Gaston, Marilyn Hughes

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Marilyn Hughes Gaston


Physician, author

The first African-American woman to assume leadership of a bureau of the U.S. Department of Health and Human Services, Dr. Marilyn Hughes Gaston has dedicated her career to the goal of making quality health care accessible to all individuals regardless of income, race, or other factors. As head of the Bureau of Primary Health Care (BPHC) of the Health Resources and Services Administration, she brought health care to thousands of sites across the country that serve needy populations. Officially retired from government service since 2001, Gaston continued to promote the goal, identified in a 1998 government initiative, of "100 percent access [to health care] and zero health disparities." In 2003, Gaston co-founded the Gaston and Porter Health Improvement Center, a non-profit organization with a mission to provide outreach programming to promote health. She also spoke frequently on health issues, and indicated her interest in starting a program to recruit youth to work toward removing barriers that can limit access to medical care.

A native of Cincinnati, Ohio, Gaston was born Marilyn Hughes on January 31, 1939. She grew up with her younger brother and older half-brother in a three-room apartment in a public housing project. Her mother, Dorothy Hughes, was a medical secretary and her father, Myron Hughes, worked as a waiter. Money was scarce, but the family, as Gaston described it in an interview published in Notable Black American Women, was rich in love and happiness. From an early age, Gaston thought of becoming a doctor, but she received little encouragement. Medical schooling was extremely expensive, and Gaston's teachers and school counselors told her she would never be admitted. They warned her that she faced too many obstacles: she was a woman; she was an African American; and she was poor. Despite these warnings Gaston persisted with her seemingly impossible dream.

Gaston's family encouraged her ambitions, which were further strengthened when, home alone one day, Gaston saw her mother faint in the living room. Mrs. Hughes had cervical cancer but, as Gaston noted on the National Institutes for Health Web site, "We were poor, we were uninsured, she was not getting health care." The experience, Gaston emphasized, made her determined to "do something to change that situation." When Gaston was 12 years old the family moved out of public housing, and she attended a college preparatory school. Though teachers tried to talk her out of pursuing a medical education, she listened instead to the advice of her mother, who told her not to give up and emphasized that racism was not an excuse for failure. Gaston was also inspired by her godmother, who led a movement to desegregate the public swimming pool in their neighborhood. With these two strong women as role models, Gaston was able to persevere in her struggle to qualify as a physician.

Gaston graduated from Miami University in 1960 and entered the University of Cincinnati Medical School, where she earned her medical degree in 1964. She did her internship at Philadelphia General Hospital and her residency in pediatrics at the Children's Hospital Medical Center. Upon completion of her training, Gaston chose not to enter private practice but to focus instead on pubic health, where she felt she could be most effective in meeting the medical needs of the poor. She applied for and received government funding to open a health center in Lincoln Heights, an all-black city near Cincinnati, Ohio.

As director of the Lincoln Heights facility, Gaston became interested in finding better ways to treat sickle cell anemia, an inherited blood disease that is seen almost exclusively among African Americans. At the time, the majority of children diagnosed with sickle cell disease were not expected to survive into adulthood. With grant money from the National Institutes for Health, Gaston set up a sickle cell center in Cincinnati, where she served as director until 1976. When she moved in 1976 to Washington, D.C., where her husband had accepted a position at Howard University, Gaston took a job at the Sickle Cell Center in the National Heart Lung and Blood Institute, part of the National Institutes for Health. Her research team found that infants with sickle cell disease who received penicillin at birth were much less likely to die from sickle cell disease than babies who did not receive this medication. This discovery led to the implementation of national screening tests to ensure that newborns with the disease could be identified and treated promptly. Gaston joined the U.S. Public Health Service Commissioned Corps in 1979, and by 1990 was promoted to the rank of Assistant Surgeon General and Rear Admiral in the U.S. Public Health Service, becoming the second African-American woman to do so.

In 1990 Gaston moved to the Bureau of Primary Health Care (BPHC) of the Health Resources and Services Administration (HRSA). There her job was to improve access and quality of health care, especially among those living in poor and isolated communities. With a $5 million budget, Gaston oversaw programs that brought medical workers, facilities, and supplies to some of the country's neediest neighborhoods and improved health outcomes for more than 12 million people. During her administration, BPHC delivered health care to more than 4,000 critical sites across the country, including community centers, migrant health centers, homeless shelters, public housing, and schools. Other programs in her bureau targeted the special medical needs of the elderly, pregnant women, and new immigrants.

