Improvements in health will be driven by those who bring value through innovation, but more importantly, it will be driven by those who establish trust, build equity and lead changes that foster community well-being.
The observation and the man who makes it slash to the heart of the cultural moment to expose a deep wound to well-being.
“It is unnerving to be thanked for my service while in uniform, and racially profiled while out of uniform,” said Terrell Foster, CHP ’22, a member of the President’s Task Force for Diversity and Inclusion. “I have similar experiences as a registered nurse. Our nation often recognizes these professions as honorable and respectable; however, no level of accomplishment or professional background makes you immune to implicit bias or systemic racism, in or out of uniform, but especially out of.”
The second lieutenant in the U.S. Air Force Reserve will return to active duty as a captain following completion of his Doctor of Nursing Practice degree in 2022. As a member of multiple underrepresented groups — African American, LGBT, veteran — and a citizen of a nation he experiences as “rife with racial injustice,” Mr. Foster gives voice to an effort that he said must be championed by those in positions of power with the means to affect change.
“One of the task force’s priorities is to empower students to be able to engage with state and national leaders in order to create sustainable change”
“This means our national and state leaders, and even here at RFU, our institutional leaders,” Mr. Foster said. “It’s important for these leaders to be personally invested and informed on the topics that impact our community.”
A new generation of healthcare professionals, more diverse in gender, race, ethnicity and socioeconomic background, is demanding systemic change, pushing for a future free of social determinants like racial discrimination and poverty that underlie so much illness. Mr. Foster envisions a future in which he can provide the best care for his patients.
“We often refer to evidence-based practice, and we’re taught about it,” he said. “But in actual practice, there are practical limitations. The business of health care can be a barrier, along with health policies that are not always in line with best practices. It would be great if we had a system where patients could receive evidence-based care and more culturally competent care that leads to desirable outcomes.”
“There are too many barriers to health,” said RFU President and CEO Wendy Rheault, PT, PhD, FASAHP, FNAP, DipACLM. “So many deaths are related to health behaviors that are shaped by social factors, including income, employment, education — things we need to work on as a society.”
The President’s Task Force, which was established by Dr. Rheault, is aimed at assessing the state of the university in relation to its historic commitment to diversity and inclusion. One of numerous efforts underway includes ensuring implementation and integration of diversity and inclusion learning outcomes across curricula. Expanded learning opportunities will emphasize cultural competence of healthcare providers and the role of systemic racism in disparities in all aspects of health care, including patient outcomes.
“The pandemic is raising awareness of glaring inequities in health outcomes among people of different races and socioeconomic backgrounds,” Dr. Rheault said. “We’re seeing a connection between the COVID-19 crisis and the racial crisis, which is helping to focus our attention as educators and health professionals on the need to tackle racism and redefine it as a public-health issue.”
Health professions students are key stakeholders in equity and inclusion efforts, and they are helping to build momentum around reform.
“One of the task force’s priorities is to empower students to be able to engage with state and national leaders in order to create sustainable change,” said Mr. Foster, who wants to see a more diverse healthcare workforce.
“Our nation’s service members deserve culturally competent care, just as civilians deserve it,” he said. “That is what has driven me to serve in the Air Force, first as a medic and soon as a certified registered nurse anesthetist.”
Advocacy around social issues that impact health have helped catapult health professionals into elected office. U.S. Rep. Brad Wenstrup (R-Ohio), DPM ’85, a colonel in the U.S. Army Reserve, recalls a patient with poorly controlled diabetes who was under treatment for neuropathy and foot ulcers.
“After one visit, he said, ‘I can’t come see you anymore because the bus doesn’t get me here in time to still get to work,’” Dr. Wenstrup said. “I told him I would come in early. As healthcare providers, we can’t ignore our patients’ larger issues. We have to take some responsibility within our communities to change those dynamics so we can provide better care.”
The only physician member of the House Ways and Means Committee, where he helped establish the bipartisan Rural and Underserved Communities Health Task Force, Dr. Wenstrup saw health disparities while serving on the Cincinnati Board of Health from 2010 to 2013.
“We could look at certain ZIP codes and see higher rates of infant and maternal mortality and STDs,” said Dr. Wenstrup, whose district in southern Ohio was rocked by the opioid epidemic — an impetus for the task force.
“We can have all these hearings in Washington about what health care should look like, but without providers, there’s no anything,” Dr. Wenstrup said. “We need to make sure everyone who goes through medical school gets a residency slot and to get doctors to where they’re most needed — places with the highest mortality and morbidity. That means expanding incentive programs for underserved and rural areas, which have the worst health outcomes across the board, including higher rates of COVID.
“In addition to a health workforce shortage, we’re seeing shared issues related to the social determinants of health: housing, transportation, nutrition. We’re raising the level of attention and knowledge on barriers to quality health care through multiple bills in and around the CARES (Coronavirus Aid, Relief, and Economic Security) Act.”
In Illinois, the General Assembly passed a bill last year to create the Diversity in Health Care Professions Task Force, and a report, including recommendations and strategies, is expected in December, said State Sen. Julie Morrison (D-Deerfield), who noted a particularly severe shortage of behavioral health and social workers.
Sen. Morrison has led an effort to fund $10,000 tuition stipends for people who want to go into child welfare social work in exchange for three years of service with the state’s Department of Children and Family Services. A pilot initiative will launch this fall.
“We’re hoping to attract men and women of color who want to serve their communities,” said Sen. Morrison, who is also pushing for more investment in prevention of chronic disease and increasing services for people covered by Medicaid. She worked for the passage of Public Act 101-649, which increases access to COVID-19 diagnostics and treatment.
“We know the uninsured, people who have not had good access to health care, are the most profoundly hurt by COVID-19,” said Sen. Morrison, who is vice chair of the Public Health Committee and chairman of the Human Services Committee. “We’re looking with a very critical eye at supporting services that are community-based and cross barriers of social services and health care. That means funding to an appropriate level so that those services can survive.”
RFU is determined to educate healthcare professionals who will embrace their responsibility to affect change for improved health, regardless of their role.
“Proactive engagement at a social and government level is what drives policy, which is the foundation of how health care is performed and in what context,” said VP for Student Success and Inclusion Rebecca Durkin, MA. “There’s a real need for civic engagement by informed providers who can share their perspective on what our communities need to be healthy. Teaching students at that level and helping them find an effective and productive path to engage can affect system-wide change.”
Patrice A. Harris, MD, the first African-American president of the American Medical Association, expressed a similar conviction during her visit to campus on Feb. 5.
“We all know decisions are made that negatively impact our ability to care for our patients,” Dr. Harris said. “At the very least, health professionals should know their elected officials at the local, state and national level. Email them. Let them know you are willing to be a trusted resource around your area of expertise.”
Ms. Durkin said RFU is committed to giving future providers the foundation they need to contribute in new and truly meaningful ways to the well-being of patients of all cultures and all races.
“We’re helping students understand the structural aspects of health in the context of their relationships with patients, and it goes beyond that to the structural components of science, how we conduct our research, how grants are funded, how we teach about sickness and health,” said Ms. Durkin, who also serves as vice president for student success and inclusion. “All those pieces contribute to the complexity of structural issues that either promote or harm health.”
Judy Masterson is a staff writer with the RFU Division of Marketing and Brand Management.
Please note, any group photo that does not feature physical distancing or mask wearing was taken prior to the State of Illinois issuing such guidelines. RFU has policies in place that require these and many other safety measures.