Category: English

Source: The Conversation – USA (2) – By Farah Nibbs, Assistant Professor of Emergency and Disaster Health Systems, University of Maryland, Baltimore County

Headlines have been filled with talk of the catastrophic power of Hurricane Melissa after the Category 5 storm devastated communities across Jamaica, Cuba and Haiti in October 2025. But to see this as a singular disaster misses the bigger picture: Melissa didn’t hit stable, resilient islands. It hit islands still rebuilding from the last hurricane.

Jamaica was still recovering from Hurricane Beryl, which sideswiped the island in July 2024 as a Category 4 storm. The parish of St. Elizabeth – known as Jamaica’s breadbasket – was devastated. The country’s Rural Agriculture Development Authority estimated that 45,000 farmers were affected by Beryl, with damage estimated at US$15.9 million.

In Cuba, the power grid collapsed during Hurricane Oscar in October 2024, leaving 10 million people in darkness. When Melissa arrived, it struck the same fragile infrastructure that Cubans had barely begun to rebuild.

Haiti’s fragile situation before Hurricane Melissa cannot be overstated. The island nation was still reeling from years of cascading disasters – deadly hurricanes, political instability, gang violence, an ongoing cholera crisis and widespread hunger – with over half the population already in need of humanitarian assistance even before this storm hit.

This is the new reality of the climate crisis: Disasters hitting the Caribbean are no longer sequential. They are compounding and can trigger infrastructure collapse, social erosion and economic debt spirals.

The compounding disaster trap

I study disasters, with a focus on how Caribbean island systems absorb, adapt to and recover from recurring shocks, like the nations hit by Melissa are now experiencing.

It’s not just that hurricanes are more frequent; it’s that the time between major storms is now shorter than the time required for a full recovery. This pulls islands into a trap that works through three self-reinforcing loops:

Infrastructure collapse: When a major hurricane hits an already weakened system, it causes simultaneous infrastructure collapses. The failure of one system – such as power – cascades, taking down water pumps, communications and hospitals all at once. We saw this in Grenada after Hurricane Beryl and in Dominica after Hurricane Maria. This kind of cascading damage is now the baseline expectation for the Caribbean.

Economic debt spiral: When countries exhaust their economic reserves on one recovery, borrow to rebuild and are then hit again while still paying off that debt, it becomes a vicious cycle.

Hurricane Ivan, which struck the region in 2004, cost Grenada over 200% of its gross domestic product; Maria, in 2017, cost Dominica 224% of its GDP; and Dorian, in 2019, cost the Bahamas 25% of GDP. With each storm, debt balloons, credit ratings drop and borrowing for the next disaster becomes more expensive.

Social erosion: Each cycle weakens the human infrastructure, too. More than 200,000 people left Puerto Rico for the U.S. mainland in Maria’s aftermath, and nearly one-quarter of Dominica’s population left after the same storm. Community networks fragment as people leave, and psychological trauma becomes layered as each new storm reopens the wounds of the last. The very social fabric needed to manage recovery is itself being torn.

The trap is that all three of these loops reinforce each other. A country can’t rebuild infrastructure without money. It can’t generate economic activity without infrastructure. And it can’t retain the skilled workforce needed for either when people are fleeing to safer places.

Rebuilding a system of overlapping recoveries

The Caribbean is not merely recovering from disasters – it is living within a system of overlapping recoveries, meaning that its communities must begin rebuilding again before fully recovering from the last crisis.

Each new attempt at rebuilding happens on the unstable physical, social and institutional foundations left by the last disaster.

The question isn’t whether Jamaica will attempt to rebuild following Melissa. It will, somehow. The question is, what happens when the next major storm arrives before that recovery is complete? And the one after that?

Without fundamentally restructuring how we think about recovery – moving from crisis response to continuous adaptation – island nations will remain trapped in this loop.

The way forward

The compounding disaster trap persists because recovery models are broken. They apply one-size-fits-all solutions to crises unfolding across multiple layers of society, from households to national economies, to global finance.

Breaking free requires adaptive recovery at all levels, from household to global. Think of recovery as an ecosystem: You can’t fix one part and expect the whole to heal.

