Breaking the Code

Removing the barriers that prevent the Black community from having long, healthy lives

By Payton R. Wade

Black health care worker interacting with Black adolescent and family

It starts at the very beginning

Imagine living in a society where the quality of life was not correlated to the color of your skin or your class in society. As trained advocates, nurses help bridge the gap in the quality of health care people receive by assessing and addressing various social determinants of health, such as a patient’s environment or their access to proper resources. For the Black community, systemic racism is one such determinant.

Systemic racism has played a major part in everyone’s lives, but it is different when a system can affect your quality of life and determine how long you live. According to the Centers for Disease Control and Prevention (CDC), for every 1,000 white babies born, only 5.2 die before the age of one. But, for every 1,000 Black babies born, 11.5 die before their first birthday. Even at birth, a Black child’s likelihood to see their first birthday is over two times less likely than if they were White.

It is a struggle that extends well into adulthood. People from racial and ethnic minority groups are consistently at a disadvantage when it comes to health care. Recently, the CDC has published findings that, “Long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.” And the inequities extend beyond the pandemic.

Sherrelle Jackson, DNP, RN, FNP-BC, clinical assistant professor at the School of Nursing, notes that diabetes, hypertension, and kidney disease are the three leading causes of death in the Black community. These three diagnoses are significant because they are all preventable. This issue starts with the lack of resources and in-depth education when it comes to health care for Black people.

“You must find that unity because there are so many forces trying to break us apart, and whenever we help each other, we’re breaking that system.” —Jessi Kendall ’14

Advocating for those who can’t

As natural advocates, it is important for nurses to help educate their patients and continue to provide the necessary resources to help make health care more equitable.

Elisha Smith ’14, DNP’21, notes the importance of nurses within their communities, emphasizing, “Nursing sees patients as a whole. We see all of the needs and are part of the whole picture.”

The direct connections and the ability to assist patients are why many nurses chose the profession; but for some, it is also deeper than that, as making change within their community drives their passion.

Jackson says, “Advocating for people who do not have a voice for themselves and wanting to help those within our community,” are two of the main reasons she got into nursing in addition to her desire to help her family.

Madison native Jessi Kendall ’14 says, “I try to use my own personal experience growing up in Madison to break the codes and bring my expertise into being an advocate. You must find that unity because there are so many forces trying to break us apart, and whenever we help each other, we’re breaking that system.”

All three of these nurses are utilizing their expertise to help break down the barriers that are preventing members of the Black community from obtaining the resources and education they need to live the healthiest and longest lives possible.

Jackson explained a time when she went through one of her patient’s schedules to see where he could incorporate lifestyle changes to help with his disease because he was not successful with utilizing the tips given before. It was this extra step that Jackson took that potentially saved this man’s life. A true advocate knows to take the time to understand their patient’s circumstances and educate them, rather than assuming the patient knows how to incorporate changes in their life.

“There’s a lot of resources for patients, but the issue is whether or not they have access to those resources,” says Jackson. “[They] also don’t always know what [they] need due to the lack of education, so [they] don’t know what to ask, and health care providers often assume people know.”

Doing the extra work

Jackson, Smith, and Kendall all identify as Black/African American. So, what can those who do not identify as Black do to be advocates as well?

Kendall says, “Others who are not Black can advocate for their patients by being willing to be honest with themselves and realize that some of the things that seem self-explanatory are not always so.” She continues to say, “Health care professionals look at themselves as someone who is out there doing something positive, and that is true. But just like when someone walks through the door to our home, we personalize and welcome them based on their needs, and health care workers must do the same thing.”

By identifying the community they are assisting, and doing the proper research to provide the correct resources, nurses can make a big impact and better advocate for their patients. Minor changes such as doing research to personalize resources given to those in the Black community can go as far as extending one’s life expectancy.

It is not only up to those in health care who identify as Black to make a difference by being advocates. People who are not Black must also see this as a priority. Health care workers save lives and making slight changes can save even more lives, especially of those whose life expectancy is already lower than the majority of the population from birth.

Smith is constantly thinking about how he can do more within his position to help others, adding, “My degree is for the community. I think we as a health care community have to do the extra work to know the community we serve. Every Black community is not the same; we need to do the research and meet them where they are.”