We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter |

Changes in Demographics of Patients Seen at Federally Qualified Health Centers, 2005-2014

Julia B. Nath, BA1; Shaughnessy Costigan, BA2; Renee Y. Hsia, MD, MSc3
[+] Author Affiliations
1Medical student, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
2Medical student, Georgetown University School of Medicine, Washington, DC
3Department of Emergency Medicine, Philip R. Lee Institute for Health Policy Studies, University of California–San Francisco, San Francisco, California
JAMA Intern Med. 2016;176(5):712-714. doi:10.1001/jamainternmed.2016.0705.
Text Size: A A A
Published online


This study describes a number of demographic differences in the populations served by Federally Qualified Health Centers, 2005-2014.

Over the past decade, federal support for Federally Qualified Health Centers (FQHCs) has expanded under both the American Recovery and Reinvestment Act and the Affordable Care Act. The 2 expansions paralleled 2 demographic shifts in demand for FQHCs’ safety net health care and social services. The first such shift occurred with the loss of employer-sponsored insurance during the economic recession of 2008-2009; and the second with the expansion of health care coverage under the Affordable Care Act, including 6.5 million persons insured through Medicaid.1 Despite the increasingly important role of FQHCs in primary care in the United States, published analyses examining the trajectory of the FQHC network’s patients predate those expansions, lack population adjustments, or focus on a single demographic variable.24 We conducted a study to overcome these shortcomings by describing the changes in the demographics of patients seen by FQHCs over the past decade.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.
Trends in Percentage of US Population Served by a Federally Qualified Health Center (FQHC)

All graphs trace trends in the percent of the US population served by an FQHC, defined by the number of FQHC patients in the 50 US states in the demographic group specified, divided by the number of total US residents in that same demographic group. Counts of FQHC patients were determined using the Uniform Data System from the Health Resources and Services administration5 (HRSA) and included all patients seen at HRSA grantee FQHC organizations in the 50 US states. Corresponding population data were gathered yearly from the US Census’s American Community Survey.6 All groups had significant differences in trends when analyzed using ordinary least squares regression with interaction between demographic group and year (P ≤ .001). AI/AN indicates American Indian and Alaska native; FPL, federal poverty line.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Change in Federally Qualified Health Center (FQHC) Population Coverage by State, 2005-2014

Numbers in parentheses indicate a decrease; all others, an increase. CT indicates Connecticut; DC, District of Columbia; DE, Delaware; MA, Massachusetts; MD, Maryland; NH, New Hampshire; NJ, New Jersey; RI, Rhode Island; VT, Vermont; and WV, West Virginia.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles