During times of social unrest and upheaval (e.g.: COVID-19 or the Black Lives Matter movement), nurses are often on the front lines of treating the sick and injured, as well as speaking out when injustice rears its ugly head. How can nurses stand up for those oppressed or unjustly treated when it comes to racial disparities? How can they position themselves as allies and advocates for patients who may otherwise be subjected to lower-quality treatment and social conditions that create poorer health outcomes? Where can nurses land in such challenging times? 

Healthcare Disparities are Real

In Indianapolis, data show that 646 out of every 100,000 African Americans are infected with COVID-19, whereas 345 out of every 100,000 white citizens are infected. The article reporting this data states: 

“…black residents in Marion County are more likely to be in situations where they could contract COVID-19, like living in more crowded housing or working in front-line occupations. They are more likely to experience underlying conditions that can increase the severity of COVID-19 cases. And some black individuals can have a harder time than white residents accessing care due to a lack of health insurance and other factors.”

The Kaiser Family Foundation puts it this way: 

“Health disparities, including disparities related to COVID-19, are symptoms of broader underlying social and economic inequities that reflect structural and systemic barriers and biases across sectors. Though health care is essential to health, it is a relatively weak health determinant. Research shows that social determinants of health—the conditions in which people are born, grow, live, work and age—are primary drivers of health. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care (Figure 2). For example, children born to parents who have not completed high school are more likely to live in an environment that poses barriers to health such as lack of safety, exposed garbage, and substandard housing. They also are less likely to have access to sidewalks, parks or playgrounds, recreation centers, or a library. Further, evidence shows that stress negatively affects health across the lifespan and that environmental factors may have multi-generational impacts.”

Adding to these cogent arguments, The League of United Latin American Citizens (LULAC) reports that “racial minorities and other vulnerable populations suffer a disproportionate burden of disease. These groups of people suffer from poorer health outcomes due to disparities in accessing health insurance coverage, quality care, and other factors.” 

What are the results and what are the costs of such disparities? LULAC continues: 

Due to these barriers to care, these groups must face higher health costs, increased number of missed work days due to illness and lower household income. In 2009 alone, health disparities amongst African Americans and Hispanics the health care system an addition $5.1 billion. This number is expected to rise to an astounding $65 billion within the decade as the number of Latinos and African Americans in the United States increases and these disparities persist.”

If you begin with the very real premise that these disparities exist and that it’s no fault of these racial groups that they have poorer access to care and are more likely to live in conditions where the social determinants of health actually work against them, what can nurses do to change this brutal equation? 

The Eyes and Ears of Justice and Equality

Nurses continue to step up and speak out when it comes to racial disparities in healthcare. While they cannot ethically discuss their personal or political beliefs with patients, they have the means to use their communication skills to build trust and dig deep into the social determinants of health for each individual and family. Once problems are identified, resources can be shared to assist with improving access and outcomes. 

Nurses’ political advocacy can take the form of meeting with local, state, and national legislators individually or under the auspices of a nursing organization. Like other citizens, nurses can choose to exercise their right to vote and support candidates who address health inequities. They may also communicate with elected officials in writing, identify themselves as nurses, and express their personal and professional concerns.

In the course of recent Black Lives Matter demonstrations, nurses have participated as demonstrators and by administering aid to those who have been injured. 

In the workplace, nurses witnessing racial disparities speak out as fierce patient advocates. As the largest segment of the healthcare workforce, numerous nurses are public-facing clinicians who bring critical thinking, a holistic view of patients’ lives, and emotional and relational intelligence to the table. Racism and discrimination take many forms in the midst of care delivery, and nurses can truly be the eyes and ears of justice and equality. 

Letters to the editor, op-ed pieces, and other means are at nurses’ fingertips. Nurse bloggers, podcasters, and social media influencers can engage large audiences, and many nurses leverage these platforms to educate others. Nurses can also use their personal social media feeds to push back against friends, family, or others who espouse views that are misguided, outwardly racist, or disparaging of racial minorities, the LGBTQ community, or other oppressed groups. 

As the most trusted professionals in the United States year after year, nurses have a platform that can reach millions if they leverage that trust in the interest of those who are underserved and discriminated against. Racial disparities in healthcare and other aspects of society can be addressed and overcome, and nurses, as the eyes and ears of healthcare, can play an important role in any solution that will truly bear the fruit of justice and equality for all. 

Learn more on topics of care in a diverse patient population with our Cultural Competency with Religious, Ethnic, and LGBTQ+ Considerations Nursing CE Course worth 2 ANCC contact hours.