A romance with the concept of community has long characterized activist healthcare movements and has more recently been taken up by academic medical centers (AMCs) as a sign of virtuous civic engagement. During the late 1960s, the word community, as deployed by administrators at prestigious AMCs, became increasingly politicized, commodified and racialized. Here, we analyze how the concept of community was initially framed in the 1963 Community Mental Health Centers Act, the first legislation to establish community mental health centers in America. We then examine the Health Policy Advisory Center’s analysis of the proposed Washington Heights Community Mental Health Center to be run by Columbia University’s College of Physicians and Surgeons, an institution that had historically neglected residents’ health needs. Community pushback against Columbia’s plan to build a multi-block center, amplified by medical students and residents critical of the professionalized community mental health movement, escalated in the late 1960s, leading the city’s planning board to reject Columbia and approve a community council’s plan for preventive and rehabilitative local services. These conflicting overtones of “community” still inform understandings of the word in medicine today; thus, a critical historical analysis of “community” is warranted.

中文翻译：

---

“服务而非陵墓”：美国医学中的种族、政治和社区概念（1963-1970）

社区概念的浪漫长期以来一直是激进医疗运动的特征，最近被学术医疗中心 (AMC) 视为良性公民参与的标志。在 1960 年代后期，由享有盛誉的 AMC 的管理人员使用的“社区”一词变得越来越政治化、商品化和种族化。在这里，我们分析了社区概念最初是如何在 1963 年的《社区精神卫生中心法案》中制定的，这是美国第一部建立社区精神卫生中心的立法。然后，我们检查了卫生政策咨询中心对拟由哥伦比亚大学内科和外科医生学院运营的华盛顿高地社区心理健康中心的分析，该机构在历史上一直忽视居民的健康需求。社区反对哥伦比亚建立多街区中心的计划，医学生和居民对专业化社区心理健康运动持批评态度，在 1960 年代后期升级，导致该市规划委员会拒绝哥伦比亚并批准社区委员会的预防计划和康复本地服务。这些“社区”的相互矛盾的色彩仍然影响着今天医学界对这个词的理解。因此，有必要对“社区”进行批判性的历史分析。这些“社区”的相互矛盾的色彩仍然影响着今天医学界对这个词的理解。因此，有必要对“社区”进行批判性的历史分析。这些“社区”的相互矛盾的色彩仍然影响着今天医学界对这个词的理解。因此，有必要对“社区”进行批判性的历史分析。