Where do you consider your hometown?
I’m from Fairmont, a small town in northern West Virginia near the Maryland and Pennsylvania borders.
Describe your nursing journey.
My mother ran a private nursing facility in West Virginia, and my brother ran a larger one across the street. From the age of 10, residents lived in our homes. Residents at both facilities had a range of physical and mental health conditions, but mainly we cared for people with dementia, mood disorders, and age-related difficulties with physical mobility.
Caring for patients came naturally to me but so did art. I worked as an adjunct art professor in central Illinois for about 6 years before I went back to school for nursing. While I was still teaching art, I enrolled at Bradley University and received my BSN and Master of Science in Nursing Administration in 2015 and 2016.
Then, I began working at an inpatient geriatric psychiatric unit. The unit was part of a behavioral health service line. Nurses were trained to work on all the units including the child and adolescent, adult, and community psychiatric floors and the drug rehabilitation center.
Through this experience, I wanted a different role in patient care and began a doctoral program at the University of Illinois Chicago. Within my DNP project, I developed a weight support group, based on feminist theory, for women with disordered eating patterns. Each of the women had experienced trauma, and often they coped in both healthy and unhealthy ways. As a practitioner, it’s difficult to discuss diet and exercise when a patient’s feelings of poor body image may be tied to traumatic experiences.
Group therapy, using feminist theory, was an effective approach. We looked at causal factors external to them such as Western ideals of beauty, diet culture, marketing, and the gender norms of food.
While leading that project, I became curious about how health is tied to environment and culture. That curiosity about the external dimensions of health led me to apply to the PhD in Nursing at UW–Madison.
I’m now certified as a Psychiatric-Mental Health Nurse Practitioner and hope to have an impact through research, rather than direct patient care.
Why did you choose the UW–Madison School of Nursing’s PhD program?
There are several great places to study nursing science. When choosing, I researched the faculty, PhD students, and postdoctoral trainees to find out their areas of research and if the program could support the study that I proposed.
The work of Dr. Susan Zahner, now professor emeritus, and Dr. Jessica LeClair, postdoctoral trainee, at UW–Madison, matched my interests in public health and the global climate crisis. I currently work with Dr. Tonya Roberts and Dr. Anne Ersig with expertise in qualitative and grounded theory methods and stress, adolescent well-being, and theory.
It was a good decision to choose a program based on areas of research. I’ve come to rely on their expertise to advance my knowledge and skills as an early researcher.
What do you like about the PhD program?
The faculty have a range of expertise, which allowed me to adjust my area of focus.
When I began the program, I was interested in climate change and its psychological impact. I’ve shifted to syndemics, which are multiple diseases co-occurring within a population and place, largely due to social factors. My region of interest is West Virginia and Appalachia.
My research explores how geographic and social issues lead to multiple health disparities rather than the specific diseases or conditions. This wider lens allows me to consider policy, cultural factors, and other conditions specific to place, such as energy extraction, the climate crisis, and health.
Over the last two years, I took seminars in Geography and Rural Sociology at UW–Madison. I also met and worked with epidemiologists at NIOSH in Morgantown, WV, who research black lung and silicosis and work directly with coal miners’ lung surveillance. These are all critical components that I now consider in my work.
I can’t separate factors of place, rurality, or industry from the health of West Virginians.
Nurses can work with other disciplines to improve the health and well-being of communities in a practical way.
What advice would you give someone interested in the PhD program?
Reach out to faculty and current students that have similar interests or who you may have an interest in collaborating with. Prospective students should also look at resources available across campus.
Again, I’ve studied with faculty in Geography and Sociology, but I’ve also taken courses from the School of Medicine and Public Health and Population and Health Sciences. There are also a significant number of research centers on campus that may also be of interest, like the Center for Health Disparities Research and Dr. Amy Kind’s Neighborhood Atlas .
How did you first get interested in syndemics in West Virginians?
I moved from West Virginia to central Illinois in 2008. I felt displaced. I still do, to a degree.
At that time, I read more about West Virginia to stay connected. What I read included news on the state of West Virginia, most often these were health and social rankings. Before I entered the nursing profession, I was aware of the disparities in the state and throughout the region—I had lived them.
West Virginia ranks lowest or near lowest for multiple physical and mental health conditions, educational attainment, poverty, poor housing, foster care, opioid use, and risk from flooding from climate change.
During the COVID pandemic, West Virginian adults were most likely to face poor outcomes due to pre-existing chronic health conditions. Social conditions follow the same pattern. I was recently reading about the demographic cliff in higher education, and I knew West Virginia University would be featured. They will face significant losses in the next decades.
Together, all of these have an impact on the well-being of a place.
Being away made me more aware of the changes and challenges back home. I realized I needed to focus my work on West Virginia—few people do.
The state is a clear example of what happens when industry interests outweigh the well-being of residents. It’s a complicated history with a profound impact on health and well-being. West Virginia shares similarities to other communities across the country that lack resources and restorative leadership.
What are you learning and what impact could your discoveries make?
Syndemic theory isn’t new—Merrill Singer introduced it in the 1990s in what he termed SAVA (Substance Abuse, Violence, and AIDS).
In West Virginia, syndemics are clearly present. Recognizing how multiple diseases and conditions interact, especially when they’re common in a place, is essential.
Nursing is well-positioned to seek out residents’ perspectives to understand how communities experience these overlapping challenges and how they affect public health. Nursing can shift how we view contextual factors relating to health and well-being.
How does your research relate to planetary health?
My interests include the impact of the energy industry on the health of people and place–these can’t be separated.
One of the biggest health factors in West Virginia is mountaintop removal (MTR) and valley fill. Mining of siliciclastic rock to reach the coal seams and the processing that follows harms coal miners and area residents.
The permanent changes to the topography will have lasting impacts on the environment and residents. Even with the decline of coal mining, the damage to the population’s health and the local economy will continue because of land use change.
How could someone support your research or get involved in planetary health?
Nursing students interested in environmental impacts on health should explore their department. At UW–Madison, Dr. Jessica LeClair has a background in public health and leads classes on the subject. She works with community-based organizations to advance planetary health.
Across campus, there are faculty and students to collaborate with. You can get involved in the Rural Sociology, Agroecology, and Geography programs and learn more about planetary health.
What career plans do you have after graduation?
I will continue my research, maintaining a geographic perspective–looking at how policy, industry, environment, and social factors influence health. Although my primary interests are West Virginia and Appalachia, my work may move to other rural settings.
In the PhD program, we focus on one significant study. I hope to follow the program with postdoctoral training and then move into an academic position at a research-intensive institution.
I want to teach and mentor other students who wish to work in an interdisciplinary and place-based manner.
How are you and other nurse researchers transforming the future?
I’m not sure I’d put myself in the same category as other nurse researchers—I work a bit differently.
I recognize that health and social disparities in West Virginia and the region are significant and multi-faceted. They need addressing by multiple disciplines.
I’ve relied on faculty for their expertise and hope to bring nursing’s expertise to highlight the complexity of disease and health in underserved communities.