At the household level: Helping amid trauma

Recovery isn’t just about repairing a damaged roof. When families experience back-to-back disasters, trauma compounds. Direct cash assistance and long-term, community-based mental health services can help restore dignity.

Cash transfers allow families to address their own needs, stimulate local economies and restore control to people whose lives have been repeatedly upended.

At community level: Mending the social fabric

Repairing the “social fabric” means investing in farmer cooperatives, neighborhood associations and faith groups – networks that can lead recovery from the ground up.

Local networks are often the only ones capable of rebuilding trust and participation.

At the infrastructure level: Breaking the cycle

The pattern of rebuilding the same vulnerable roads or power lines only to see them wash away in the next storm fails the community and the nation. There are better, proven solutions that prepare communities to weather the next storm:

• Decentralized power grids with renewable energy sources can operate independently when the main grid fails.

• Natural infrastructure such as restored mangroves and wetlands provide natural storm barriers.

• Strong enforcement of modern building codes can require structures to withstand Category 4 and above winds.

At the global level: Fixing the debt trap

None of this is possible if recovery remains tied to high-interest loans. There are ways for internal financial institutions and global development lenders to allow for breathing room between disasters:

• Hurricane clauses in bond agreements can automatically pause all debt payments when disasters strike. These clauses allow governments to automatically suspend debt service payments to bondholders for up to two years when a qualifying disaster strikes. After Beryl, Grenada became the first government to activate a hurricane clause with private creditors.

• Comprehensive debt-for-climate swaps involve reducing existing debt – owed to private banks, institutional investors, countries or multilateral banks – in exchange for the debtor country committing funds to climate adaptation or resilience projects.

• Pre-positioned climate finance is money made available through dedicated international climate funds, such as the Green Climate Fund and Loss and Damage Fund, or parametric insurance mechanisms. It pays out before storms hit, not months later, so countries are ready to respond to the damage.

The current international disaster finance system, controlled by global lenders and donors, requires countries to prove their losses after a disaster in order to access assistance, often resulting in months of delay. “Proof” is established by formal evaluations or inspections, such as by the United Nations, and aid is released only after meeting certain requirements. This process can stall recovery at the moment when aid is needed the most.

The bottom line

The Caribbean needs a system that provides support before disasters strike, with agreed-upon funding commitments and regional risk-pooling mechanisms that can avoid the delays and bureaucratic burden that slow recovery.

What’s happening in Jamaica, Cuba and Haiti today is a glimpse of what’s coming for coastal and island communities worldwide as climate change accelerates. In my view, we can either learn from the Caribbean’s experiences and redesign disaster recovery now or wait until the trap closes around everyone.

Farah Nibbs does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. No time to recover: Hurricane Melissa and the Caribbean’s compounding disaster trap – https://theconversation.com/no-time-to-recover-hurricane-melissa-and-the-caribbeans-compounding-disaster-trap-268641

Source: The Conversation – USA – By Adrian Bardon, Professor of Philosophy, Wake Forest University

“Time flies,” “time waits for no one,” “as time goes on”: The way we speak about time tends to strongly imply that the passage of time is some sort of real process that happens out there in the world. We inhabit the present moment and move through time, even as events come and go, fading into the past.

But go ahead and try to actually verbalize just what is meant by the flow or passage of time. A flow of what? Rivers flow because water is in motion. What does it mean to say that time flows?

Events are more like happenings than things, yet we talk as though they have ever-changing locations in the future, present or past. But if some events are future, and moving toward you, and some past, moving away, then where are they? The future and past don’t seem to have any physical location.

Human beings have been thinking about time for as long as we have records of humans thinking about anything at all. The concept of time inescapably permeates every single thought you have about yourself and the world around you. That’s why, as a philosopher, philosophical and scientific developments in our understanding of time have always seemed especially important to me.

Ancient philosophers on time

Ancient philosophers were very suspicious about the whole idea of time and change. Parmenides of Elea was a Greek philosopher of the sixth to fifth centuries BCE. Parmenides wondered, if the future is not yet and the past is not anymore, how could events pass from future to present to past?

He reasoned that, if the future is real, then it is real now; and, if what is real now is only what is present, the future is not real. So, if the future is not real, then the occurrence of any present event is a case of something inexplicably coming from nothing.

