“After ten years of working with vulnerable populations, it has become clear that in order to improve patient outcomes, the health care system needs to address social determinants of health. This realization has been the most clarifying concept in my career and has now been the driving force of my passion to improving health outcomes for vulnerable populations. We can have the best treatment plans in the world, but if a person is hungry, or they leave the appointment to sleep on the street, very little can be accomplished.”

For the past five years Courtney Pladsen has worked as a nurse practitioner at a Federally Qualified Health Center, Unity Healthcare, in Washington, D.C. Her clinic time is divided between a community health center and providing medical outreach to people experiencing homelessness. The community health center provides primary care to individuals and families of all ages and serves a majority immigrant population from Central America. When providing care to people experiencing homelessness the main goal is to decrease barriers to care and to develop relationships over time. This care happens in soup kitchens, on the streets, and in shelters. Courtney and her colleagues go where the patients are, and see them in their comfort zones.

In December, Unity opened the first ever women’s respite program in Washington, D.C. Courtney is leading this program and is developing it from the ground up with a wonderful group of nurses, mental health providers, pharmacists, and primary care providers. This program provides medical care to acutely ill women within a homeless shelter. Previously if a woman was experiencing homelessness and became acutely ill, once discharged from the hospital they were discharged to the street. Often surgery had to be delayed, wounds worsened, and women went without life-saving treatment. Now, the respite program is able to provide medications, wound care, care coordination, social services, and daily nurse care.

Every person has inherent dignity and worth. The current U.S. health care system too often sees a patient as a diagnosis rather than a whole person. Cura personalis, care of the whole person, includes understanding a person’s social determinants of health. That includes education level, housing status, social supports, resources like transportation, immigration status, employment, and others. Courtney believes that when providers learn this information about their patients, they can not only provide better care, but can begin the long work of addressing these social determinants of health. Addressing these barriers to care on an individual and community level through advocacy and policy will help decrease health care disparities. One of Courtney’s favorite professors once told her that “community health is moving a mountain stone by stone,” and after ten years of her efforts, she’s starting to see that new mountain being created.