April is National Minority Health Month, and this year, the HHS Office of Minority Health (OMH) is focusing on the impacts COVID-19 is having on racial and ethnic minority and American Indian and Alaska Native communities and underscoring the need for these vulnerable communities to get vaccinated as more vaccines become available. According to the Center for Disease Control and Prevention (CDC), certain vulnerable populations, such as non-Hispanic African Americans, individuals living in nonmetropolitan areas, and adults with lower levels of education, income or who do not have health insurance, have a higher likelihood of forgoing getting vaccinated.
This year’s theme for National Minority Health Month is #VaccineReady. The goal of this campaign is to empower vulnerable populations to get the facts about COVID-19 vaccines, share accurate vaccine information, participate in clinical trials, get vaccinated when the time comes, and proactively practice COVID-19 safety measures.
Studies show that COVID-19 vaccines are effective at keeping people from getting COVID-19 and the CDC recommends that everyone get vaccinated as soon as they are eligible. As more vaccines become available, there are steps communities can take to protect themselves until they can get vaccinated:
- Wear a mask to protect yourself and others and stop the spread of COVID-19.
- Wash your hands often with soap and water for at least 20 seconds.
- Stay at least six feet (about two arm lengths) from others who do not live with you.
- Avoid crowds. The more people you are in contact with, the more likely you are to be exposed to COVID-19.
To learn more about National Minority Health Month and to receive updates on news and activities, sign up for OMH email updates and follow us on Twitter, Facebook, and Instagram.
Visit the National Minority Health Month webpage to download and share this year’s logo.
The COVID-19 Health Equity Task Force will provide recommendations for addressing health inequities caused by the COVID-19 pandemic and for preventing such inequities in the future
As the COVID-19 pandemic continues to plague the country, it has had a disproportionate impact on some of our most vulnerable communities. Shortly after COVID-19 was first identified in the United States, disparities in testing, cases, hospitalizations, and mortality began to emerge. These inequities were quickly evident by race, ethnicity, geography, disability, sexual orientation, gender identity, and other factors.
President Biden and Vice President Harris have released a National Strategy to combat the pandemic that has equity at its core. To help ensure an equitable response to the pandemic, the President signed an executive order on January 21 creating a task force to address COVID-19 related health and social inequities. This Task Force is chaired by Dr. Marcella Nunez-Smith.
Today, President Biden and Vice President Harris announced the following individuals to serve as non-federal members of the Biden-Harris COVID-19 Health Equity Task Force. Individuals selected by the President are:
Mayra Alvarez of San Diego, CA
James Hildreth of Nashville, TN
Andrew Imparato of Sacramento, CA
Victor Joseph of Tanana, AK
Joneigh Khaldun of Lansing, MI
Octavio Martinez of New Braunfels, TX
Tim Putnam of Batesville, IN
Vincent Toranzo of Pembroke Pines, FL
Mary Turner of Plymouth, MN
Homer Venters of Port Washington, NY
Bobby Watts of Goodlettsville, TN
Haeyoung Yoon of New York, NY
The twelve Task Force members represent a diversity of backgrounds and expertise, a range of racial and ethnic groups, and a number of important populations, including: children and youth; educators and students; health care providers, immigrants; individuals with disabilities; LGBTQ+ individuals; public health experts; rural communities; state, local, territorial, and Tribal governments; and unions.
As Chair, Dr. Nunez-Smith will also ask six additional Federal agencies to be represented on the COVID-19 Health Equity Task Force as federal members. This includes the United States Department of Agriculture, Department of Education, Department of Health and Human Services, Department of Housing and Urban Development, Department of Justice, and Department of Labor.
The Task Force is charged with issuing a range of recommendations to help inform the COVID-19 response and recovery. This includes recommendations on equitable allocation of COVID-19 resources and relief funds, effective outreach and communication to underserved and minority populations, and improving cultural proficiency within the Federal Government. Additional recommendations include efforts to improve data collection and use, as well as a long-term plan to address data shortfalls regarding communities of color and other underserved populations. The Task Force’s work will conclude after issuing a final report to the COVID-19 Response Coordinator describing the drivers of observed COVID-19 inequities, the potential for ongoing disparities faced by COVID-19 survivors, and actions to ensure that future pandemic responses do not ignore or exacerbate health inequities.