Parmenides wasn’t the only skeptic about time. Similar reasoning regarding contradictions inherent in the way we talk about time appears in Aristotle, in the ancient Hindu school known as the Advaita Vedanta and in the work of Augustine of Hippo, also known as St. Augustine, just to name a few.

Einstein and relativity

The early modern physicist Isaac Newton had presumed an unperceived yet real flow of time. To Newton, time is a dynamic physical phenomenon that exists in the background, a regular, ticking universe-clock in terms of which one can objectively describe all motions and accelerations.

Then, Albert Einstein came along.

In 1905 and 1915, Einstein proposed his special and general theories of relativity, respectively. These theories validated all those long-running suspicions about the very concept of time and change.

Relativity rejects Newton’s notion about time as a universal physical phenomenon.

By Einstein’s era, researchers had shown that the speed of light is a constant, regardless of the velocity of the source. To take this fact seriously, he argued, is to take all object velocities to be relative.

Nothing is ever really at rest or really in motion; it all depends on your “frame of reference.” A frame of reference determines the spatial and temporal coordinates a given observer will assign to objects and events, on the assumption that he or she is at rest relative to everything else.

Someone floating in space sees a spaceship going by to the right. But the universe itself is completely neutral on whether the observer is at rest and the ship is moving to the right, or if the ship is at rest with the observer moving to the left.

This notion affects our understanding of what clocks actually do. Because the speed of light is a constant, two observers moving relative to each other will assign different times to different events.

In a famous example, two equidistant lightning strikes occur simultaneously for an observer at a train station who can see both at once. An observer on the train, moving toward one lightning strike and away from the other, will assign different times to the strikes. This is because one observer is moving away from the light coming from one strike and toward the light coming from the other. The other observer is stationary relative to the lightning strikes, so the respective light from each reaches him at the same time. Neither is right or wrong.

How much time elapses between events, and what time something happens, depends on the observer’s frame of reference. Observers moving relative to each other will, at any given moment, disagree on what events are happening now; events that are happening now according to one observer’s reckoning at any given moment will lie in the future for another observer, and so on.

Under relativity, all times are equally real. Everything that has ever happened or ever will happen is happening now for a hypothetical observer. There are no events that are either merely potential or a mere memory. There is no single, absolute, universal present, and thus there is no flow of time as events supposedly “become” present.

Change just means that the situation is different at different times. At any moment, I remember certain things. At later moments, I remember more. That’s all there is to the passage of time. This doctrine, widely accepted today among both physicists and philosophers, is known as “eternalism”.

This brings us to a pivotal question: If there is no such thing as the passage of time, why does everyone seem to think that there is?

Time as a psychological projection

One common option has been to suggest that the passage of time is an “illusion” – exactly as Einstein famously described it at one point.

Calling the passage of time “illusory” misleadingly suggests that our belief in the passage of time is a result of misperception, as though it were some sort of optical illusion. But I think it’s more accurate to think of this belief as resulting from misconception.

As I propose in my book “A Brief History of the Philosophy of Time,” our sense of the passage of time is an example of psychological projection – a type of cognitive error that involves misconceiving the nature of your own experience.

The classic example is color. A red rose is not really red, per se. Rather, the rose reflects light at a certain wavelength, and a visual experience of this wavelength may give rise to a feeling of redness. My point is that the rose is neither really red nor does it convey the illusion of redness.

The red visual experience is just a matter of how we process objectively true facts about the rose. It’s not a mistake to identify a rose by its redness; the rose enthusiast isn’t making a deep claim about the nature of color itself.

Similarly, my research suggests that the passage of time is neither real nor an illusion: It’s a projection based on how people make sense of the world. I can’t really describe the world without the passage of time any more than I can describe my visual experience of the world without referencing the color of objects.

I can say that my GPS “thinks” I took a wrong turn without really committing myself to my GPS being a conscious, thinking being. My GPS has no mind, and thus no mental map of the world, yet I am not wrong in understanding its output as a valid representation of my location and my destination.

Similarly, even though physics leaves no room for the dynamic passage of time, time is effectively dynamic to me as far as my experience of the world is concerned.

