Beyond This Moment in Black History
Published February 2021
Health equity is the fair and just opportunity for optimal health and well-being for all. In contrast, health disparity is the vast health differences observed between groups.
Although not limited to race, an existing health disparity in the U.S. is the disproportionate number of Black men and women who have been severely impacted by COVID-19.
However, health disparity is not a new issue, and it is not confined to COVID-19. It stems from a variety of barriers that will require a multifaceted approach to address, and it affects the full spectrum of health care: physical, mental and spiritual.
Three Black Northwestern Medicine staff members provide their invaluable perspectives on historic barriers to health equity and how to address the disparities. They offer steps for promoting health and well-being in the Black community beyond this moment in history, and they share their own remarkable work as healers themselves.
Building Representation and Momentum
Northwestern Medicine Lake Forest Hospital Radiation Oncologist Joy L. Coleman, MD, finds great purpose in her role as a healer.
"It's my job and my duty to try to help others. I often see patients when they're feeling very vulnerable having just been diagnosed with cancer. I help them navigate their healing journey and decide on the best treatment plan moving forward."
By taking into account her patients' values and evaluating their individual circumstances, Dr. Coleman is able to present them with options for moving forward. No matter what treatment path her patients choose, she says, "I reassure them that we are in this together, and we will work toward healing together."
Dr. Coleman is also dedicated to finding a road map to reducing health disparities in cancer care. When it comes to breast cancer, she notes, "Black women have a lower overall survival rate than white women. In fact, this is the case for most cancers."
There are several factors that create this health disparity, including a prolonged time to diagnosis, underrepresentation of racial minorities in clinical research, the lack of Black physicians represented in the community and the lack of treatments developed for conditions that are more commonly experienced by Black patients, including triple-negative breast cancer. This type of breast cancer has the worst prognosis, it is far less responsive to available breast cancer treatments and it is often associated with worse outcomes.
Narrowing in on the factor of representation, racial and ethnic diversity of healthcare providers is correlated with the delivery of quality care to people of color.
"It is vital that all patients feel that the providers helping them are a part of the communities they trust," says Dr. Coleman. "Until you have trust, you can't make any big change. We need to give Black people the chance to see themselves on the other side of the table."
Dr. Coleman notes that Northwestern Memorial HealthCare has a few programs that expose students from underserved communities in Chicago to the different facets of medicine. One of these programs is the Northwestern Medicine Pre-Med Internship Program, which provides undergraduate students with experience in clinical observation and focused project work. Dr. Coleman is helping to expand this program to the Cancer Center at Northwestern Medicine Lake Forest Hospital in 2021.
After movements like Black Lives Matter and White Coats for Black Lives, Dr. Coleman says, "Part of me is very hopeful because people are more aware, but part of me is also a little cynical because people tend to have a short memory."
Looking forward, she adds, "I remain proud of the steps we took last year, and am excited to keep the momentum going in 2021 because the fight for health equity is too important to let this be the cause of the week."
Cultivating Trust and Access to Resources
Growing up in different neighborhoods throughout Chicago, Northwestern Memorial Hospital Clinical Psychologist Inger E. Burnett-Zeigler, PhD, quickly observed the unequal access to health resources, education and employment opportunities. This planted the seed that grew her interest in how this disparate access can change one's life trajectory, and it inspired her to become a resource for patients along their journey toward healing.
"Despite historical trauma, persistent racism and discrimination, I try to give patients the tools to manage the emotions of traumatic stress, depression and anxiety. I remind them of their inherent worth and power while encouraging them to practice self-compassion," Dr. Burnett-Zeigler says.
She works to eradicate mental health stigma while breaking down barriers to mental health treatment for the Black community, including the lack of access to mental health resources in underserved communities.
"In addition to issues like having the time, financial capability, child care and healthcare access, stigma is a major piece that prevents Black people from seeking care for mental health, trusting mental health providers and even seeing themselves as having a mental health problem," adds Dr. Burnett-Zeigler.
Dr. Burnett-Zeigler conducts research that is focused on factors like stigma, which alter access and engagement, so she can implement evidence-based mental health interventions within community health centers. Additionally, she is focused on training a pipeline of Black mental health professionals and developing culturally sensitive approaches to treatment so Black individuals can trust that their medical team recognizes and can relate to their experiences.
"Healing a community requires building trust, so that community members are able and willing to access resources available to them," she says.
Dr. Burnett-Zeigler also notes that mental health issues have surged during the COVID-19 pandemic. In particular, she notes, "Black people are holding a heavier burden of stress due to disproportionate suffering from COVID-19, persistent racial disparities and other systematic barriers." She reminds her Black patients to lean into communities that are validating and that provide a sense of support.
"When we turn to our elders, they remind us that things have changed and things are still changing," she adds. Seeking generational wisdom can help put things into perspective — to see how far we have to go but also how far we've come."
Creating Connection and Strength
Sister Appolonia Irika, Northwestern Medicine chaplain and interim manager of spiritual care in the northwest suburbs, believes that spiritual care can relieve pain and build strength for all of humanity.
"As a Black woman, I recognize that all humans bleed the same red blood," she says. "No matter our different geographic location, we all have one unique characterization of spiritual needs."
Over the past 24 years, Irika has devoted her life to addressing spiritual needs and advocating for spiritual healing. "I feel called to this work, and I derive joy from this calling."
Irika's vocation began during her early life. Living in the southeastern part of Nigeria in West Africa, she had a strong desire to care for the less privileged, the aged and the sick. Years later, she continued her work in Europe and eventually migrated to the U.S., where she currently cares for patients at Northwestern Medicine Huntley Hospital.
Irika defines human spirituality as "a search for what gives a human strength and hope in a particular situation." She feels this quest for strength is a two-way street where a person can both give strength and draw strength from the care they offer to others. After her father recently died, Irika found strength and comfort from not only her friends but also the inspirational words she had given to others.
Even during challenging times, healing can come from extending compassion, listening and seeking connection with others. "Spiritual healing involves relational presence, trust and care from both parties involved," says Irika. "A consoling presence could help a person rise up from the bottom and climb from the darkest hole to see rays of light."