Mayra Alvarez, MPH
Mayra E. Alvarez, MHA is President of The Children’s Partnership, a California advocacy organization working to advance child health equity. Previously, she served in the U.S. Department of Health and Human Services during the Obama-Biden administration, including at the Centers for Medicare and Medicaid Services, the Office of Minority Health, and the Office of Health Reform. She has also served as a Legislative Assistant in the US Senate and House of Representatives. A native of California, she graduated from the School of Public Health at the University of North Carolina at Chapel Hill and the University of California at Berkeley.
James Hildreth, PhD, MD
James Hildreth is president and chief executive officer of Meharry Medical College, the nation’s largest private, independent historically black academic health sciences center. Dr. Hildreth served previously as dean of the College of Biological Sciences at University of California, Davis and as a professor and associate dean at Johns Hopkins University School of Medicine. Dr. Hildreth is a member of the National Academy of Medicine and an internationally acclaimed immunologist whose work has focused on several human viruses including HIV. He currently serves on the advisory council for the NIH director and as a member of the FDA Vaccines and Related Biological Products Advisory Committee. Dr. Hildreth has led Meharry’s efforts to ensure that disadvantaged communities have access to COVID-19 testing and vaccines. He graduated from Harvard University as a Rhodes Scholar, from Oxford University with a PhD in immunology, and obtained an MD from Johns Hopkins School of Medicine.
Andrew Imparato, JD
Andy Imparato is a disability rights lawyer and the Executive Director of Disability Rights California, where he has spearheaded advocacy on crisis standards of care and vaccine prioritization in the last year. Imparato joined DRC after a 26-year career in Washington, DC, where he served as the chief executive of the Association of University Centers on Disabilities and the American Association of People with Disabilities. From 2010-2013, Imparato served as Chairman Tom Harkin’s Disability Policy Director on the U.S. Senate Committee on Health, Education, Labor and Pensions. Imparato’s perspective is informed by his lived experience with bipolar disorder.
Victor Joseph was elected by the 42 member tribes to the position of Tanana Chiefs Conference (TCC) Chief/Chairman in March of 2014 and served through October of 2020. As the Chief Chairman he was the principal executive officer for the corporation and presided over all corporate meetings of the member tribes. Prior to being elected TCC’s Chief Chairman Victor was employed as TCC’s Health Director from 2007 to 2014. He worked for TCC a total of 28 years in a variety of leadership position. He has also served as Alaska Representative on the U.S. Department of Health and Human Services Secretary’s Tribal Advisory Committee and on the Indian Health Services Budget Formulation Committee. Joseph is a tribal member of the Native Village of Tanana. He has extensive experience building strong working relationships with tribal leaders, colleagues, staff, funding agencies and corporate beneficiaries.
Joneigh Khaldun, MD, MPH
Dr. Joneigh S. Khaldun is the Chief Medical Executive for the State of Michigan and the Chief Deputy Director for Health in the Michigan Department of Health and Human Services (MDHHS). She is the lead strategist for Michigan’s COVID-19 response. Prior to her role in Michigan she was the Director of the Detroit Health Department, where she established a comprehensive reproductive health network and led Detroit’s response to the Hepatitis A outbreak. Dr. Khaldun has held former roles as the Baltimore City Health Department’s Chief Medical Officer and Fellow in the Obama-Biden Administration’s Office of Health Reform in the US Department of Health and Human Services. She obtained her BS from the University of Michigan, MD from the Perelman School of Medicine at the University of Pennsylvania, and MPH in health policy from George Washington University. She practices emergency medicine part-time at Henry Ford Hospital in Detroit.
Octavio Martinez, MD, MBA, MPH
Octavio N. Martinez, Jr. is the Executive Director of the Hogg Foundation for Mental Health at The University of Texas at Austin. Additionally, Martinez is a Senior Associate Vice President within the university’s Division of Diversity and Community Engagement; clinical professor in the university’s School of Social Work; and professor at Dell Medical School’s Department of Psychiatry. A native Texan, Martinez has an MPH from Harvard University’s School of Public Health, an MD from Baylor College of Medicine, and an MBA and BBA in Finance from The University of Texas at Austin.
