Though she was initially assigned to work only with black patients, she was one of the first to integrate the public health nursing system. Despite experiencing racism and threats to her safety, Mrs. Elder’s determination and courage during those difficult times established her as an icon, advocate, and dedicated servant leader to so many in the communities she served. Mrs. Elder provided leadership in advancing public health priorities such as health care access and health equity. Her dedication to championing health literacy and health education as public health priorities became the inspiration and legacy of the Thereasea Clark Elder Community Health Leadership Academy. Though she retired in 1989, Mrs. Elder continued to champion a variety of causes including voter registration, preservation of Black history, and economic development. She was the president of the Greenville Historical Association and was active member of the National Association of Negro Business and Professional Women. She founded the Charlotte-Mecklenburg Black Historical Society and was on the Board of Greater Carolinas Chapter of the American Red Cross. In 2013, she was recognized by Johnson C. Smith University for her work in strengthening the Rockwell neighborhood, and subsequently, the Thereasea Clark Elder Neighborhood Park on Rockwell Church Road was named in her honor. Mrs. Elder peacefully passed away at home on January 5, 2021 at the age of 93.