Guest blogger Dr. Monica Diamond-Caravella, Assistant Professor and Academic Coordinator, Farmingdale State College, Department of Nursing, says public health nurses and health communicators understand the root causes of structural inequities, and they are adept at addressing them.
COVID-19 exposed the glaring health and racial inequities that exist in our society. These have always existed, and we have reams of research and data to prove that.
The daunting challenge is how do we erase these inequities?
Education
Identifying and discussing the multiple complex root causes driving health inequities in this country should start in programs/schools of nursing, schools of medicine and programs in the other allied health professions. If we can expose our students early on in their careers to evidence-based concepts and policies related to health disparities and inequities, the potential for structural change in our health care system can be real.
First, we must get to the root causes of the issue. There’s no better place to start the conversation about root causes for health inequities than in a classroom, whether it be face-to-face or remotely. The passion for this topic becomes quickly apparent. Health inequities are so ubiquitous; every student has a story.
Those teaching in public health have been incorporating these concepts about health and racial disparities, and the associated social determinants of health (SDoH) framework, into curricula for the past decade or more. What’s new and unfortunate today – as we navigate the COVID-19 pandemic – is that we can emphatically say to our students, “This is what health disparity and inequity look like.” They are experiencing disparities in real time and close to home.
The learning experience for public health students becomes inherently authentic and resonant because of COVID-19. We can formally embed social and structural determinants of health into population-health frameworks, and expose students to these concepts within the context of their lived experiences with the COVID-19 pandemic. (Abuelezam, 2020). This is the framework of Applied Learning. It is all about knowledge and skills learned in the classroom and applied in a hands-on, real-world environment. Farmingdale State College utilizes such an approach in teaching core public-health concepts, as well as in courses across the campus.
Public Health Nursing
Public-health nurses who are knowledgeable about SDOH framework play an especially important role in the current pandemic, as they do with any natural and man-made disaster in this country. They are there on the frontlines, always.
The journal, Public Health Nursing, just released its May/June issue, with the key editorial, A Call to Action for Public Health Nurses During the COVID-19 Pandemic Public-health nurses are working countless hours serving our local health departments, investigating case-contacts; providing timely education on self-isolation and quarantine through hotlines and home visits; and interpreting data and guidance for the public from the Centers for Disease Control and Prevention (CDC).
The Trust for America’s Health recently issued a report about the severe underfunding of the United States public-health infrastructure. It notes that less than three percent of the $3.6 trillion the U.S. spends annually on healthcare is directed toward public health and prevention. Public-health nursing positions have been grossly underfunded, eliminated or replaced over the past three decades. Yet, today’s pandemic speaks volumes of the invaluable and critical role that the public-health nurse serves during times of disaster. There has never been a better time to start a dialog about investing in a strong public-health infrastructure to weather the next few months, and for the future of the nation’s health. And that investment begins with educating the next generation of public-health practitioners.
Public-health nursing has always been grounded in the concepts of health equity, health parity, social justice, nondiscrimination, epidemiology, health promotion and risk reduction. Foundational to this nursing specialty is the understanding and appreciation of the very concepts filling the headlines of social media –systemic and structural racism.
Health Disparities
Public-health nurses and other public health practitioners are keenly aware of the disproportionate effect the coronavirus has had and continues to have upon minorities. Part of this inequity stems from the higher rates of chronic disease that communities of color experience. The data show that chronic disease is a risk factor for COVID-19. So, from the start, minorities are more vulnerable to the virus. This, coupled with language and cultural barriers many minorities face, makes them especially susceptible to COVID-19. Public-health practitioners are aware of this population’s limited health literacy skills, and consider this and other barriers when dispensing care and communicating instructions.
Communication
This is one of the reasons Farmingdale State College developed the Health Promotion and Wellness degree program last year. Its goal is to graduate individuals who will use leadership, management and collaborative skills within a multidisciplinary approach to forge health promotion and planning interventions for individuals, groups, and local at-risk populations. The Health Promotion and Wellness curriculum is grounded in public-health/community-health concepts, along with emphasis on the pursuit of wellness in all dimensions of life: social, physical, emotional, occupational, intellectual, environmental and spiritual. Graduates learning within this multidimensional approach to wellness will undoubtedly be a critical addition to a workforce that will be challenged with the long-term sequelae of the COVID-19 pandemic.
The Nation’s Health discusses how COVID-19 is reshaping the future of public health in this country. Before the pandemic, the general public did not appreciate nor understand what those in public health do. Now they do.
Dr. Monica Diamond-Caravella is Assistant Professor and Academic Coordinator for Farmingdale State College, Department of Nursing. You can reach her at monica.diamond-caravella@farmingdale.edu.
About the Suburban Hospital Alliance of New York State
The Suburban Hospital Alliance of New York State advocates on behalf of hospitals in the Hudson Valley and Long Island regions. It engages key lawmakers and regulatory decision-makers in Albany and Washington to ensure reasonable and rational health care policy prevails.
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The Nassau-Suffolk Hospital Council represents the not-for-profit and public hospitals on Long Island. It works in conjunction with the Suburban Hospital Alliance of New York State to advance legislative and regulatory priorities. NSHC serves as the local and collective voice of hospitals on Long Island.
About the Northern Metropolitan Hospital Association (NorMet)
The Northern Metropolitan Hospital Association represents the not-for-profit and public hospitals in the Hudson Valley region. It works in conjunction with the Suburban Hospital Alliance of New York State to advance legislative and regulatory priorities. NorMet serves as the local and collective voice of hospitals in the Hudson Valley.
The Dahill Dose 