Started in the 1960s with a commitment to justice, the community health center (CHC) movement emphasized that everyone deserves respectful, quality health care and that addressing social drivers of health is within the remit of health-care organizations. Sixty years on, the network of federally funded community health centers that developed from this movement remain committed to serving vulnerable populations in America as they set the standard for high-quality, wraparound primary care services. This essay draws on the authors' qualitative study of moral uncertainty in community health to show how CHC providers enact a commitment to justice as they both improve access to care and services and recognize their patients' humanity in a society where too many of them are "chewed up and spit out." CHCs' ability to enact justice, however, is limited in the US's fractured health-care system and profoundly unequal society, and their success and financial viability are not assured. In order for CHCs to fully enact their mission, it will take appreciating the key role they play in advancing health justice in America, and strong, savvy advocacy efforts.

始于20世纪60年代并致力于正义的社区健康中心（CHC）运动强调，每个人都有权获得尊重且高质量的医疗服务，并认为解决社会健康驱动因素是医疗机构的责任。六十年过去了，从这场运动中发展起来的一系列联邦资助的社区健康中心仍然致力于为美国弱势群体提供服务，并设立了高标准的一体化初级保健服务。本文基于作者对社区健康道德不确定性进行的质性研究，展示了CHC从业者如何通过改善医疗服务和认可患者的人性，在一个太多人被“吞没又吐出”的社会中践行正义承诺。然而，由于美国支离破碎的医疗体系和极度不平等的社会现状，CHCs实现正义的能力受到限制，并且其成功与财务可行性也并不确定。为了使CHCs能够完全履行使命，需要认识到它们在美国推进健康正义中的关键作用，并采取强有力、聪明的倡导努力。