Tim Putnam, DHA, EMS
Tim Putnam is President and CEO of Margaret Mary Health, a community hospital in Batesville, Indiana and has over 30 years of healthcare experience. He received his Doctorate in Health Administration from the Medical University of South Carolina where his dissertation was focused on acute stroke care in rural hospitals. He is a past president of the Indiana Rural Health Association and the National Rural Health Association. In 2015 he was appointed by the Governor to the newly created Indiana Board of Graduate Medical Education and has chaired the Board since its inception. Dr. Putnam is also a certified Emergency Medical Technician.
Vincent C. Toranzo is an active student from Broward County, Florida. Mr. Toranzo has experience with the inner workings of municipality functions. He serves as the State Secretary of the Florida Association of Student Councils advocating for the inclusion of student voices in their community, such as assistance to foster children and the assurance of students’ safety amidst the COVID-19 pandemic. Mr. Toranzo was awarded the U.S. President’s Award for Educational Excellence and a Citizenship Award for School and Public Service from his local U.S. congresswoman.
Mary Turner, RN
Mary Turner is an ICU nurse at North Memorial Medical Center in Robbinsdale and in her sixth year as President of the Minnesota Nurses Association (MNA) union—the Minnesota affiliate of National Nurses United. She previously worked at Abbott Northwestern Hospital in Minneapolis for 10 years. Turner has been on the National Nurses United’s Joint Nursing Commission since 2011. She serves as the Chair of the Board for Isuroon, which provides empowerment, culturally sensitive health education, and advocacy for Somali women.
Homer Venters, MD
Homer Venters is a physician and epidemiologist working at the intersection of incarceration, health and human rights. Dr. Venters is currently focused on addressing COVID-19 responses in jails, prisons and immigration detention facilities. Dr. Venters is the former Chief Medical Officer of the NYC Correctional Health Services and author of Life and Death in Rikers Island. Dr. Venters has also worked in the nonprofit sector as the Director of Programs of Physicians for Human Rights and President of Community Oriented Correctional Health Service. Dr. Venters is a Clinical Associate Professor of the New York University College of Global Public Health.
Bobby Watts, MPH, MS
G. Robert (“Bobby”) Watts is CEO of the National Health Care for the Homeless Council, which supports 300 Health Care for the Homeless FQHCs and 100 Medical Respite programs with training, research, and advocacy to end homelessness. Watts has 25 years’ experience in administration, direct service, and implementation of homeless health and shelter services. Watts served as Executive Director of Care for the Homeless in New York City for twelve years. He is a graduate of Cornell University and Columbia University’s Mailman School of Public Health from which he holds an MPH in health administration and an MS in epidemiology.
Haeyoung Yoon, JD
Haeyoung Yoon is Senior Policy Director at the National Domestic Workers Alliance. Over the course of her career, Yoon has worked on low-wage and immigrant workers rights issues. Prior to National Domestic Workers Alliance, Yoon was a Distinguished Taconic Fellow at Community Change. Yoon also has extensive litigation experience and taught at the New York University School of Law and Brooklyn Law School. She recently testified before the House Judiciary Committee’s Subcommittee on Immigration and Citizenship regarding Immigrants as Essential Workers during COVID-19. Yoon received her JD from CUNY School of Law, her MA from Harvard University, and her BA from Barnard College.
Almost any nurse knows 2020 can’t be compared to any other point of time they have lived through. And 2021’s progress is in sight, but it’s slow going getting there. Vaccines are on the horizon and some nurses have even completed both doses, but hospitals are still seeing more patients than they can sometimes handle and the new strains of COVID-19 bring the threat additional surges. Nurses are seeking short bursts of stress relief to combat the burnout they are feeling.
The COVID-19 pandemic has left a path of devastation few are equipped to deal with physically, emotionally, or spiritually. As front-line workers, nurses bear the brunt of overwhelming stress, grief, and exhaustion. Stress relief is a priority, but hard to come by for most nurses.
Minority Nurse recently spoke with Crystal Miller RN, past president of the Infusion Nurses Society (INS) about the ways nurses are just trying to get through these times when days blur together and overtaxed is the normal state.
The emotional toll on nurses can’t be overlooked, she says. “Anyone in health care has been impacted,” says Miller. “Even if it’s not every shift, it has challenged us emotionally.” Nurses, who are problem solvers by nature, aren’t always able to find a solution, let alone the best solution, out of many choices. “The patients are so so ill and you can effect only so much change,” she notes.” And it’s not necessarily for a positive outcome.”
