When "Patient-Centered" is Not Enough: A Call for Community-Centered Medicine.

Before entering medicine, I was inspired by community organizing as a model for driving social change and improving public health. As a clinician, I remain inspired by this approach; however, I find that it has been more challenging to integrate into my day-to-day work than I expected. In this essay, I describe my journey from community organizer to primary care clinician and reflect on the lessons I've learned about the value of community organizing and ways that it can be incorporated into clinical practice. Ultimately, I propose a model for how clinicians and health centers can proactively partner with community organizing groups and facilitate referrals to help patients directly engage in transforming the root causes of their health challenges. This model shifts the focus from the patient as an individual agent of change to the community, and offers important lessons to clinicians interested in community health equity.

Responding to the Health Needs of Newly Arrived Families Within Fractured Policy Environments.

The increase in forcibly displaced populations seeking refuge in the United States has been met with fragmented, chaotic, and highly politicized responses to the detriment of migrants and receiving communities alike. Migrants encounter compounding systemic barriers to accessing basic resettlement resources. Expanding on pandemic-era innovations can strengthen social safety net infrastructure as a whole. Pediatricians are a potential early touchpoint for newly arrived families, providing an opportunity to support their specific health needs, refer to critical safety net services, and advocate for improved systems and policies. [Pediatr Ann. 2024;53(5):e161-e166.].

The ripple effects of deportations in Honduras.

Hondurans have been targeted for deportation since the 1980s, but today their deportations have grown disproportionate to their immigrant population size. They are more likely to face deportation than other targeted groups, such as Mexicans, Salvadorans and Guatemalans. Given Hondurans' singular position in the deportation system and the dearth of research about this group, we ask: What are the potential short- and long-term consequences of deportation for Honduran migrants, their families, and the broader community? To address this question, we utilize qualitative interviews with deportees, their families, and community members collected in Honduras in 2011 and 2014 as part of a multi-country research project our team conducted on the social impacts of deportations. While our findings in Honduras parallel those in other studies, we capture economic, social, and emotional effects beyond the individual deportees, including non-migrant family members and the broader community that receives them. Our longitudinal approach allows us to capture re-migration patterns as well.

The health implications of deportation policy.

The United States detains and deports over 400,000 people annually. This large-scale effort has important consequences for the health of affected individuals and communities. A growing body of research suggests that deportation increases stress and mental illness, economic deprivation, and individual exposure to violence, while also contributing to destabilization and crime at the community level. The challenges to reintegration experienced by deportees are additional push factors that increase their desire to re-emigrate. Furthermore, the related destabilization of local communities also contributes to the push, not just for deportees, but for all affected people in the region. This phenomenon has important implications for the long-term effectiveness of current U.S. deportation policies, which may be contributing to destabilization in home countries and thus potentiating further unauthorized emigration to the U.S.