At a Glance …

Born Marilyn Hughes on January 31, 1939, in Cincinnati, OH; married Alonzo Gaston; children: two. Education: Miami University, BA, 1960; University of Cincinnati Medical School, MD, 1964.


Associate professor of community pediatrics, 1968-1970; community health center, Lincoln Heights, OH, founder and director, 1969-1972; sickle cell research center, Cincinnati, OH, founder and director, 1972-1976; National Institutes for Health, Bethesda, MD, medical expert and deputy branch chief of Sickle Cell Center, 1976-1990; U.S. Public Health Service Commissioned Corps, medical expert, 1979-2001; U.S. Health Resources and Services Administration, Bureau of Primary Health Care, director, 1990-2001; Gaston and Porter Health Improvement Center, Potomac, MD, co-founder and co-director, 2003-.


American Academy of Pediatrics, fellow; National Academy of Sciences, Institute of Medicine.


State of Ohio Governor's Award, 1987; National Medical Association Scroll of Merit, 1999; Dr. Nathan Davis Award, American Medical Association, 2000; Capital Breast Care Center Award for Outstanding Achievement in Women's Health and Wellness, 2006; National Medical Association Lifetime Achievement Award; Civic Ventures, Purpose Prize (with Gayle Porter), 2006; three honorary doctorates.


Agent—Publicity Department, Random House, 1745 Broadway, 18th floor, New York, NY 10019; Office—Gaston & Porter Health Improvement Center, 8612 Timber Hill Lane, Potomac, MD 20854; Web—

Realizing the importance of preventive medicine in improving health outcomes for women and minorities, Gaston worked with clinical psychologist Gayle K. Porter to write Prime Time: The African American Woman's Guide to Midlife Health and Wellness. The book, Gaston explained in the interview for Notable Black American Women, "is about living a lifestyle of prevention," an especially important consideration for black women who, in Gaston's view, often neglect their own health because they are busy caring for others. "We as Black women are dying at rates greater than any other group of women," Gaston said in the interview, but many if not most of these causes of death are preventable. The book urges readers to improve their health and well-being by proper diet, exercise, and attention to emotional needs. A reviewer for Essence called the book a "groundbreaking" work. To further the goal of the book, Gaston partnered with Porter to co-found the Gaston and Porter Health Improvement Center, a non-profit organization dedicated to providing outreach programming to help people make lifestyle changes to improve their health. One of the most successful programs is the Prime Time Sister Circles, support groups created to help women achieve their health goals, which in 2006 earned Gaston and Porter the first Purpose Prize awarded by Civic Ventures.

Gaston's work to improve public health has earned her numerous individual honors. In addition to numerous city and state awards and honorary degrees, she was awarded the National Medical Association's highest honor, the Scroll of Merit, in 1999. The following year she received the American Medical Association's Dr. Nathan Davis Award. The University of Cincinnati created the Marilyn Hughes Gaston Scholarship in 1999, which grants full-tuition medical scholarships to two low-income minority students each year. In 2006 the Capital Breast Care Center (CBCC) in Washington, DC created the Marilyn Hughes Gaston Award for Outstanding Achievement in Women's Health and Wellness. In a press announcement published on the Georgetown University Web site, the CBCC noted that "Dr. Gaston has dedicated her life to improving the health of our nation, focusing on poor and minority families."

Selected works


(With Gayle K. Porter) Prime Time: The African American Woman's Complete Guide to Midlife Health and Wellness), Ballantine, 2001.



Notable Black American Women, Book 3, Gale Group, 2002.


Essence, August 1, 2001, p. 64.

Publishers Weekly, May 7, 2001, p. 244.


"Changing the Face of Medicine: Dr. Marilyn Hughes Gaston," National Institutes for Health, (January 5, 2007).

"Inaugural Marilyn Hughes Gaston, MD, Award for Outstanding Achievement in Women's Health Given," Georgetown University, (January 5, 2007).

                                                                —E. M. Shostak