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• 1 2023-12-12T21:55:27+00:00 Access to Quality Healthcare: 1970’s - Present 10 plain 2023-12-12T22:08:11+00:00

  Since hospital integration, Black communities have continued to struggle to access high-quality healthcare. The hospitals and medical centers that predominantly serve Black Chicagoans continue to be underfunded. In the American healthcare system, wealthier people with private health insurance can usually access better care, and Black people in Chicago are disproportionately poorer than any other racial group.1 Poverty also comes with its own social challenges, such as access to nutritious food, exposure to violence and chronic stress, that ultimately result in poorer health.2 Many Black Chicagoans are not able to have regular contact with medical care and if they do, their care is limited by their insurance. As Deborah Bump, a Black psychiatric nurse practitioner explains: “[s]ome of the medications that I want to prescribe for my patients…the insurance company doesn't want to pay for it…A lot of people, a lot of therapists, don't want to take Medicaid.”
  
  Janice Phillips, the assistant director of the Illinois Department of Public Health, explains that some of the biggest health inequalities stem from the fact that many low-income people and people of color do not have access to a regular primary care physician. This means that they do not receive regular check-ups and might not deal with health issues until they become very severe. Additionally, many Black Chicagoans have had negative experiences with white doctors and nurses who judged them and did not understand their background or needs. This might lead people to avoid seeking out medical care in the future.
  
  Black nurses in Chicago have sought to address these issues in many ways.
  
  Addressing Racism in Hospitals and Communities
              Black nurses have found meaning in addressing the barriers to health that their community faces. June Young began her career at a hospital in Hinsdale, Illinois, where the patient population was largely affluent, white and occasionally racist. When she switched to working at the VA Hospital in downtown Chicago, she described it as a dramatic cultural shift, where she was now mostly caring for African American veterans. She notes that at the VA “I enjoyed helpin’ my people…it felt like, "Oh, I'm takin’, care of my uncle, like family.” Tamara Bland describes her first job out of nursing school similarly. She was working in the medical-surgical unit at RUSH Hospital and struggling because her supervisor was unsupportive and criticized her in front of patients. But she continued in nursing because she felt the impact of her work in how “the patient population [at RUSH] reflected the community in which I grew up.” She felt that she was “giving back to the community” and that her patients were teaching her how to be a better nurse.        
  
  Many Black nurses see a value in how their position allows them to educate their community. Janice Phillips has always felt passionately that “You can’t just take care of people you have to educate them too.” As a nurse at the University of Chicago she used to hang educational information on the bulletin boards in the waiting room, so that visitors could learn about topics like how to take care of someone having a seizure. She also focused on educating patients with sexually transmitted infections or who had been in car accidents about safer approaches to prevent these issues in the future. Phillips has spent much of her career promoting cancer screenings in the Black community, including working in the Englewood community in Chicago going to churches, laundromats, and other community spaces to promote breast and cervical cancer screenings.
  
  Black immigrants, having spent their formative years in the countries of their birth, upon arrival in the United States tend to have a limited understanding of U.S. racial politics. Regardless, these migrants face racism as well as othering from both Black and white Americans. Nurses Margaret Okodua and Titilola Turton founded the Nigerian Illinois Nurses Association (NINA) to “improve the health and quality of lives of Nigerians at home and abroad”3 while creating a space for Nigerian nurses to connect and support each other and their communities.
   

  “I think that nurses are doing more. I think they're giving more... Humanitarians on a mission to deliver healthcare and meet the needs of humanity. And that we can do that using sound, logical principles, and we can do it in any theater that you put us in. Just give us that opportunity to show you what we can do. We are achievers.”

                                                                                                                                         – Sandra Webb Booker
  
  Advocating for their Patients
  Because of the long history of racist healthcare practices in the U.S., Black nurses have been essential healthcare providers for patients of color who are understandably distrustful of healthcare institutions. Tamara Bland explains that as a hospital nurse she felt the difference in how she was able to connect with patients of color while other (white) nurses could not or did not. Much research has shown that healthcare workers are statistically likely to provide Black patients with worse treatment than white patients because of internalized bias.4 While working as a nurse at the VA in downtown Chicago, where most patients were African American, June Young taught night classes as part of the patient care committee, which trained all the hospital staff, including maintenance people, nurses, doctors, and even the CEO. The class focused on staff learning how to connect with the hospital’s patient population. “I want patients to be well taken care of,” Young explains, “and I want you to empathize with the patients.”
  
  Young is not alone in focusing on the education of other medical staff: many Black nurses have turned to educating the next generation of nurses as a way to fight healthcare inequalities. Sandra Webb Booker taught courses at Chicago State from 1980 until the early 1990’s. She focused on diseases like hypertension, those with a strong hereditary component, to try and help her students understand how to consider a patient’s health not just as individuals but within their families. Tamara Bland also went on to work as a as a professor at nursing schools, and currently serves as the Dean of the Borra College of Health Sciences at Dominican University. Bland focuses on issues like how the nursing school curriculum often do not prepare students adequately to care for patients of color. For example, (white) student nurses rarely learn that when a nurse bathes a Black patient, the washcloth might appear dirtier than it would for a white patient but, in reality, all patients’ skin sheds on a washcloth, and darker skin simply leaves a more visible residue. Similarly, assessing for jaundice, burns, or bruising appears differently in melanated (darker) skin compared to unmelanated (lighter) skin. If these details are mentioned in nursing textbooks, Bland argues, the authors (mostly white nurses) include them as cultural exceptions – as though Black people are the exception to what is normal (white skin) rather than having an equally valid variation in skin tone. These examples are critical ways that Bland focuses on educating students of all racial backgrounds about how to properly assess and connect with their patients.
  
  Like many Black nurses, she also focuses on supporting nursing students of color. Many patients benefit from having nurses who share their backgrounds, but nursing students of color often struggle in largely white schools of nursing, where they feel a lot of pressure to act as representatives of their race or ethnicity. Learn more about efforts to support nursing students of color here.
   

  “You just went…wherever the need was.”

                                                                       - Sandra Webb Booker
  Many Black nurses also serve their community through public health work, continuing a long history of Black nurses’ contributions in this field. Sandra Webb Booker worked at the Chicago Visiting Nurses Association in the 1980’s, where she visited the homes of people who had recently been discharged from the hospital and needed additional care. Some patients needed wound dressings changed and others needed help managing chronic illnesses like diabetes. Booker cared for patients in many Black communities on the Southside and Westside of Chicago, including the Robert Taylor and Altgeld Gardens public housing complexes. Booker described carrying heavy medical equipment from home-to-home, sometimes up many flights of stairs in buildings where the elevators broke down. “You just went around the city,” she explained, “to wherever the need was to provide the services that the patient needed.” Learn more about Black nurses in public health here.