Black America: from community health care to crisis medicine.

Abstract

This study traces the major policy shifts in medical care that have affected disadvantaged African-Americans and the response of this community's medical leadership to these changes. Since World War II policy has passed through three major phases. The first--engagement--ran from the mid-1960s through the mid-1970s. During this phase a community health policy orientation prevailed as national government targeted resources to health care programs for needy blacks and other poor Americans. From the late 1970s to the mid-1980s the period of submersion occurred: black community health professionals and political leaders experienced a new-found inclusion in health policy debate, but, at the same time, broader policy-making circles in government and health care reduced medical resources for the inner-city poor. Finally, in the third phase--crisis recognition--a network developed of community health advocates who seek to reorient the health system so that it addresses needs within urban American's "New Ghettos."