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  • From Undocumented Immigrant to Surgeon: Coming Full Circle to Serve My Community

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    Posted October 5, 2023

    By Carolina Solis Sanabria, M.D., M.P.H., FACS
    Physician (Research), Program Official
    Division of Clinical and Health Services Research,     National Institute on Minority Health and Health Disparities

    Returning to the Washington D.C. area to do health disparities work at the National Institute on Minority Health and Health Disparities (NIMHD) and practice as a general surgeon at Holy Cross Hospital has been an opportunity to return to my community and my roots. I get an amazing opportunity to tackle health problems at the systemic/public health level as a program official at NIMHD. I also have the immense privilege of making an impact on individuals as a community general surgeon serving patients who are underserved. The combination of surgery and health disparities research reflects my personal experiences and passions.

    As a 4-year-old girl, my family and I crossed the Rio Grande from Juarez, Mexico to El Paso, Texas. We quickly learned the challenges that came with being undocumented in the United States. Growing up, my family had limited access to health care—rarely seeing a doctor unless it was an emergency. Given these challenges, my family was quick to instill in me the value of getting an education.

    It did not take much convincing on my family’s part for me to engage in academic pursuits. Early on, I developed a love for the medical sciences and in particular surgery given my love for human anatomy. I was always very curious about learning about how things work, and I got my first exposure to research in high school after winning a summer internship at the National Cancer Institute. In college, at Yale University, I studied Hookworm disease, a disease that is prevalent in low- and middle-income countries and contracted by walking barefoot on contaminated soil. After graduating from Yale, I was accepted into Harvard Medical School. I continued my interest in research and spent a summer in San Juan del Sur, Nicaragua, doing a prevalence study on intestinal parasites. These experiences led to my interest in health disparities research.

    Photo of Dr. Carolina Solis Sanabria at the Cerro Negro Volcano in Leon, Nicaragua where she did a prevalence study on intestinal parasites.

    Even though I had a strong interest in parasitology, I ultimately reverted to my original passion for surgery. One of my mentors was a surgeon who was doing global health work. It was exposure to this surgeon that showed me that I could merge my interests in surgery and health disparities research. As a result, in the middle of my residency at Duke University, I returned to Harvard University to pursue a master’s in public health and specializing in global health. I later won a Fulbright scholarship and traveled to Nicaragua to study access to surgical care.

    After completing my training in surgery at Inova Fairfax Hospital in Virginia, I practiced as a traveling surgeon, working with the Indian Health Services in rural communities in Oklahoma, Montana, and Appalachia. As a traveling surgeon, I witnessed some of the challenges associated with practicing medicine in rural settings. This, and other experiences, help to inform the work I do daily at NIMHD. For example, my previous global health experiences helped to inform my participation in the Latin America: Synergizing Health Research Across the Hemisphere workshop, which focused on discussing research opportunities to reduce health and health care disparities related to non-communicable diseases. It also helped with my role as a project scientist in the Data Science Center for the Study of Surgery, Injury, and Equity (D-SINE) Africa. Additionally, my experiences in rural settings have helped to inform my work with the NIMHD Rural Health concept.

    I worked full time as a general surgeon at Holy Cross Hospital from 2018–2020. A large segment of the populations I worked with was Hispanic/Latino and many were uninsured. I witnessed the differences in access between those who had insurance and those who did not. Those without insurance came primarily to the emergency department and had complicated cases. I was truly grateful to be able to serve my community during this time.

    When I was offered the role of a program official at NIMHD, I felt it would be an opportunity to help my community on a more significant level. It would provide an opportunity to contribute to policy and research on health issues related to my community, while I can still positively affect people’s lives as a physician and surgeon.

    My clinical practice drives my public health work and vice versa. I currently work at the Holy Cross Health Center and the patients appreciate having a Hispanic physician who speaks their language. My experiences working with populations who are medically underserved fuels the passion for my health disparities work at NIMHD.

    My work with populations experiencing health disparities has been influential in helping to develop various initiatives at NIH. For example, the Health care Worker Well-Being initiative was inspired by my work as a traveling surgeon in rural communities and seeing how nursing shortages affected patient care in these settings. I presented a concept on spirituality and religiosity that was, in part, fueled by identifying a health gap — which is that patients need to receive whole person health care for holistic well-being. Oftentimes, patients coming to me have complex psychosocial factors impacting their physical health and it is important to take these into consideration when providing care to them.

