This report tells the story of the first 30 years of Mary’s Center, documenting its evolution from a basement clinic to a nationally recognized federally qualified health center serving nearly 55,000 participants in 2018. Mary’s Center’s ongoing experience provides a useful framework for understanding the benefits and opportunities of providing comprehensive medical, social, and educational services in underresourced communities. It also highlights some of the challenges to implementing and sustaining such an approach.

As Mary’s Center enters its fourth decade, its leadership is interested in more precisely defining the theory of change behind its social change model, both to rigorously evaluate its effectiveness and to provide a model for other health care organizations interested in addressing the social determinants of health. This report describes Mary’s Center’s social change model—an integrated care approach to addressing the social determinants of health—including its progression over time and how Mary’s Center applies it in day-to-day operations.

To learn more about Urban’s ongoing work with Mary’s Center, watch a recording of the October 12, 2018, symposium, “Successful Pathways to Education, Health, and Well-Being: The Role of a Community Health Center.”