The Neighborhood Health Center — Reform Ideas of Yesterday and Today

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Abstract
The early health centers of the 1900's were meant to solve special out-of-hospital health problems of the poor, chiefly infectious disease and infant malnutrition. Preventive measures consisted of immunization and infant feeding. The organizational ideas of centers, district location, community participation, bureaucratic organization and centralization of community health and social services were derived from democratic, religious and industrial ideas common to the era of progressive reform. In actual practice some of the organizational goals were contradictory. For example, whereas such a goal as community participation was important to bring services close to people, simultaneous pressures for efficiency in bureaucratic organization often conflicted. The new health centers, whether traditional or organized as private group practice, have a different and more complex set of health problems requiring social rehabilitation through personal health services. Although new definitions are being applied to the older organizational ideas, contradictions in dealing with modern problems are also being encountered.

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