Understanding the social determinants of health is an important first step in caring for patients across all populations. This understanding, however, must be paired with a continued push for progress and advocacy to improve access to care and quality of care.
These topics were central to a recent panel discussion hosted by the National Black Nurses Association on Feb. 9, 2021. Titled, “Understanding and Addressing HIV Risk in Black Communities,” this panel featured an important discussion around providing care for the Black community as well as understanding the history of oppression, the stigma around HIV and more.
University of Alabama at Birmingham School of Nursing Associate Professor of Nursing Crystal Chapman Lambert, PhD, CRNP, NP-C, FNP-BC, ACRN, was one of three panelists in the discussion, alongside Regional Coordinator of the REACH Initiative at Johns Hopkins University Dorcas Baker, RN, BSN, ACRN, MA, and Family Nurse Practitioner Ashakie Phillips, DNP, MSN, RN, FNP-C.
“This panel was important, as it allowed an opportunity to discuss the importance of social determinants of health in HIV prevention and management as well as possible strategies to address health inequities. Most important, the panel highlighted Black nurses from diverse backgrounds who are working to reduce health inequities. I chose to participate in this panel in order to highlight the importance of diversity, equity and inclusion in the field of nursing”
The panel began with a historical look at how slavery, segregation and continued microaggressions impact the Black community and continue to impact how patients interact with the health care system.
“We in nursing are not satisfied with the status quo, and we never have been,” said moderator and National Black Nurses Association First Vice President and Associate Dean for Equity Inclusion at Penn State College of Nursing Sheldon Fields, PhD, RN, CRNP, FNP-BC, AACRN, FAANP, FNAP, FAAN. “Despite efforts to advocate for our patients and members of the Black community, many obstacles remain in the way of progress for our patients in gaining access to HIV testing.”
In nursing, a field which is 90 percent female and 80 percent white, it is important to understand these obstacles in order to improve access to care and to reduce stigma around care, especially regarding HIV.
As a researcher, Chapman Lambert addressed the role research has in improving care by addressing these articles. First, however, changes to improve diversity in research and nursing also need to occur.
Crystal Chapman Lambert, PhD, CRNP, NP-C, FNP-BC, ACRN “In order for Black nurses to be change agents in the research setting, we have to be in the research setting. Organizations must review their hiring policies and practices to make sure they’re equitable,” she said. “And once they’re there, Black nurses need resources. We need funding so that we can do the work we’re passionate about. This is our community, and we’re passionate about that work. We need those people who are sitting at the table to advocate for us also to be at the table.”
Education is also important. Nursing schools need to include curriculum regarding the social determinants of health, and nurses need to know how to check their own biases.
The next step, panelists added, is in patient care. As a care provider, it is important to build trust with patients and approach care in a culturally appropriate way.
“Nurses are the most trusted profession,” Baker said. “It is important to use that to your advance as you work to educate and improve health in your community.”
Regarding HIV, this includes approaching conversation about sexual health, risk factors and testing in a non-judgmental manner. By making questions about potential exposure a standard in primary care visits, patients may feel less singled out by questions. Instead, they can build trust with their provider and gain access to needed resources and medication.
“In order for nurses to change their practice, we need to make sure they first have the information,” Chapman Lambert said. “If they believe HIV risk is based on a behavior, that’s how they’re going to approach the conversation. We need to shift that conversation to include social determinants of health, and away from any approach that places blame or supports a stigma.”
Chapman Lambert’s research focuses on improving health outcomes for minority populations, specifically women living HIV.
“There is so much work to be done, and we need more researchers,” she said. “And if you’re a researcher of color, we really need you and your ideas.”
The panel is available to watch on demand at this link.