Maintaining a patient connection is now a hard-to-grasp process, but Miller says her team makes a significant impression in any way they can. “We’ve been put to the test in so many ways,” she says. “Making sure we have eye contact –that’s pretty much the most impactful contact we can have right now.”
What else helps? Miller offers a few suggestions based on her conversations with other nurses.
Talk to a Professional
“It’s about more than us and the care we provide and the equipment we use,” says Miller. “It’s about us being emotionally resilient and maintaining our mental health.” Miller, who has spoken or interviewed many nurses who are fighting back tears, says the hurt and the pain nurses are feeling is so dominant. With her own team, she tries to promote the use of employee assistance programs that offer counseling services and encourages that resource. “Sometimes it’s better to talk to someone who doesn’t work in health care and gives you a new perspective,” she says.
Find a Distraction
From watching quick and easy-to-digest TikTok videos to feeding the birds to deep breathing—finding something fast to calm you or make you laugh is valuable. And don’t worry how silly it might seem to others—you need relief and an immediate escape. If a few bursts of cat videos or watching reality TV or breaking out in song and dance help you, then just do it.
“I can’t stress journaling enough,” says Miller. Again, you’re not going for profound entries. You can write that today was a horrible day and just get that out. Or you can write that out of the horrible day your coffee was perfect and you’re grateful for that one thing.
Find Your Own Soothing Habit
“One person I know grounds herself before her next patient interaction,” says Miller. She touches the door or doorframe before entering the room as a way to say “I am going to see someone else now.” The purposeful action provides a divide between the experience she just had and the one she is beginning.
Acknowledge Your Limits
“Right now, most of us are of the mindset of work, go home, go to bed,” says Miller. “We are so tired.” Still, the grinding workload doesn’t mean nurses have lost their legendary spirit that keeps them going even when things are bleak. “At the end of the day, we just try to enjoy moments of levity when they present themselves and however they present themselves,” says Miller. “And chocolate goes a long way in my book.”
Caroline E. Ortiz, MS, MPH, RN, NC-BC
Caroline E. Ortiz, MS, MPH, RN, NC-BC, Associate Professor, Holistic Nursing, Pacific College of Health and Science, grew up in a bicultural and bilingual household. So it’s not surprising that she learned a great deal about traditional healing practices of Mexican-American women —especially from her grandmother.
When Ortiz decided to pursue a PhD, she chose this topic to study. We interviewed her about it to see what all nurses could learn from her research.
How did you get interested in the traditional healing practices of Mexican-American Women? Why did you choose this for your PhD topic?
Growing up in deep South Texas on the coastal border with Mexico, I was raised in a bicultural/bilingual region where Mexican culture and traditions mixed with those considered American. My mom was a nurse, so when we were sick, she would take us to the pediatrician. However, if we were staying with our grandmother—my mom worked a lot—she would either administer home remedies or take us one block down the road to the local traditional healer.
As a child, I did not understand the difference between Western biomedicine and traditional medicine. I just knew that receiving care from my grandmother and the local healer felt so much more love-infused than when taken to the doctor. As I further explored complementary and alternative medicine and holistic nursing, the childhood memories of my grandmother’s healing rituals and remedies and the feelings of being deeply cared for returned.
My decision to study traditional healing practices among Mexican-American women of deep South Texas is more an act of honor and gratitude to my ancestral medicine-keepers than being strictly an intellectual endeavor. Through this work, I am returning home to learn from caregivers and healers with the intention of sharing what the traditional medicine from ancient Mesoamerica by way of Mexico can teach us today about well-being and healing in mind, body, spirit, and emotions.
Have you or anyone you know actually practiced these traditional healing techniques? If so, please say which ones and explain.
- Plática – an organically unfolding heart-centered talk for arriving at the root of a problem and mutually working it through to resolution
- Limpia – an energetic spiritual cleansing using various tools, such as healing herbs or a whole, uncooked egg, meant to harmonize imbalanced physical, emotional, mental, or spiritual aspects
- Botanicals – the use of healing herbs and botanicals for numerous ailments (physical, emotional, or spiritual) in a variety of preparations, including infusions, tinctures, or in natural form; Commonly used are rue, basil, rosemary, chamomile, rose, sage, lavender, fever few, cinnamon, and aloe vera.