    Although it has been a long journey since first crossing the Rio Grande to arrive in the United States, my experiences have brought me back full circle to pursue my passions while serving my community and the nation.



  • Honoring Trailblazing Women in the Pursuit of Health Equity

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    Posted March 24, 2023


    By Triesta Fowler, M.D.

    Scientific Diversity Officer, National Institute on Minority Health and Health Disparities


    Monica Webb Hooper, Ph.D.

    Deputy Director, National Institute on Minority Health and Health Disparities


    March is women’s history month, and we thank and celebrate women across the U.S. and globally for their many essential contributions to science and medicine. Entering and succeeding in a field of study and/or professional practice, especially as a member of an underrepresented group is no small feat. Getting there often means beating the odds and rising above continual challenges. Women’s history includes many exemplars of such formidable efforts, people who are deserving of celebrations this, and every, month.

    In this blog, we commemorate the work and legacies of pioneering women whose historic accomplishments made critical strides toward improving minority health, reducing disparities, and advancing health equity, from the late 1800s to today.


    Trailblazing Women in Science

    In 1864, Dr. Rebecca Lee Crumpler (1831-1895) became the first African American woman to obtain an M.D. degree at the New England Female Medical College in Boston, Massachusetts. Dr. Crumpler provided medical care to formerly enslaved people at the Freedmen’s Bureau in Richmond, Virginia, and later took care of patients in her home in Boston regardless of their ability to pay. She also published the first medical text by an African American author in 1883 entitled A Book of Medical Discourses, which focused on women and children’s health and was based on journal notes she kept while in practice.

    In 1933, Dr. Inez Beverly Prosser (unknown birth year – 1934) became the first African American woman to earn a Ph.D. in psychology from the University of Cincinnati in Ohio. With a passion for education, she taught at Historically Black Colleges and Universities (HBCUs) and was interested in personality, self-esteem, and adjustment among children. Her research focused on the impact of racism on the education and educational experiences of African American children and was cited in the debates leading to the landmark 1954 civil rights case, Brown v. Board of Education of Topeka, Kansas.

    Drs. Crumpler and Prosser were remarkable women who blazed the trails so that we could follow in their footsteps. They overcame racial discrimination, biases, segregation, and societal and cultural norms that prevented women from working outside of the home, and barred Black women from educational opportunities. They helped launch the cross-cutting fields of minority health and health disparities research. And while there has been some progress, there remains much more work to be done. About 37.1% of total active physicians are women (American Medical Association 2021), but only 2.8% are Black women. About 69% of psychologists are women, but just 5% are Black (women and men combined).


    NIMHD’s Very Own Trailblazer

    We also acknowledge and celebrate a modern-day pioneer in the field, Dr. Anna María Nápoles, Scientific Director of the Division of Intramural Research at NIMHD, who retired from federal service on February 28, 2023. Dr. Nápoles is a behavioral epidemiologist and the first Latina named to the position of Scientific Director at an NIH Institute. She worked tirelessly to grow the Division and maintained a steadfast commitment to mentorship and sponsorship. We benefitted tremendously from her expertise and outstanding leadership.

    We honor the legacies of these amazing individuals with a daily commitment to mentor and sponsor the next generation of scientists as they maximize their potential. We encourage others to learn about the many historic women in science and medicine, and to emulate their persistence and determination for improving the health of populations with health disparities.

    NIMHD is committed to supporting the careers of all women, and a culture that supports recruitment and retention. In science and medicine, we know that this must include opportunities for mentorship, professional network development, and research funding, which are associated with increased productivity, career satisfaction, and achievement of professional goals and skills.


    NIMHD Supports Women

    Funding Opportunities

    We strongly encourage investigators supported by eligible grants to identify and support scientists through our funding mechanisms.

    Training Opportunities

    Our flagship program, the annual Health Disparities Research Institute, is a big draw for early career investigators and an opportunity to foster peer relationships and expand professional networks. The idea of a shared vulnerability and the ability to connect is key to building knowledge and skills and promoting wellness.

    In short, NIMHD has resources in place to support women’s professional trajectories and success. And we are proud that over half of principal investigators supported by grants awarded by NIMHD identify as women.

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    Dr. Triesta Fowler leads NIMHD diversity, equity, inclusion, and accessibility efforts in collaboration with NIMHD leadership and staff. She was previously a medical officer and Director of Communications and Outreach within the Division of Intramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), leading key diversity activities. She began her work in diversity outreach and engagement at NICHD in 2007 as the director and creator of The National Child and Maternal Health Education Program.

