Alumni Profile: Angela Diaz’81

By Julia Hickey González

During her pediatric residency rotation at Mount Sinai Children’s Emergency Department, Angela Diaz’81 noticed a pattern: When trainees approached the wall of patient assignments, they reached up to box five or below to box seven rather than take box six—the adolescent exam room.

“Nobody wanted to deal with the teenagers, so I would go and take number six.”

What she found was refreshing: When she gained a teen’s trust, each teen was like an “open book.” Whether it was her level temperament, her proactive questioning, her nonjudgmental responses, or any number of disarming qualities, Dr. Diaz connected with her adolescent patients. They met her with authenticity and a willingness to receive support. 

“Everybody was saying how great I was with teenagers,” she recalls.

She was so glad that the hospital offered her a fellowship in adolescent medicine. In 1989, she was asked to direct the Mount Sinai Adolescent Health Center, where she refined and expanded a barrier-free and developmentally tailored model that is now recognized as a gold standard for serving vulnerable adolescent and young adult populations.

Patients arriving at the center find services for physical, behavioral, and mental health; sexual and reproductive health services; legal and social support; dentistry; optometry; nutrition; health education; and leadership programs under one roof and always provided free of charge. More than 800 youth have received gender transition services. Medication, testing, and subway or bus fare are paid by the program. The center places no restrictions on residency or nationality for use of its fully confidential resources.

“They land at Kennedy, and somehow without papers they make their way to the center,” says Dr. Diaz. “We serve them the same way.”

All of this is possible because Dr. Diaz took on the role of fundraiser-in-chief to create unhindered access to care. She expanded the ages for accepted patients to between 10 and 26 years old. At any moment, the center has about 38,000 eligible patients (about twice the seating of Madison Square Garden) on its roster, with about 12,000 of them actively visiting the center each year. Ninety-eight percent of the center’s patients come from low-income families. 

In 2021, Dr. Diaz was named dean of global health, social justice, and human rights at the Icahn School of Medicine at Mount Sinai. In addition to her medical degree from Columbia, she has a PhD in epidemiology from Columbia’s Mailman School of Public Health and an MPH degree from Harvard. She is a member of the National Academy of Medicine and an NIH-funded researcher into the real-world effectiveness of the vaccine for human papillomavirus, sexual and reproductive health, and interpersonal violence in adolescent and young adult populations.

Dr. Diaz’s goal, she says, is to keep kids healthy so they can thrive in school and attend college, which she sees as the great “equalizer.” She wants teens who are not college-bound to be able to work in jobs that allow them to support themselves and their family with dignity.

The center maintains a policy of not judging patients who fall off track. They get every chance they need to succeed. And teenagers, because they are in a continual state of self-invention and exploration, are surprisingly pliant when they feel supported and safe.

“I work with them as if I were a sculptor, like an artist—shaping them. So I just feel like it’s very creative when I connect with them. I was never bored or burned out.”

One of Them

“I believe that every kid that comes here is extremely brilliant. They may not have done well. They may be failing in school. But that is more the impact of external society, and sometimes including those closest to them,” says Dr. Diaz. “They are born like anybody else: full of potential, full of intelligence, full of possibilities, full of promise. And I think, you know, for some kids, their core gets destroyed by people in the environment who abuse them or do not understand them.”

The center’s success stories are dramatic and numerous. Ninety percent of the patients graduate from high school, and more than 50% go to college. Many have gone on to excel in all levels of academic and professional life—gaining Ivy League PhDs, publishing memoirs, or becoming health and public health professionals and advocates who use their hard-earned experience with the social determinants of health to improve the health and well-being for the next generations.

Dr. Diaz is one of them.

Born in the coastal province of Barahona, Dominican Republic, Dr. Diaz describes her childhood context as “extreme poverty,” with no access to health care. While her mother worked far away in the capital laundering sheets at a hotel, Angela was supervised alongside several other children by her busy grandmother, extended relatives, and neighbors.

The earliest of many childhood traumas was medical: At the age of 2, she was severely burned by boiling water from a toppled pot, which had been heating upon coals on a dirt floor. At 4, while walking with her grandmother to the grocery store for one day’s measure of cooking oil, she tripped on uneven concrete and fell forward while carrying a glass jar.