The passage of time is inextricably bound up with how humans represent our own experiences. Our picture of the world is inseparable from the conditions under which we, as perceivers and thinkers, experience and understand the world. Any description of reality we come up with will unavoidably be infused with our perspective. The error lies in confusing our perspective on reality with reality itself.

Adrian Bardon does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. What is time? Rather than something that ‘flows,’ a philosopher suggests time is a psychological projection – https://theconversation.com/what-is-time-rather-than-something-that-flows-a-philosopher-suggests-time-is-a-psychological-projection-266634

Source: The Conversation – USA – By Adam G. Klein, Associate Professor of Communication and Media Studies, Pace University

When the NFL in September 2025 announced that Bad Bunny would headline the next Super Bowl halftime show, it took only hours for the political outrage machine to roar to life.

The Puerto Rican performer, known for mixing pop stardom with outspoken politics, was swiftly recast by conservative influencers as the latest symbol of America’s “woke” decline.

Homeland Security Secretary Kristi Noem joined the critics on conservative commentator Benny Johnson’s podcast.

“Well, they suck, and we’ll win,” she said, speaking of the NFL’s choice. “And they’re so weak, we’ll fix it.”

President Donald Trump called Bad Bunny’s selection “absolutely ridiculous” on the right-wing media outlet Newsmax. And far-right radio host and prominent conspiracy theorist Alex Jones fanned the flames of anti-NFL sentiment online. Hashtags like #BoycottBadBunny spread on the social platform X, where the performer was branded a “demonic Marxist” by right-wing influencers.

Then it was Bad Bunny’s turn. Hosting “Saturday Night Live,” he embraced the controversy, defending his heritage and answering his critics in Spanish before declaring, “If you didn’t understand what I just said, you have four months to learn.”

By the time NFL Commissioner Roger Goodell addressed the backlash, the outrage had already served its purpose. The story had become another front in the culture war between left and right, complete with nationalism, identity politics, media spectacle and performative anger.

As a researcher of propaganda, I’ve spent the past three years tracking these cycles of outrage across social platforms and partisan media, studying how they hijack the national conversation and spill into local politics. My recent book, ““Populism, Propaganda, and Political Extremism,” is guided by a single question: How much of our political outrage is really our own?

Outrage before the event

Culture wars have long shaped American politics, from battles over gun rights to disputes over prayer in schools, book bans and historical monuments.

Sociologist James Davison Hunter coined the term “culture wars” to describe a recurring struggle, not just over social issues but over “the meaning of America.” These battles once arose from spontaneous events that struck a cultural nerve. An American flag is set ablaze, and citizens quickly take sides as the political world responds in kind.

But today that order has reversed. Culture wars now begin in the political sector, where professional partisans introduce them into the public discourse, then watch them take hold. They’re marketed to media audiences as storylines, designed to spark outrage and turn disengaged voters into angry ones.

One clear sign that outrage is being manufactured is when the backlash begins long before the designated “controversial event” even occurs.

In 2022, American audiences were urged by conservative influencers to condemn Pixar’s film “Lightyear” months before it reached theaters. A same-sex kiss turned the film into a vessel for accusations of Hollywood’s “culture agenda.” Driven by partisan efforts, the outrage spread online, mixing with darker elements and eventually culminating in neo-Nazi protests outside Disney World.

This primed outrage appears across the political spectrum.

Last spring, when President Donald Trump announced a military parade in Washington, leading Democrats quickly framed it as an unmistakable show of authoritarianism. By the time the parade arrived months later, it was met with dueling “No Kings” demonstrations across the country.

And when HBO host Bill Maher said in March that he would be dining with Trump, the comedian faced a preemptive backlash, which escalated into vocal criticism from the political left before either of the men raised a fork.

Today, few things are marketed as aggressively as political anger, as seen in the recent firestorm against Bad Bunny. It’s promoted daily through podcasts, hashtags, memes and merchandise.

Increasingly, these fiery narratives originate not in politics but in popular culture, providing an enticing hook for stories about the left’s control over culture or the right’s claims to real America.

In recent months alone, outrage among America’s polarized political bases has flared over a Cracker Barrel logo change, “woke Superman,” Sydney Sweeney’s American Eagle ad and, with Bad Bunny, the NFL’s Super Bowl performer.

