Here’s my definition of equity and equality. Equality is giving everyone equal pieces of pie despite how hungry they are. Equity is giving everyone a piece of pie that reflects what they need to no longer be hungry. Equity for me is what we need to progress in public health. Those who are a part of the fight to better public health in the United States must realize that although we want equality we really need to focus on equity. Providing communities with resources and tools to receive the same, or close to the same, level of quality care.
We all have seen the headlines and social media posted targeted at nursing not being considered a “professional” degree. As a result, we have seen current and aspiring nurses pulling away from getting further in the healthcare industry. I admit I need to do more research on the topic, but I don’t believe it’ll tell me anymore than what I assume as a current registered respiratory therapist who knows she needs them just as much as they need her.
Regarding maternal and child health, it has been noted one way to address structural inequities and intersectional vulnerabilities is to invest in primary care within a community that can tend to diverse women that differ in race, age, and socioeconomic status in a range of settings. The professionals needed to do this are midwives, doulas, and nurse practitioners (1). They have the potential to greatly impact maternal health in Black communities. The very people in the current administration are trying to diminish the weight in which these professional degrees carry in bettering the health outcomes in some of the most disadvantaged communities.
As a healthcare practitioner myself, I know healthcare facilities are severely understaffed and have only gotten worse since the COVID-19 pandemic. Keep in mind I have worked in two states and three healthcare systems, and I’ve seen it unfolding since I entered the field in late 2018. If anything, things have gotten drastically worse in the last three years since my practicum with the Tennessee Department of Health (TDH) as a Title V Intern in the summer of 2022. Working as a Title V intern, I had fully emerged in the world of how health policies make a difference outside of a textbook. I was getting real life experience quick and fast. The overturn of Roe v. Wade was the start of it all. There was an emergency meeting as soon as the decision hit headlines on 1) keeping personal feelings and beliefs out of the workspace and most importantly 2) how does it affect the work of the TDH past, current, and future.
As I reflect on my pregnancy, I used my clinical background along with internet searches to build my birthing plan. The death of young black mothers such as Kira Dixon (2016), Shalon Irving (2017), Sha-Asia Washington (2020), Amber Rose Isaac (2020), Yolanda Kadima (2020) would have never happened if their voices were heard. The statistic repeatedly goes “Black women are three to four more times more likely to die during childbirth”. The second portion to the statistics is the fact that we are more likely to die despite our socioeconomic status or education. Shalon Irving held multiple graduate degrees, worked for the Center for Disease Control and Prevention researching how childhood experiences affect health later as well as addressing food deserts, a rock-solid support system, and a member of the Commissioned Corps of the U.S. Public Health Service as a lieutenant commander (2). Amber Rose Isaac was a teacher in Lutheran Social Services of New York’s Early LIFE program in the midst of pursuing her graduate degree (3). Sha-Asia Washington was a yound mother who loved having fun with friends, fashion, and looking forward to the family she was creating (4).
All three women were from different parts of the United States, in different fields, and had different level of education but when it all boiled down them being black and ignored before, during, and after childbirth caused them to no longer be here with their families raising the children they were excited to see.
One has to ask would these outcomes be different if the areas they were from did not have medical service centers that were understaffed or professionals who cared for them hearing their voice. I can’t help but think if they had the quality of care, equity, and attention white women had they would still be here today. With that being said I take the efforts to label nursing a non-professional degree as an attack on the equity being sought out to decrease the black maternal and mortality rate.
There has been an attack on public health since the first Trump administration, and this latest one has the potential to raise the statistic higher than we could have imagined. I believe this mislabeling of nurses is a way to deter BIPOC communities from pursuing these degrees with the heart of creating equity for those who look like them.
Ask yourself truly, what does considering nursing a non-professional degree do for the various avenues in healthcare? Remember, nursing is a career where there are endless opportunities greater than what we see at bedside in the hospital, at schools, or during our primary care or specialty visits. They wear more hats than one may think of. What could this do to medical homes that are already struggling to become established?
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References
- CDC. Working Together to Reduce Black Maternal Mortality. Available online: https://www.cdc.gov/healthequity/features/materal-mortality/index.h
- GLAMOUR. Black Women Who’ve Died in Childbirth Won’t Be Forgotten. Available online: https://www.glamour.com/story/black-women-whove-died-in-childbirth-wont-be-forgotten
- ABC News. 26-year-old Black Woman’s Death During Childbirth Leads to Call for Change. Available online: https://abcnews.go.com/GMA/Wellness/calls-change-26-year-black-woman-dies-childbirth/story?id=71698417
- TheCinemaholic. Who was Amber Rose Isaac? How Did She Die? . Available online: https://thecinemaholic.com/who-was-amber-rose-isaac-how-did-she-die/