The severe abdominal laceration and resulting infection nearly killed her. But at the hospital she heard the word “doctor” for the first time. During her long hospital stay, she remembers her family and nurses bringing her pear nectar (which she loved) and apple juice (which she didn’t).

“Those people who were taking care of us—they were good to us. They were kind. And so, I thought, ‘I want to be that.’ I wanted to be like them, to be nice to kids."

She decided to become a doctor, but her interactions with the health care system would still prove sparse. She was first vaccinated, for polio, during a campaign on the street in Santo Domingo and would not receive another immunization until two decades later, after the birth of her second child.

When Angela was 8, her mother immigrated to the United States and left Angela with the family of her father, a military officer. During the country’s coup, she recalls fleeing for their lives with the cover of U.S. Marines to shelter in another province.

When she immigrated to the Bronx at age 12 to reunite with her mother, Angela remembers going to the emergency room at Fordham Hospital for migraines. (The hospital closed in 1976, and the site is now a parking garage.) With no health insurance or access to primary care, Angela’s younger sister went untreated for a case of strep throat. It developed into rheumatic fever and lifelong heart disease.

Angela also suffered the psychological stress of knowing she was undocumented. She overstayed her visa to remain with her mother, who spent most of her hours cutting garments at a factory in Long Island City. Angela was sent back to the Dominican Republic to wait a year and re-enter legally at age 15.

Despite all this, Angela performed well academically, especially in math and physics, and her teachers took note. A guidance counselor sent her to a Saturday morning program at Mount Sinai that introduced low-income youth to health professions, and Angela took English and math classes. In the summer, she worked feeding patients and changing bedpans. The program also introduced her to the Mount Sinai Adolescent Health Center and helped her make connections outside her family. The nurse who directed the program would make time to take Angela to Central Park. “People say, ‘Feeding pigeons, what’s the big deal?’ But that was a big deal, somehow, to me. I was doing something different,” says Dr. Diaz.

It all halted in her senior year, when Angela tilted into a depression, stopped leaving the apartment, and dropped out of high school. “I think I just crashed. I don’t think it was something specific at that moment, but it was an accumulation of all the stuff that had happened in the past. I had like 10 different traumas.” 

After months, she got out of bed and went to the Mount Sinai Adolescent Health Center—this time for mental health treatment. She improved enough to graduate. She enrolled in City College, mostly attending night classes. She spent her days in the packing department of the same factory where her mother worked and Saturdays working at a beauty salon, where she washed hair and gave manicures.

Although her path to becoming a doctor was still arduous, at least she was back on it.

A Second Chance

In 1977, Angela walked into the admissions office at Columbia’s medical school to find out exactly what stood between her and the study of medicine. Realizing she had already completed the requisite math and science classes with top marks, Angela asked for a pen, completed the application in the reception area, and returned both pen and paper to the secretary.

“She looked at me as if I had three heads” and accepted the application without payment.

Angela attended her interview in borrowed clothes and remembers making a strong connection with her interviewer, who was a psychiatrist.

After a rocky start, she went on to excel in medical school and graduated with honors in some classes. But she was far from the typical student at that time. For one, she arrived as a newlywed and conceived every year in medical school. During her first year, she lost a baby after a series of medical complications and a major surgery. (The second and third pregnancies ended in miscarriages.) Her postop recovery kept her out of class for months.

Angela’s classmates—realizing that she was on the verge of being kicked out—came together to keep her in medical school. “White, Black, Latino, everyone. I cannot tell you how many people were helpful.” She was amazed every day when classmates would show up at her apartment on 174th Street to teach her the material she had missed. Students also challenged the administration and expressed their faith in Angela—demanding that she stay.

It worked.

“If Columbia had either not accepted me to begin with or if they put me out during that first year, imagine the hundreds of thousands of kids that would not have been helped by this work.” 

At graduation, Dr. Diaz was nine months pregnant with her oldest child. Thirty-one years later (including more than 25 years working as a single mother), Dr. Diaz saw Daniela, her third and youngest child, graduate in 2012 from VP&S, where she is now an assistant professor of medicine and medical director of the Access to Care NYP Sphere and the Central Clinical Triage Center, two access centers at NewYork-Presbyterian Hospital. She also cares for underserved patients at Farrell Community Health Center on 158th Street.

