Health Centers after Fifty Years: Lessons from the Health Disparities Collaboratives

The fertile social movements of the 1960s in the United States gave birth to the community health center model. During the past 50 years, health centers have emerged as a national primary care institution serving over 20 million of the nation's most vulnerable people. Founded on the shared health center mission and commitment to collective action, the Health Disparities Collaboratives (HDC) provided a cultural and social milieu for accelerated learning as well as a homegrown system and infrastructure for collaborative learning and improvement. Although the HDC only existed during the years from 1999-2006, they generated positive health outcomes and strengthened the capacity of health centers for quality improvement. After a description of the history and the characteristics of the HDC, six recommendations are presented for the re-design and implementation of a second-generation health center learning and improvement system.