Overcoming Institutional Barriers Faced by Community-Based Healthcare Institutions

  • Airín D. MartínezEmail author
Part of the International Perspectives on Social Policy, Administration, and Practice book series (IPSPAP)


Although community-based health institutions in the United States have a foundational history in grassroots advocacy and community autonomy, today they face multiple barriers in promoting their community’s values and addressing their community’s material, political, and health needs. The goals of this chapter are to identify the institutional barriers that community-based health institutions (CBHIs) in the United States face to promote health in their communities and to propose solutions to overcome these institutional barriers in order to return to CHC’s purpose of empowering local community members to eliminate health inequalities. I argue that one of the fundamental ways that U.S. community-based health institutions can overcome these barriers and foment the grassroots advocacy that shaped the community health center movement of the 1960s and 1970s, is if the United States implemented a single-payer universal healthcare system. Examining the effects of the implementation of Patient Protection and Affordable Care Act of 2010 on federally-qualified health centers, I will identify the institutional barriers that CBHIs face to deliver patient-centered care, empower marginalized populations, and circumvent constant fiscal threat. In response to each barrier, I propose recommendations which include legislative and regulatory recommendations, organizational changes, grassroots involvement, and finally, implementing a single-payer system.


Community-based healthcare Institutional barriers University healthcare Community-based model 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Massachusetts-Amherst, School of Public Health & Health SciencesAmherstUSA

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