These practices are commonly noted in Mexican-American communities today, whether used by informal caregivers independently or with the assistance of a traditional healer.
How do you think that your research may help the nursing field? Should some of these practices be used in Western medicine? Or are you focusing more on how and why nurses should be aware of these practices?
My intentions are to share with nurses and health care practitioners and leaders what so many patients are practicing and have kept as valuable cultural expressions for improving health, healing, and well-being individually and collectively.
Why is it important for the health care field to be aware of these traditional healing practices?
Research shows that medical pluralism is commonplace, especially in geographical regions where cultures intersect, as they do along the U.S.-Mexico border. This means that people are utilizing more than one medical system or paradigm of care at a time. However, patients of Mexican ancestry are often not disclosing their home treatments to health care providers, and their providers are often not exploring those practices beyond a superficial level, if at all.
The standard of high-quality health care includes being effective, safe, and culturally responsive. Knowing more about traditional medical practices in U.S. communities of Mexican origin and leveraging their potential for improving health expands opportunities for meeting those standards. Moreover, the U.S. medical system may come to learn additional approaches to health, healing, and well-being practiced by other cultures with positive outcomes. The World Health Organization’s Traditional Medicine Strategy has the incorporation of traditional medicine into Western health care systems as one of its goals for increasingly accessible and equitable health care worldwide.
Is there anything I haven’t asked you about that is important for our readers to know?
Curanderismo is the Spanish term describing traditional medicine from ancient Mesoamerica and currently practiced by many communities in Mexico, Central America, the Andes, and the Amazon. It comes from the word curar, meaning “heal.” In curanderismo, the health state means being in harmony internally and externally. Internal harmony balances the physical, mental, spiritual, and emotional aspects, while external harmony balances the self in relationship with others, the natural world, and the greater, multi-dimensional universe. However, this paradigm, in essence, acknowledges no separation between any of these elements.
Cervical health is an essential part of well-health screenings and can help detect cervical cancer, one of the more preventable types of cancer. January is Cervical Health Awareness Month and highlights the steps that can help prevent cervical cancer.
According to the National Cervical Cancer Coalition, more than 13,000 people are diagnosed with invasive cervical cancer every year. And while any case of cancer is one too many, cervical cancer rates were once much higher and more deadly than they are now. Cervical cancer used to be the leading cause of cancer deaths among women in the United States, but several developments have led to dramatic positive change.
Most cases of cervical cancer are caused by the human papilloma virus (HPV). According to the Centers for Disease Control and Prevention (CDC), most men and women will be infected with one of the strains of HPV at some point. Currently, 80 million Americans are infected with HPV, with 14 million additional infections yearly. In most cases, the virus will stay present in the body and will go away, like many viruses do, within a couple of years. There are more troublesome strains that will remain in the body and can cause different types of cell changes that can lead to cancer.
According to the CDC, there are a few ways the medical community can approach prevention detection, and treatment. The introduction of the HPV vaccine, regular Pap smears, and tests to detect the presence of HPV have dramatically reduced the incidence of cervical cancer in the United States.
Development of the HPV vaccine was a game-changer for preventing this kind of disease. Nearly all cervical cancers are caused by HPV, a virus with many strains. Some strains of the virus can cause genital warts while other strains cause few or no symptoms but can lead to changes in the cervix over time that cause cancer if left undetected and untreated.
Although adults can get the HPV series of vaccinations up until age 45 (it is most recommended up until age 26), it is highly recommended for youths beginning around age 11 or 12. Receiving the vaccine before any potential exposure to HPV can prevent infection with the virus, but isn’t a treatment if the virus is already present.
Increasing attention to screening for cancerous changes in the cervical cells with Pap smears and for detection of any HPV levels in cells (two separate tests that can be done at the same visit) has upped the detection rate of more treatable precancerous changes. If cervical cell changes are detected, treatment options are available and will depend on the findings. Removal of the precancerous cells may be recommended to prevent cancerous changes. And a positive HPV test with a normal Pap smear offers valuable information that may lead to more frequent screening to catch changes early.