Platforms like X and TikTok deliver the next diatribes, amplified by partisan influencers and spread by algorithms. From there, they become national stories, often marked by headlines promising the latest “liberal meltdown” or “MAGA tantrum.”

But manufactured outrage doesn’t stop at the national level. It surfaces in local politics, where these stories play out in protests and town halls.

The local echo

I wanted to understand how these narratives reach communities and how politically active citizens see themselves within this cycle. Over the past year, I interviewed liberal and conservative activists, beginning in my hometown, where opposing protesters have faced off every Saturday for two decades.

Their signs echo the same narratives that dominate national politics: warnings about the left’s “woke agenda” and charges of “Trump fascism.” When asked about the opposition, protesters reached for familiar caricatures. Conservatives often described the left as “radical” and “socialist,” while those on the left saw the right as “cultlike” and “extremist.”

Yet beneath the anger, both sides recognized something larger at play – the sense that outrage itself is being engineered. “The media constantly fan the flames of division for more views,” one protester said. Across the street, his counterpart agreed: “Politics is being pushed into previously nonpolitical areas.”

Both camps pointed to the media as the primary culprit, the force that “causes and benefits from the outrage.” A liberal activist observed, “Media tend to focus on whoever shouts the loudest.” A conservative demonstrator agreed: “I feel like the media promotes extreme idealists. The loudest voice gets the most coverage.”

“It’s been a crazy few years, moving further to the extremes, and tensions are always rising,” one protester reflected. “But I think people are realizing that now.”

Across the divide, protesters understood that they were participants in something larger than their weekly standoffs, a system that converts every political difference into a national spectacle. They saw it, resented it and yet couldn’t escape it.

That brings us back to Bad Bunny. The anger that Americans are encouraged to feel over his selection – or in defense of it – keeps the country locked in its corners. Studies show that as a result of these cycles, Americans on the left and right have developed an exaggerated sense of the other side’s hostility, exactly as some political demagogues intend.

It has created a split screen of the country, literally in the case of Bad Bunny. On Super Bowl night, there will be dueling halftime shows. On one screen, Bad Bunny will perform for approving viewers. On the other, the conservative nonprofit Turning Point USA will host its “All-American Halftime Show” for those intent on tuning Bad Bunny out.

Two screens. Two Americas.

Adam G. Klein does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Bad Bunny is the latest product of political rage — how pop culture became the front line of American politics – https://theconversation.com/bad-bunny-is-the-latest-product-of-political-rage-how-pop-culture-became-the-front-line-of-american-politics-269063

Source: The Conversation – USA (2) – By Robert Mitchell, Associate Professor, College of Education, University of Colorado Colorado Springs

Leaders of Colorado’s rural schools are more likely to encourage a total stranger to go into teaching than a member of their own family, according to a Colorado-based survey published in October 2025.

The results come at a time when nearly every state in the United States faces critical teacher shortages.

We collected data in the fall of 2023 with the goal of describing the perceived strengths and limitations of rural schools in Colorado as understood by the people leading them. We sent an electronic survey to the 146 rural school principals and superintendents in the state, received 100 responses and analyzed 98.

Nearly every respondent mentioned issues related to the declining number of people who want to teach, which also reflects national trends. The number of individuals completing educator preparation programs annually in the United States has declined by more than 200,000 since its high point from 2008 to 2021.

When pressed for additional detail about the primary problems affecting their local schools and districts, more than 85% of respondents identified recruiting and retaining talented teachers as one of the most important issues. This was closely followed by concerns about supporting underprepared and underperforming students and poverty’s effect on student learning.

The Colorado context

In Colorado, more than 80% of school districts are rural. They serve more than 130,000 students.

For the past decade, I have worked closely with Colorado’s rural school districts. I also worked as an administrator with the Colorado Department of Higher Education from 2013-2016. These positions have taught me a great deal about the challenges facing smaller schools throughout the state – both in Colorado’s agricultural areas and in the resort regions. Issues related to small budgets, student safety and community poverty are common challenges to schools throughout the state.

As a faculty member at the University of Colorado Colorado Springs, I routinely spend extended time at several of these small schools – even serving as a fill-in classroom teacher and principal when needed.

