The Health Disparities Podcast

Access deserts, Magnet designation, and comorbidity management centers in Boston. Featuring Sasha Dubois.

Brigham and Women’s nurse Sasha Dubois, MSN, RN discusses how racial segregation, gentrification, and displacement in her native Boston can create “healthcare access deserts” that fuel health disparities, even in an area where there are a number of high-quality hospitals. Establishing medical homes in the communities where patients are is one approach that Brigham and Women’s is implementing, together with centers that focus on understanding and managing multiple co-morbidities by integrating factors such as social determinants into care plans and health records. Sasha is an expert in Magnet designation, a driver for excellence which raises standards of care and encourages a more patient centered approach. Magnet also emphasizes the importance of cultural competency, unconscious bias, and understanding disparities. With Dr Carla Harwell.

Collaborative approaches and hospice care in the Sunshine State. Featuring Lyn Peugeot.

Lyn Peugeot MSN, RN, is a nurse focused on hospice care, and has recently completed her doctoral research project looking at dementia diagnosis in African Americans. She discusses her concerns about the relatively low percentage of African Americans who choose hospice care, which may be less about access and more due to misperceptions about the role of hospice and its implications. Because of this, Lyn believes it is very important to educate all nurses about hospice care as a positive philosophy built around providing comfort and care at the end of life while maintaining dignity and autonomy. In terms of disparities, she sees access to care and medication as the areas where minorities experience the greatest barriers, and she discusses how the closure of safety net hospitals can exacerbate these access issues by reducing the availability of care navigation support, as well as care itself. Lyn helped found the Broward County, Florida chapter of NBNA, they will host the national conference in summer 2020. With Dr Carla Harwell.

Making sure healthcare isn’t a lottery in rural Nevada. Featuring Debra Toney.

Dr. Debra A. Toney PHD, RN, FAAN, is Vice President of Quality Management at Nevada Health Centers, President of NCEMNA and a past president of NBNA. She discusses her groups approach to population health management in Nevada, a primarily rural population where remoteness is a major factor in health disparities. Dr Toney talks about the importance of social determinants, particularly in the context of FQHC care provision, and how telehealth and mobile units are making a difference to disparities in conjunction with the consistent implementation of evidence-based guidelines and care personalization. Dr Carla Harwell and Dr Toney also discuss the decline of paternalistic medicine and the rise of patients as partners in their own health, and how better engagement can be facilitated by meeting patients where they are.

Carter Todd: Nursing inspirations and aspirations in Sacramento, California

Pediatric ICU nurse Carter Todd RN, MS, CCRN, switched from athletics to nursing and this changed his life completely. On graduation he realized he could help both his community and the nursing profession by advocating for greater workforce diversity. Carter went on to start his local NBNA chapter and create a barbershop outreach program. In California, health access is the number 1 issue, like most other states. But uniquely, California has the highest number of undocumented or uninsured agricultural workers, all deserving and needing care. Carter discusses the importance of health literacy and integrating an understanding of social determinants into day to day care decision making and talks about a collaboration with the African American Health Legacy initiative to bring preventive health to the community. With Carla Harwell, MD.

NBNA’s 50th Anniversary vision: Getting patients engaged in their own health by moving away from the illness model.

Incoming NBNA President Martha Dawson, DNP, RN, FACHE, shares her priorities for the organization as she becomes its 13th President. As the NBNA approaches its 50th anniversary in 2021, Martha is planning to highlight its founders and past leaders, and to focus on emphasizing the importance of meeting patients where they are, before they get sick. Martha describes how the 122 chapters are at the heart of NBNA, and ways their community programs have been effective in mitigating health disparities. Local programs include working with politicians on environmental aspects such as lead levels, addressing violence, recognizing the importance of social determinants, and facilitating better access to care. The NBNA is one of very few professional development organizations that bring together RNs, LPNs, and students under the same umbrella, and then supports them along varied career paths, which include business and management positions as well as the clinical track. Martha believes that legislation is perhaps the most important conduit to change, and she talks about why she supports mentoring future leaders to ensure there are strong voices from the black nurse community able to influence future health policy. With Carla Harwell, MD.

Going beyond disparities and competency: why we need to focus on achieving health equity and cultural proficiency.

Eric J. Williams, DNP, RN, CNE, FAAN, is a Professor of Nursing and the outgoing President of the National Black Nurses Association (NBNA). Eric talks about some of the priority initiatives at NBNA during his leadership, and how NBNA has built on its mission to improve health equity in America since its founding in 1971. As well as discussing the importance of treating violence as a public health crisis and building a culture of health, Eric discusses ways that we can move beyond cultural competency to attain the higher skill level of cultural proficiency – skills that are good for healthcare and the wider world. Eric also discusses an important new initiative to increase diversity in the nursing workforce, working in collaboration with AARP and the Robert Wood Johnson Foundation. With Carla Harwell, MD.

Primary care, private practice: A dedicated physician tackles zip code related health disparities.

Cleveland, Ohio native Carla Harwell, MD has had “boots on the ground” working to eliminate health disparities in the Cleveland area for many years. As an African American setting up a primary care private practice in an underserved location, Carla was very conscious that zip codes often define health and determine life expectancy, along with other social determinants. She set out to do something about this reality by providing a local alternative to clinics and hospitals, taking a 360-degree view of her patients, and encouraging patients to keep moving. With Bonnie Mason, MD. 

Left bank, right bank. Mississippi River Delta health disparity problems and solutions.

Orthopedic nurse and Louisiana native Charla Johnson, RN, MSN, ONC, discusses zip code related health disparities on opposite banks of the Mississippi. Charla shares some effective ways to spark changes that improve quality of life, and she believes that education programs must be tailored to people’s unique circumstances, taking into account access to the household and community resources that people need to be successful. A proponent of balance exercises and Tai Chi, “Motion is lotion” is one of her favorite mantras. Charla also discusses how all healthcare professionals can work together and bring their voices and connections to the battle against health disparities, helping to bring about positive change in local communities. With Rose Gonzalez.

The National Black Nurses Association (NBNA): Professional development leadership and supporting minority inclusion in health research.

Millicent Gorham PhD (Hon), MBA, FAAN, is the Executive Director of the National Black Nurses Association (NBNA), a long-time "Movement is Life" collaborator, and a champion of the health benefits of physical activity. Here she discusses how the NBNA is leading many facets of minority representation and participation in healthcare. With Rose Gonzalez PhD, MPS, RN.

Can “trauma informed care” help eliminate disparities?

Physical therapist Shawn Tucker provides care that is informed by adverse childhood events (ACEs), trauma and toxic stress, all of which can contribute to the development of chronic health conditions in adulthood. Trauma informed care seeks to address the root causes of unhealthy behavior by helping to resolve previously hidden and unexplained conflicts. Do populations who experience more ACEs have higher prevalence of chronic conditions, and can toxic stress help explain health disparities in the obesity pandemic? With Rolf Taylor.