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Health Status of a Low-income Vulnerable Population in a Community Health Center

Cashman, Suzanne ScD; Savageau, Judith MPH; McMullen, Maureen DNSc, RNC; Kinney, Rebecca MPH; Lemay, Celeste RN, BSN; Anthes, Frances MSW


Healthcare safety net providers are under increasing pressure to meet the physical and mental health—as well as the range of social service—needs of traditionally vulnerable and hard-to-reach populations. The extent to which health center patients are less well and in poorer health than is the rest of society, thus requiring greater depth and breadth of service, has not generally been the focus of systematic assessment. This case study uses the 12-Item Short-Form Health Survey (SF-12) and selected years of healthy life questions from the National Health Interview Survey to assess the self-perceived health status of patients at one Section 330 community health center in central Massachusetts. Five hundred thirteen patients completed all questions on the SF-12; 619 completed each of the years of healthy life questions. Respondents' physical and mental component summary scores were significantly lower than national norms for all age groups (P < .001). Respondents were also significantly more likely than the civilian noninstitutionalized population to be unable to perform major activities (P < .0001) and to be in fair or poor health (P < .0001). Analyses give an indication of the magnitude of difference in self-perceived health status between this poor, vulnerable population and the citizenry at large and suggest implications for policy related to safety net healthcare facilities.

Department of Family Medicine and Community Health (Dr Cashman and Ms Savageau), Office of Community Programs (Dr Cashman and Mss Kinney and Lemay), and Graduate School of Nursing (Dr McMullen), University of Massachusetts Medical School, Worcester, Mass; and the Family Health Center of Worcester (Ms Anthes), Worcester, Mass.

Corresponding author and reprints: Suzanne Cashman, ScD, Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA 01655 (e-mail:

The authors acknowledge the important contributions of the following persons in the development and conduct of this research project: Annette Hanson, MD, MBA; Kenneth Fletcher, PhD; Ellen Long-Middleton, PhD, RN; Patricia Reidy, RN, NP; and staff of the community health center. This work was made possible through an Interagency Service Agreement between the Massachusetts Division of Medical Assistance and the University of Massachusetts Medical School. The contents of the article are the sole responsibility of the authors and do not necessarily represent the official views of these organizations.

© 2005 Lippincott Williams & Wilkins, Inc.