Exploratory Study of New York City Community Acupuncture Clinics Serving Low-Income Communities

Introduction: Acupuncture, effective in treating many health problems, is widely practiced in the U.S. but minimally accessible to low-income populations and communities of color. Lincoln Detox (“Detox”), a 1970s South Bronx acupuncture clinic led by radical activists, had great success in reaching such communities and reversing addiction. Little research has been done on factors affecting the ability of current acupuncture clinics to serve such communities. This exploratory study aimed to identify those factors and suggest directions for further research.

Methods: A comparative case study examined three New York City acupuncture clinics targeting low-income populations; the People’s Organization for Community Acupuncture (POCA), an international co-op; and Detox. Phone interviews were conducted with seven current clinic staffers and three former Detox staffers. Questions covered clinics’ goals, theories, successes, and challenges, and respondents’ recommendations. Observation was also done at the NYC clinics.

Results: All five entities report goals of social justice and expanded healthcare access. Detox ex-staffers say their largely low-income Black and Latino staff helped reach their communities; current clinic staffers report mixed results, though POCA has greatly expanded low-income access. Government funds made Detox financially viable; current NYC practitioners report difficulties, primarily due to insurance coverage restrictions. POCA’s model of low-cost group treatment and non-acceptance of insurance provides more stability. Detox’s healing model included political education on societal issues undermining health; current clinic staffers report little such activity, although one center provides anti-oppression staff training. Practices and opinions vary about group versus individual treatment. Interviewees have many recommendations for best practices and policy changes.

Discussion:  Today’s acupuncturists serving low-income communities and communities of color have been influenced and inspired by Lincoln Detox, but have developed their own models. Their practices will face continual sustainability challenges until public and private insurance lift restrictions on acupuncture coverage. Future research, aimed at developing best practices and policy recommendations, should include comparative studies of clinics with different target populations, structures, financial models, and treatment models (group vs. individual). Studies should also be done on practices by acupuncture schools and insurance plans that affect access to underserved communities.