Colorado’s remote and rural schools remain difficult to staff. The salaries offered by these schools are consistently below state averages. Some rural districts have average salaries of $33,000. That’s far below the state average teacher’s salary of $65,838.

In addition, the challenges of living in towns that may not have a grocery store or any entertainment options is less appealing to many teachers. That’s especially true for newly certified teachers right out of college.

Multiple challenges, with a few bright spots

Our survey shows some deep concerns from the state’s rural education leaders. Only 2% of rural Colorado education leaders believe their district was very effective in working with English language learners and students who are performing below grade level. More than 13% of Colorado’s English language learners are attending school in rural areas, equating to more than 15,000 students. When working with LGBTQA+ students, only 3% believed their district was very effective in supporting these students.

In contrast, nearly 60% of school leaders think their district is either effective or very effective in supporting students performing above grade level. Half of these rural educators see their work with supporting homeless or foster students as effective or very effective.

While nearly half of respondents do not have positive feelings about the current state of education in the U.S., 76% are excited about the future of their individual school districts.

Only about 14% believe that schools today are better than at any other time, and nearly 60% reported that they believe American public schools can be fixed only with major changes.

How to fix rural school challenges

The school leaders we surveyed are very concerned about the realities associated with finding and keeping qualified teachers in their schools.

We asked respondents to rank a series of commonly stated solutions related to teachers shortages. The options ranked highest included higher wages for teachers, more respect for the teaching profession, lowering barriers that allow people to become teachers and better benefits.

Wealth of experience, depth of doubt

Despite some bright spots, rural school and district leaders in Colorado are not enthusiastic about the future of American education overall.

Many school districts consistently have unfilled positions. Some have resorted to filling vacant classroom positions by hiring retired teachers or long-term substitutes. With fewer educators per school, teacher effectiveness is reduced, reducing overall student learning.

The results of our study are exceptionally notable to me and my research team because most of the respondents in this study have 15 or more years of K-12 education experience and more than six years of experience as a rural school leader. Going into the project, we thought these dedicated educators would be more positive about the current and future state of American schools. Yet, this does not seem to be the case.

If these leaders are not optimistic, it is difficult to believe that parents or other members of rural communities would feel any differently.

Robert Mitchell does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Colorado’s rural schools serve more than 130,000 students, and their superintendents want more pay for their teachers – https://theconversation.com/colorados-rural-schools-serve-more-than-130-000-students-and-their-superintendents-want-more-pay-for-their-teachers-268332

Source: The Conversation – USA (3) – By Jennifer Spinghart, Clinical Assistant Professor of Biomedical Sciences, University of South Carolina

Affordable health care was the primary point of contention in the longest government shutdown in U.S. history, which hit 43 days on Nov. 12, 2025.

This fight highlights a persistent concern for Americans despite passage of the landmark Affordable Care Act 15 years ago.

In 2024, 27.2 million Americans, or 8.2% of the population, lacked health insurance entirely. A significant number of Americans have trouble affording health care, even if they do have insurance. The tax and spending package signed by President Donald Trump into law in July 2025 puts a further 16 million Americans at risk of losing their health care insurance by 2034, according to the Congressional Budget Office.

Many people who lack or have insufficient health insurance seek health care from a network of safety net clinics called community health centers. Even though community health centers provide care for 1 in 10 people in the U.S. – and 1 in 5 in rural areas – many people are unaware of their role in the country’s medical system.

As an emergency physician and the director of the student-led community health program at the University of South Carolina School of Medicine in Greenville, I collaborate with the community health center in Greenville and am closely familiar with how these types of providers function.

These clinics often operate on razor-thin margins and already function under continual demands to do more with less. Slated cuts to health care spending from the tax and spending bill and funding uncertainties that were driven by the shutdown threaten to destabilize them further.

What are community health centers?

Community health centers are clinics typically located in low-income areas that provide affordable health care to everyone, regardless of their ability to pay. Their history is rooted in the Civil Rights Movement.

In 1964, as activists traveled through the South to register Black voters, a group of doctors, nurses and social workers that called themselves the Medical Committee for Human Rights formed to provide emergency first aid and to support civil rights workers, volunteers and the local communities they engaged with.