Having recently become a parent, Daniela Diaz expresses awe at her mother’s accomplishments: “I have been raising my son for only a few months and it is already one of the hardest things I have done. I am stressed and tired and I have a flexible job schedule and we have a two-parent home. It is beyond my understanding how my mother managed to raise three small children as a single parent with a demanding career.”

The Shocking Numbers

While society generally labels teens as “difficult,” in the 40 years she has spent listening to them, Angela Diaz knows they may be grappling with problems far more advanced than their age: the effects of physical, sexual, and emotional abuse, racism, homelessness, the trauma of immigration, gender dysphoria, survivorship of incest, child labor, sex trafficking, or simply being an adolescent in a world that expects them to be like adults.

Perhaps because Dr. Diaz inspires high rates of disclosure, the statistics she reports are alarming: 23% of patients she sees for routine care have reported a history of childhood sexual abuse. Of them, 66% survived incest. Approximately 50% of her female identifying patients report sexual violence including rape.

“People are shocked by the numbers. I have dedicated my life to bringing awareness.”

Dr. Diaz’s program helped advocate in 2007 for the successful passage of New York State’s Safe Harbor Act, among the first state laws to recognize youth who experience commercial sexual exploitation as victims, rather than perpetrators, of crime.

Because abuse victims are more likely to land in the emergency room and clinics for injuries and infections, Dr. Diaz trains health providers to better identify trafficked youth. She took part in the creation of the National Academies report, “Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States,” a landmark publication that raised awareness of the commercial sexual exploitation of children and led to several national initiatives. In 2019, she teamed up with a lawyer to co-author the book, “Preventing Child Trafficking: A Public Health Approach.”

While Dr. Diaz has worked to shift the lens of society toward teenagers and the care they deserve—a top-down approach—she also recognizes that healing happens quietly, in the day-to-day interactions with one’s doctor, family, and community. “When they’re being abused, kids feel terrible about themselves. Their self-esteem is low, and they are more likely to be abused as they go through life. So I wanted to work with them to help them discover their strength and their power to help them heal,” she says, “to help disrupt a pipeline into domestic violence, or abusing their own kids, or witnessing their kids being abused. I wanted to help break the cycle of intergenerational trauma.”

“My mom works tirelessly for the people she cares about,” says Daniela Diaz. “Even as she gets older, she can still easily work from before the sun comes up to well into the night. Serving young people is truly a passion for her and she cannot understand any barriers that are put up against helping them. The term ‘above and beyond’ does not even begin to cut it for the way she serves her family, the adolescent health center, and adolescents at large.”

A Global Vision

Dr. Diaz has decided it is time to step down as director of the Mount Sinai Adolescent Health Center to focus on her research and ambitious new duties as dean of global health, social justice, and human rights at Mount Sinai.

“I find that teenagers are the thermostat of a society,” she says. “When things are not going well, you see things happen with teenagers. They become restless trying to inspire a more harmonious, just, and equitable society.”

With that said, Dr. Diaz’s abilities are in constant demand. Domestically, she has been a White House Fellow, a member of the Food and Drug Administration Pediatric Advisory Committee, and a member of the Board of Directors of the New York City Department of Health and Mental Hygiene, where she was also an adviser. She has held board and advisory roles at the National Academy of Medicine, the Robert Wood Johnson Foundation, and the Doris Duke Charitable Foundation.

Internationally, Dr. Diaz receives calls from anywhere there are problems with teenagers. When Mongolia transitioned from communism to a democracy and mixed market economy in the early 1990s, its health and educational systems were not prepared to adequately care for adolescents in a context of sudden economic shift. She spent significant time on the ground, learning about the factors contributing to the rise of Mongolian street youth, creating extensive recommendations for a system to serve them, and designing a national policy for children and youth. She has consulted in Nigeria, Brazil, Nicaragua, the Pacific Islands, the Virgin Islands, her native Dominican Republic, and more.

“She is an innovative thinker,” Daniela Diaz says of her mother, who has the rare combination of two abilities: She is able to conceive grand, visionary solutions and also able to plan and track the smallest of details to accomplish them.

Her vision is one of equity and abundance in a society where everyone has access to health care.

“While my mother is always mild-mannered and kind, I wish luck to anyone who tries to stand in the way of her vision,” Daniela Diaz says.

“I’m hopeful,” says Angela Diaz, “to the point that not only do I see the glass half full, I see the water coming over the border of the glass. Everything to me is possibilities.”