Investing or Squandering Social Capital? Community-Based Organizations for Indigent Health Care

Abstract

Externally funded collaboratives are compared in a US–Mexico border location, focusing on the local commitments that are made in financial and social capital for long-term sustainability. The border offers special challenges to sustainable health care programs, given the substantial crossing that occurs among health care users in both North-to-South and South-to-North directions. Funding organizations that decentralize programs to community collaboratives, demanding considerable local leverage and in-kind contributions, create a pernicious tax on poor communities in the name of building community capacity. Despite good intentions, precious community social capital is squandered.