Witnessing how intimately poor health in some of these communities was tied to living in conditions of extreme poverty, the group embraced the mission of providing health care as a way to fight the injustice of racism. Their idea was that treating illnesses and chronic conditions that stemmed from poverty would enable people to rise out of poverty and shape their own destiny.

The original community health centers were called Neighborhood Health Centers, and the first two – one in Boston and the other in Mississippi – opened in 1966. They were funded as part of President Lyndon B. Johnson’s War on Poverty, which introduced legislation that launched safety net programs, including Medicare and Medicaid, designed to support Americans experiencing economic hardships.

Community health centers quickly multiplied over the following decades and became a cornerstone of the U.S. health care system. These health centers took a broad approach to patient care, focusing on preventive nutrition and health education. They also sought to help with challenges that weren’t strictly medical but also affect people’s health, such as language barriers, lack of transportation and housing insecurity.

Different types of community health centers

Most community health centers receive the majority of their funding from the federal government. These clinics, called Federally Qualified Health Centers, must fulfill some specific requirements.

For one thing, they must be strategically located to be accessible to people in low-income communities with fewer available medical professionals. They must also minimize other barriers to care – for example, by providing language interpreters and offering telehealth services if appropriate. Additionally, they must be governed by a board in which at least 51% of the members are people who live in the local community.

In 2023, such clinics received over US$5.6 billion in federal funding. In addition to direct federal government support, they often rely on reimbursements from Medicaid to cover their costs. Some also receive state funding and private funding, as well as money from private insurance of the few patients who do carry it.

People who lack Medicaid or private insurance, or who are underinsured, receive care at no cost if their income is below 200% of the poverty level, and on a sliding scale otherwise.

Another type of community health center is often referred to as a “free clinic” or a “look-alike” clinic. These clinics typically rely on private grant funding or charitable donations. They are usually run by volunteers, and they often operate on limited schedules and have limited access to specialists.

In 2024, there were more than 1,500 federally funded health clinics providing services in over 17,000 different locations and more than 775 documented free or charitable clinics across the U.S. Together, these two types of community health centers provide free care to over 30 million people.

The community health project that I direct, called Root Cause, falls into a third category of free safety net health care generally referred to as “pop-up” or makeshift medical clinics. These projects vary widely, but Root Cause, which is run by medical students, operates as a monthly health fair that provides simple screenings for high blood pressure and diabetes as well as education on preventive care and healthy lifestyles.

Pop-up projects like ours are more precarious than other types of community health centers, but through grants and partnerships with organizations in Greenville, we have managed to keep this program funded for eight years.

Compounding stressors

Community health centers are extremely cost-effective, providing primary care to more than 10% of the U.S. population at the cost of just 1% of the country’s total health care spending. But with health care costs rising and Medicaid and insurance reimbursements failing to keep up, community health centers are increasingly being asked to do more with less.

The 2025 government shutdown added further uncertainty to community health centers’ operations. Although government funding and reimbursements through Medicare and Medicaid continued, having fewer government workers to complete the administrative tasks that these clinics rely on slowed their access to funds.

In the long term, cuts to Medicaid of up to $1 trillion included in the government’s tax and spending package are likely to decrease community health centers’ funding by limiting Medicaid reimbursements.

Simultaneously, those cuts and other policy changes, such as new work requirements for Medicaid, are likely to strip millions of Americans of health coverage – pushing more people to seek free or low-cost care. Cuts to Supplemental Nutrition Assistance Program benefits would increase food insecurity as well as stress – both factors that directly affect health – and thus may have the same effect.

Given that community health centers provide a kind of long-term stopgap for health care in high-need areas, decreasing their capacity could destabilize other elements of local health care delivery systems. For example, uninsured people who can’t access care at community health centers may turn to already overburdened hospital emergency rooms, which are required by law to treat them.

As funding cuts imperil health care access, the need for safety net health care only grows. These opposing forces may be putting an untenable strain on a vital service so many Americans rely on.

Jennifer Spinghart does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Community health centers provide care for 1 in 10 Americans, but funding cuts threaten their survival – https://theconversation.com/community-health-centers-provide-care-for-1-in-10-americans-but-funding-cuts-threaten-their-survival-267582