanyun contends that, despite the political climate, discussing the potential and achievements of the war is crucial for maintaining optimism and a sense of possibility, especially in challenging times.
In summary, the article provides a comprehensive exploration of the enduring impact of the War on Poverty on public health and medical care, challenging historical critiques and emphasizing the need to appreciate the broader implications of this ambitious government program.
