FROM KAMMONKE, OBASE-WOTTA
The Dallas Examiner
Black communities are said to be disproportionately affected by COVID-19 in the United States with social determinants of health as the main factor contributing to the disparities. Umeika Stephens, Cynthera McNeil and Tara Walker, professors at Wayne State University, have written a peer-reviewed textbook Urban Health: A Practical Application for Clinical Based Learning. The book reveals these disparities and proposes some solutions to the problem.
Along with their careers in academia, Stephens is also a psychiatric nurse practitioner and a family nurse practitioner; McNeil is an internal medicine provider at one of the city’s urban hospitals; and Walker is a critical care nurse at Ben Harper Hospital in the same city.
Reflecting on the years since the COVID-19 pandemic began, the professors expressed initial surprise that the disparity was still so evident amid a global crisis.
“It’s interesting to me. I am always shocked and surprised that a disparate community would have worse outcomes related to something like COVID,” Stephens said.
“This pandemic, while it has impacted us from a healthcare perspective, has so many other societal ramifications as we look at how people of color in general are treated within healthcare systems. And so, I think it highlighted a problem that we already knew was there. We talked a lot about the social determinants of health and stuff like that. They are not new concepts. They weren’t new concepts at the time the COVID pandemic hit. I think what he showed was a huge, very significant flaw in our health care system and he provided probably the most unique evidence we’ve had in a long time to show the difference in how African Americans and people of color are treated and our results in general health care”.
As professors, they have shared this knowledge with their students, who are future medical professionals.
“I have sought to teach students about the social determinants of health and how future providers need to be aware of other factors impacting the health and health outcomes of underserved urban populations,” McNeil said.
He went on to say that COVID-19 has exposed areas of the healthcare system that have not been performing well. Over time, the communities that suffered the most were those that were struggling in other areas. Like someone in academia, she looked at how prospective providers should be taught based on knowledge of well-documented disparities.
“We always talk about the disparity, the statistics that talk about you know, low income low socio-economic status, low education, poverty, the statistics talk about how the disease is more important in these particular communities that also suffer from determinant social problems of sanitary barriers. All of this is already well documented. But what was not documented was: how do we as providers who are supposed to help people, improve their health or maintain it? And when COVID hit, it further highlighted the disparity that already existed and enabled a platform to really highlight the disparities in healthcare across all sectors. And then the result of this disconnected health system on disadvantaged populations. So my role as an educator is how am I going to train future providers to be able to be equipped to navigate and help patients improve their health outcomes amidst all of these disparities?
With the realization that systemic problems existed across the country, they felt a good step in finding solutions on a larger scale was to document their journeys through the healthcare system as nurses, academics and providers and offer insights for improving the healthcare system.
“Well, the first solution was to write a textbook that teaches hands-on skills to providers who don’t have a hands-on experience working with minority populations or underprivileged populations or urban populations,” McNeil said. “I think people assume working in urban communities is a skill, the way you have to borrow and negotiate things that should be a standard of care.”
The professors said the textbook can be beneficial to everyone, but especially improve the provider-patient relationship.
“Our attempt has been to improve the patient-provider relationship to better train providers to understand patients’ lived experiences. Because at this particular time, we have to work with patients where they are,” McNeil said.
“So, our book and our perspective is really about the here and now and lived experience. As we wait and try to make a change on Capitol Hill and legislation and all that type of stuff, people are going about their daily lives and that’s where we’d like to make an impact.
The book is about learning how to create interprofessional networks and collaborations to help patients, how to get uninsured patients the health care and services they deserve. Because medical guidelines have been designed based on a resourceful mindset, experience has revealed to them that changes need to be made to make the guidelines meaningful to the lives of patients in underprivileged communities, according to the authors.
Additionally, the book was intentionally written in a non-technical conversational style for use by a variety of professions, including but not limited to other medical areas, social work, any area that focuses on how to interact with disparate communities. Various professions can use it as a starting point or foundational piece for opening dialogues on critical issues and having those serious conversations that acknowledge the lived experience of patients in communities that lack adequate resources and how to care for them.
The authors wanted to make sure the book was easily accessible. It is available as a free download at https://digitalcommons.wayne.edu/oa_textbooks/2.
As of Wednesday, the textbook had been downloaded by 24 universities and educational institutions, plus a library and 21 healthcare facilities and other businesses. In total, it has been downloaded 733 times and in 59 countries.
Robyn H. Jimenez/The Dallas Examiner contributed to this report.