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Abstract

In the 1960's, working class communities all over the country, particularly minority inner city neighborhoods, exploded in violent anger. The federal government responded with a pacification or cooling-out program: the War on Poverty. The War on Poverty provided federal funds to bring a few programs into the community, to create a few jobs, and to buy off working class leaders who were a threat to those in power. In the course of this program of counterinsurgency, the War on Poverty took over a slogan of the 1960's, "community control," and turned it into its opposite; rather than control by the community, "community control" came to mean control over the working class majority of the community. One of the War on Poverty's important programs was the neighborhood health center program to provide ambulatory health care to low income people. This program, initially slated to reach 25 million people through 1,000 health centers, was scaled down to 125 centers serving only 1.5 million people. The standard view of the neighborhood health center program holds that its aims were 1) to bring high quality health care to people previously denied such care, 2) to provide employment opportunities and training to neighborhood residents, and 3) to allow community members to participate in the governance of the health centers (Davis and Schoen, 1978). A more realistic view sees the neighborhood health center program as a means to control, rather than to assist, minority working class populations. This paper takes the example of one neighborhood health center, Mission Neighborhood Health Center in San Francisco, to show how federal counterinsurgency works in the 1970's and to expose the class character of "community control."

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