    Dr. Monica Webb Hooper is an internationally recognized translational behavioral scientist and licensed clinical health psychologist. She has dedicated her career to science that benefits and serves communities with a focus on chronic illness prevention and health behavior change. Her overarching goal is to do the work necessary to produce meaningful, positive change and assure health equity. Before joining NIMHD, Dr. Webb Hooper was a tenured Professor of Oncology, Family Medicine & Community Health, and Psychological Sciences at Case Western Reserve University and Associate Director for Cancer Disparities Research at Case Comprehensive Cancer Center.



  • It Takes a Village: Community Support and the Fortification of Health among Black or African American Youth

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    Posted on February 28, 2023

    NOTE: For Black History Month, NIMHD Insights is reposting this piece with permission from the National Library of Medicine’s blog, Musing from the Mezzanine.

    By Triesta Fowler, M.D.
    Scientific Diversity Officer, National Institute on Minority Health and Health Disparities

    Monica Webb Hooper, Ph.D.
    Deputy Director, National Institute on Minority Health and Health Disparities


    In honor of Black History Month 2023, we are highlighting positive and protective factors that raise awareness of and show appreciation for the myriad of cultural and community strengths that facilitate safe spaces, where the health of children and adolescents can be fortified and maintained.

    “It takes a village” is a proverb that has been attributed to African cultures. For example, in Lunyoro—the language of Bunyoro, a Bantu kingdom in Western Uganda—“Omwana takulila nju emoi,” means “A child does not grow up only in a single home.” The idea behind the proverb is that although parents have the primary responsibility for raising children, the “village,” or their community, also plays an important role in how a child is raised. It is a longstanding belief that the community should and can create a safe and healthy environment in which the child grows. This belief in the power of community is an important component and strength of African American culture.

    Members of the village become part of a redefined extended family that share a common culture, values, and customs. These members may include other relatives, close friends, neighbors, and a trusted religious community. These connections have been defined as “fictive kin,” or people who reinforce and extend the familial bonds beyond a biological relationship.

    One area that is impacted by the village concept is caring for children, which becomes a shared responsibility across all the members of the fictive kin. Parents and their children are given the opportunity to be supported by and connected to additional community resources and to gain an increased awareness and access to what is available in the community, including opportunities to enhance a child’s learning and developmental processes. The village can also have positive effects on a child’s well-being and physical and mental health. Indeed, the social support and perceptions of cohesion in such neighborhoods are related to fewer symptoms of anxiety and depression.


    As children grow up surrounded by fictive kin, they develop their own sense of community and connection to their village. Conscious community-building can also spark a sense of responsibility to give back to the community and its members beyond any personal benefit. This sense of community consists of four components: a sense of belonging, a belief that you can make a difference in your community, a feeling that needs will be met through the resources provided by the community, and an emotional connection that results from shared experiences.

    This emotional connection can help address the feeling of isolation that may arise from the pressures of society such as systemic racism, and surrounding children with people who share these experiences help can increase positive coping skills and reduce mental health concerns. That is, the community has the power to act as a buffer and offer needed protection to children and adolescents.

    For generations, the idea of “it takes a village” has been at the center of African American culture because it creates an environment of love, support, and protection for all its children. It highlights the belief that the environment provided by the extended family gives children the best start in life and is an investment in their future. This concept will never grow old and is something that everyone from all cultures can actively support.

    During Black History Month and beyond, we encourage advocates for holistic physical and mental wellness to learn more about the importance of community-level social support—the village—and fictive kin.

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    Dr. Triesta Fowler leads NIMHD diversity, equity, inclusion, and accessibility efforts in collaboration with NIMHD leadership and staff. She was previously a medical officer and Director of Communications and Outreach within the Division of Intramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) leading key diversity activities. She began her work in diversity outreach and engagement at NICHD in 2007 as the director and creator of The National Child and Maternal Health Education Program.

    Dr. Monica Webb Hooper is an internationally recognized translational behavioral scientist and licensed clinical health psychologist. She has dedicated her career to science that benefits and serves communities with a focus on chronic illness prevention and health behavior change. Her overarching goal is to do the work necessary to produce meaningful, positive change and assure health equity. Before joining NIMHD, Dr. Webb Hooper was a tenured Professor of Oncology, Family Medicine & Community Health, and Psychological Sciences at Case Western Reserve University and Associate Director for Cancer Disparities Research at Case Comprehensive Cancer Center.