Hero: The Honorable Thomas McLain “Mac” Middleton, Senator District 28 Charles County; Chairman, Maryland Senate Finance Committee

Rural Health, Health Care Financing, Agriculture and Health, Health Care Workforce, Social Justice for Rural and Minority Communities

First elected to the Maryland Senate in 1994 and a member of the Senate since 1995, Senator Thomas “Mac” Middleton serves as an advocate for health care quality and social justice, especially for rural, agricultural, and medically underserved diverse communities. He has served as Chair of the Senate Finance Committee since 2002. His district is District 28 in Charles County located in the rural part of Southern Maryland.

Sen. Middleton’s contributions extend beyond the health care realm and support marshalling sectors such as agriculture and education to ensure a nutritious and sustainable food supply and an environment that fosters intake of nutritious food, which is fundamental to ensuring wellness and health. Much of his work in these areas preceded many of the later academic discussions of the social determinants of health.

Known to many as “Mac”, Sen. Middleton was an early visionary in legislative and policy solutions to address rural health and education, health care finance and access, and agricultural and health disparities issues.

In addition to serving in the Maryland Senate, Senator Middleton is a farmer, the owner and operator of Cedar Hill Farm near Waldorf, Maryland. In October every year, hundreds of school-aged students and their parents visit the Middleton Farm to tackle the corn maze, visit the farm animals, pick pumpkins from the pumpkin patch, and enjoy a hayride around the farm.

An early advocate for assuring access to fresh food for the working poor, Sen. Middleton has worked for decades on farm food access. His recent leadership in this area can be seen in his lead sponsorship for SB 486 “Hub and Spoke” legislation. SB 486 explores the types of infrastructure needed to support fresh produce distribution from farmers and to determine possible incentives that could alleviate costs to farmers who donate food.

I have had the privilege to work with the Senator on a variety of state and national health disparities and social justice–related policies. During early 2000, the Center to Reduce Cancer Health Disparities (CRCHD) at the National Cancer Institute (NCI) pioneered cancer health disparities infrastructure development and community-engaged research to address the burden of cancer in communities of color, including African Americans and others as well as rural cancer health disparities. I served as the principal investigator for the Maryland grants (called “Special Populations Research and Community Network I”). A critical component was health policy research and science-guided advocacy. The policy aspects were critical for ensuring that underserved and minority communities had access to beneficial cancer prevention, screening, and treatment. Senator Middleton’s leadership supported this new NCI research area (called “cancer disparities health policy research”) and advocacy. His leadership in regional agricultural and rural legislative organizations such as the Southern Legislative Conference and its Agricultural and Rural Development Committee led to dissemination within this organization of a novel cancer disparities research collaboration model of significance to rural America. This leadership was recognized by the National Institute on Minority Health and Health Disparities of the NIH as well as NCI.

Thomas McLain “Mac” Middleton

A few of Sen. Middleton’s relevant leadership and member roles of significance to health care for the poor and underserved and social determinants of health are:

• • Member, Task Force on Tobacco Crop Conversion in Maryland, 1999;

• • Co Chair “Task Force to Review Physician Shortages in Rural Areas, 2008–09”;

• • Co Chair Maryland Health Care Reform Coordinating Council, 2010, 2011–(co-chair, health care workforce work group, 2010, 2011–);

• • Long-Term Care Reform Work Group, Dept. of Health and Mental Hygiene, 2010–;

• • Task Force to Study the Applicability of the Maryland Prevailing Wage Law, 2013–Member;

• • Task Force to Study the Implementation of a Hub and Spoke Program in the Southern Maryland Region, 2013.

In addition to his ongoing leadership in legislation to ensure mental health equity, his leadership in resolving health and social issues are included in the very...