More Than Money: How Microfinance Is Fueling Health Equity in the United States

By Greg Mann

When Bertha left Ecuador for the United States 22 years ago, she was fueled by a fierce determination to give her children the education and opportunities she never had. A seasoned bank manager in Ecuador, she had overseen five branches without a formal college degree — rising through the ranks with grit, intelligence, and an unwavering belief in hard work. 

​But in Charlotte, North Carolina, her first job was cleaning floors in a bank.
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“I found it funny,” Bertha says. “From manager to cleaner. But I never stopped fighting for my children. My daughter studied at a prestigious school, and now she’s the director of one. That’s one of my proudest achievements.” 

Microfinance, American-Style 
When most people hear the word microfinance, they picture rural villages across the globe. But microloans are quietly transforming communities right here in the United States. Organizations like Grameen America are leading a movement to provide small, low-interest loans—often just a few thousand dollars—to women living below the federal poverty line. In cities across the U.S., microfinance is not just about launching businesses. It's about dignity, opportunity, and improved health outcomes. 

For Bertha, it was life changing. After years of cleaning, she decided to start her own business. Through a friend, she was introduced to Grameen America. The program not only gave her the capital she needed, but also a support network, financial training, access to a Community Health Worker, and something more elusive: belief. “Thanks to Grameen America, I was able to buy the supplies I needed and grow professionally,” she said. 

When Financial Access Becomes a Health Intervention 
The connection between economic stability and health might not seem obvious at first. But for women like Bertha, financial inclusion is foundational to health equity. Living with diabetes for 15 years, Bertha struggled to manage her condition. Like many underserved immigrant women, she faced barriers to accessing health information, preventive care, and culturally relevant support. That began to shift when she had access to Grameen America’s Promotoras program—an initiative that provides health education and chronic disease management resources. Through regular group educational workshops, she learned more about nutrition, blood sugar control, and how to take care of herself. “My well-being is the foundation for everything,” she said. “Thanks to what I’ve learned, I’m healthier, more active, and able to continue supporting others.” 

The U.S. Microfinance Model: A New Kind of Community Health 
Programs like Grameen America don’t just hand out loans. They foster community accountability, financial literacy, leadership development, and critical peer support. In this model, a business loan becomes a tool for physical, mental, and social wellness. 

Bertha is now a group leader in her microfinance group, helping onboard and mentor new women entrepreneurs. “I consider myself an innate leader,” she said. “I guide other women like me—strong women who want more for their families.” She ensures her group remains united and disciplined, as she knows that supporting each other is part of the path to success. 

Why Health Equity Requires Financial Equity 
Health equity cannot be achieved in a vacuum. It’s not enough to expand clinics or lower prescription costs if people don’t have the income to access healthy food, stable housing, or basic transportation. Microfinance bridges this gap by addressing the social and structural determinants of health—especially for women who have historically been excluded from traditional banking and healthcare resources. 

A Call to Recognize Microfinance as a Public Health Strategy 
Bertha’s story is a reminder that health doesn’t begin in a hospital — it begins in our homes, our communities, and our wallets. Microfinance is more than money. It’s a strategy for investing in people who are often overlooked. It creates ripple effects: thriving local economies, stronger families and better health for women like Bertha. 

Image Credit: Grameen America

Grameen America is a 2024-2025 grantee partner of Health Equity Initiative, which also includes unrestricted funding for this blog post.  

Author’s Bio
Greg is the Vice President of Education & Health at Grameen America. He joined the organization following its merger with Grameen PrimaCare, where he helped expand healthcare initiatives for underserved communities. He brings deep nonprofit experience, including roles at the Harvard Eating Disorders Center and The Michael J. Fox Foundation for Parkinson’s Research. As a global traveler, he has visited 134 countries.