Talking to Patients and Families
Despite its effectiveness, rates of HPV vaccination lag behind what many medical professionals consider ideal. If patients and families in your practice seem hesitant, it might help to offer a few facts. The vaccine is to prevent cancer, but because HPV is transmitted sexually, some families relate the vaccine with condoning sex. The more you can separate the two so that the concern is for long-term health and is for potential exposure, the more success you might have. The American Academy of Pediatrics’ HPV Champion Toolkit is another resource to help increase vaccination rates which will lead to fewer cases of cervical cancer.
The most important prevention for preventing cervical cancer is to keep up with regular screenings. If you haven’t had a Pap smear in a while or have been postponing your annual visit because of a packed schedule, put it back on your high-priority, staying healthy list. Outcomes are drastically different when these changes are caught at a treatable stage.
What comes to mind when you hear the words, “Physical Activity”? For some, it might conjure up a negative connotation while for others, they may already be a go getter for an active lifestyle. Believe it or not, physical activity and exercise are two different terms although used interchangeably. Physical activity is any movement of the body done through skeletal muscle contraction that causes the energy expenditure to go beyond its baseline. Simply stated, physical activity is movement, in any form.
Sadly, less than 5% of adults participate in 30 minutes of physical activity, and 28-34% of adults aged 65-74 are physically active in the United States. It is important to gather some perspective on the impact of a sedentary lifestyle and how it is more common than physical activity. According to the Center for Disease Control, physical inactivity is even more common among ethnic and racial groups in most states. The CDC’s January report from 2020 showed overall, Hispanics had the highest prevalence of physical inactivity (31.7%), followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%).
We all have heard of vital signs. Part of that assessment should also involve the type of physical activity one engages in. As nurses, we are the largest body of the health care workforce, and studies show that we are not following healthy practices when it comes to our self-care and well-being. The American Nurse Association even launched a Healthy Nurse, Healthy Nation initiative to address the core elements that address nurse’s self-care and well-being, Activity, being one of them which goes to show that this is a pressing concern.
Some of the challenges posed as to why people do not take part in physical activity is location. The neighborhood in which people live may not have access to outdoor parks, paved streets, or recreation centers. Depending on your home environment, you may not have the space to exercise in.
The good news is just doing any activity, especially one in which you enjoy doing is acceptable in burning calories. Anything is better than being sedentary. The risks of sedentary behavior are universal and it is important for nurses to adopt a more active lifestyle. Physical inactivity is closely related to premature death, preventable disease, and health care costs.
Exercise is a subset of physical activity and is defined as an activity that is organized, planned, and reoccurring which is done with the intent of improving or maintaining one or more components of one’s health. Having said this, physical activity can involve any movement and does not have to involve a schedule or with an “all or nothing” attitude. For those who are trying to lose weight, exercise is not as important as much as your food intake. There needs to be a calorie deficit in order to lose weight. Nutrition and physical activity work in tandem but about 80% is based on nutrition and 20% should be focused on physical activity.
Physical activity come with benefits such as: heart health and prevention of diabetes, improved strength and mobility, release of dopamine, endorphins and serotonin (the “feel good” hormones), increased lifespan, and increased insulin sensitivity. Carrying on extra weight can contribute to joint pain. For every additional pound that you are overweight, an extra 5 pounds of pressure is exerted on your joints.
It cannot be argued that the majority of nurses are female and women tend to hold onto more fat than men; that is how nature intended us to be designed. As we age, we are also at risk for bone loss. For that reason, we do not want to lose weight too quickly because we also want to protect our bones, which is why muscle resistant training is so important. Half a pound per week of weight loss is the ideal; it is all very specific to how much weight the person needs to lose. Even a 5-10% weight loss can reap positive effects on overall health.
Nurses, especially those of other ethnicities can become role models and advocates for system changes at the workplace as well as at home. Even if nurse leaders are not fully on board, it is important to heighten awareness on the benefits of physical activity which would improve morale as well as productivity. Identifying barriers is the first step and serving as a role model would also provide an impetus for behavior change.
Just like with patients, we need to assess our readiness and meet ourselves where we are at. We need to give ourselves permission to work on our fitness regimen so it can be more sustainable. The best exercise to lose weight is the exercise you will do. If you have to ask yourself, “Should I work out today?” hopefully, the answer is yes. If you choose “No”; well, yes you should.