How a Nurse Leader Took on the Social Determinants of Health (rwjf.org)

To read more of Najaf Ahmed's article, please click here.

Maria Gomez was 13 years old when she immigrated to the United States with her widowed mother to escape violent political turmoil in Colombia. They landed in Virginia on a snowy day with no boots, no coat, and not speaking a word of English. Together, they faced many challenges while navigating their new life. In spite of them, Maria’s gratitude and drive to give back led her to a nursing career. She ultimately joined a group of advocates in launching Mary’s Center to address gaps in access to healthcare and structural barriers that many immigrants face.

Today, Mary’s Center uses an integrated model of healthcare, education, and social services to serve patients at five clinics and two senior wellness centers in Washington, D.C. and Maryland. In 2012, President Obama presented Maria with the Presidential Citizens Medal, the second highest civilian honor in the United States.

After an illustrious career, Maria retired in December of 2021. She shared reflections on how she has led efforts to serve a diverse population and insights into the challenges our healthcare system and nation face. In this interview, Maria discusses how she shaped a system of care that aims to build trust with patients and provide integrated care that addresses more than medical needs.

Mary’s Center started out as a community health center that primarily served pregnant women and infants. Can you describe what that work has entailed and how you’ve continued serving pregnant immigrant women?

Mary’s Center started out caring for pregnant women from Central America who were fleeing war and violence, and who struggled to find care for a variety of reasons, including insurance status and language barriers. These challenges put them and their babies at risk for poor maternal and infant outcomes.

Today, many of our patients grapple with conditions beyond the pregnancy itself. Their lives are shaped by social determinants of health—the social, economic, and environmental factors that influence health. For instance, they may live in an apartment with occupancy limits, so the addition of a baby brings fear of being evicted. They may fear the pregnancy will cost them their jobs. Potential job loss and the additional mouth to feed makes new mothers worry about their finances. And there are constant concerns about family members being deported. As if these stresses aren’t enough, the brutal toll of domestic violence often begins or escalates around pregnancy and can lead to homelessness.