July 2008

Meet Our Featured Guest Columnist:
Dr. Jack Geiger

is a founding member of Physicians for Social Responsibility and established the first community health centers in the United States.

Q: How did you first get involved in health and human rights issues?

A: I've been involved in civil rights and human rights for 65 years, since I first started as a teenager in 1942. That was in college in Madison, Wisconsin, and I ended up working with Bayard Rustin and A. Philip Randolph on the first planned march on Washington, which not many people know about, the threat of which produced FDR's executive order banning discrimination in defense plants. A year later, I was one of the people who started, I think, the second chapter in the country of the Congress of Racial Equality with Jim Farmer and it has just gone on in one way or another since then.

Q: How do community health centers help? 

A: One of the things that community health centers do by their existence and their work is to make a community feel reassured: comfortable that they have ready and immediate access to a quality source of primary care that's there, that's responsive, that knows them, that will be there continually, that has in most cases seen them in the past, and that is structured in ways that are responsive to their needs. That's an enormous difference from not knowing how you are going to get medical care for a sick child in an emergency.

Q: What are some of the successes you have seen?

A: There is a wide variety of community health centers. There are rural health centers, there are urban health centers, there are public housing project health centers, there are migrant health centers that stationed to catch the flow of migrant workers with the crops in a wide variety of parts of the country and there are school-based health centers. So to start with, there is a considerable variety of health centers meeting the needs of different populations in different areas.

Q: What are some of the challenges?

A: We have, there are plenty of problems left despite all the community health centers that we have and there is plenty of work still to do and there is still in this country growing inequity not just in health terms but in economic terms and so there is another two or three or four decades of work still to be done but we have made a beginning. We need health centers. We need social change in the circumstances that distribute illness so inequitably across the population. We need a commitment to reduce and eliminate poverty. We need a commitment that every one regardless of their means should have access to quality health care.

Q: How can young people make a difference?

A: We're not doing enough because we have 47 million people uninsured and there aren't enough community health centers to reach all of them, urban or rural in the first place. In the United States, there are not many people left drinking unclean water from the drainage ditch or without protected water systems, either wells or sewer systems and piped water. But there are some, and it is a responsibility of community health centers to fight, lobby together with the community for the kinds of clean water sanitary resources that they need, as well as adequacy of food stamps, adequacy of grocery store resources and the like that the population needs. In urban areas, community health centers are still involved in training teenagers from the population to do randomized home surveys for lead paint and lead dust, one of the greatest threats to the health of children in poor and minority urban communities in older housing, and to do the kinds of housing surveys that will pick up the dangerous environments in which some of our patients and some of the populations live. We look and we train our students in medical school now to look at the adequacy of recreational spaces, the adequacy of traffic patterns on the way to and from school, the same as we did way back in the beginning.