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100917 Beyond the Limits 1

Beyond the Limits of Traditional Health Care: A State-Level Systematic Review of Community Health Programs in the United States

Sep 26, 2017

By Marlon GrafMariam Hakim and Ken Sagynbekov


Traditional health care has not reached all pockets of the U.S. population due to income inequality, increasing ethnic and cultural diversity, and deep fragmentation of the health care system. Community-based health models have evolved as alternative, individualized, and context-specific modes of care to bridge this gap. This study examines and compares community-based health programs across U.S. states and provides the following key findings:

  • California is the leader in community health with the highest number of community social service workers (CSW) and the most community health programs.
  • Rhode Island, Washington, Oregon, and Colorado are very successful at implementing community health initiatives and establishing financing structures that allow these programs to thrive.
  • Only seven states have green building and environment programs and only 15 states have community health initiatives focused on healthy food
  • Food insecurity is especially concentrated in Southern states
  • In states with majority-white populations, the CSW workforce is extremely limited. States with high racial heterogeneity and diversity have expansive CSW workforces.