Racism and health inequity present a serious public health crisis in the United States (Centers for Disease Control and Prevention [CDC], 2021). Health inequities related to race, ethnicity, disability, gender expression, and sexual orientation are well documented in the literature (Bailey et al., 2017; Institute of Medicine, 2003; Krahn et al.2015; Restar et al., 2021). For many decades, nursing and health care publications have illustrated the connection between race and health disparities. The relationship between racism and other forms of oppression and adverse health outcomes is not a new concept. Over 20 years ago, Dr. Camara Jones (2000) authored a framework for understanding racism using a gardener’s metaphor explaining that health disparities are not a result of race, but rather, they are a result of the social determinants of health that result from structural, institutional, and individual racism. However, this knowledge about the causes and solutions to health inequity have not resulted in substantial improvements in health outcomes.
Additionally, despite the knowledge that a diverse nursing workforce is needed to improve health outcomes, little progress has been made in the demographics of nurses in the United States (Aragon et al., 2020; The Sullivan Commission on Diversity in the Healthcare Workforce, 2003). A diverse nursing workforce is key to impacting future health outcomes and providing culturally informed care for increasingly diverse communities and patients. OADN is committed to addressing the public health crisis caused by racism, structural inequities, social injustice, and implicit and explicit biases.
Recent disturbing events have raised awareness of the impact that racial and social injustice have on Americans’ health and well-being. The COVID-19 pandemic highlighted the severe toll that structural racism has on health outcomes and nurses with diverse ethnic and racialized backgrounds. Black/African American, Indigenous, and Latinx people have disproportionately experienced higher rates of infection, hospitalization, and death when compared with white Americans (CDC, 2020; Khazanchi et al., 2021). Hate and violence directed towards Asian and Pacific Islander populations have increased significantly since the COVID-19 pandemic began.
These inequities remain present in all aspects of healthcare and society at large in the United States. Inequities and injustices based on racism, ableism, gender expression, sexual orientation, residency status, religion, and a socio-economic system continue to persist and are dominating features of American society. The collective power and unified voice of over four million nurses provide an opportunity for leadership to influence meaningful change and dismantle systems of oppression.
OADN recognizes that the need for action goes beyond vows of commitment to achieving health equity. We understand that genuine commitment will necessitate a combination of leaning into discomfort, inviting, and listening to historically excluded voices, and dismantling and reimagining present systems to improve our communities. We support meaningful change in nursing programs, schools, communities, and healthcare systems.
OADN is committed to taking the action needed to address racial and social injustice across the healthcare system and in nursing education. To accomplish this mission, we must engage in challenging conversations and transformational work. To that end, OADN is taking the following immediate actions:
- The OADN Board has appointed a Diversity, Equity, and Inclusivity Task Force that is charged with assessing the current state of Associate Degree Nursing education and proposing strategies to improve diversity, equity, and inclusion in nursing education.
- OADN leadership and task force members are engaging in critical conversations between and among stakeholder groups with the specific aim to increase the diversity of the nursing workforce and address health inequities.
- OADN will curate and share educational resources and tools for nursing faculty to support the development of antiracism and social justice competencies in nursing education.
- OADN actively participates in the American Nurses Association National Commission to Address Racism in Nursing and is collaborating with other professional nursing organizations to adopt antiracist policies and practices.
- OADN enhances the quality of nursing education by providing learning opportunities for nursing faculty and students that critically examine the social determinants of health, the social mission of nursing, and the needs of under-resourced communities.
Unanimously Endorsed OADN Board of Directors: June 8, 2021
References
Aragon, S., Beauvais, A., Friday, V., Green, C., Kiger, A.J., King, S., Lear, T., Mahowald, J., McGuill, G., Perkins, D., Valdez, A., Velasco, B. & Wangerin, V. (2020). Equity, achievement, and thriving in nursing academic progression. Teaching and Learning in Nursing, 15(4), 255-261. https://doi.org/10.1016/j.teln.2020.06.002
Bailey, Z. D., Krieger, N., Agenor, M., Graves, J., Linos, N., & Bassett, M. (2017). Structural racism and health inequities in the USA: Evidence and interventions. The Lancet, 389(10077), 1453-1463. https://doi.org/10.1016/S0140-6736(17)30569-X
Centers for Disease Control and Prevention. (2021). Racism and health. Racism is a serious threat to the public’s health. https://www.cdc.gov/healthequity/racism-disparities/index.html.
Centers for Disease Control and Prevention. (2020). COVID-19 racial and ethnic health disparities. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/index.html.
Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. The National Academies Press.
Jones, C. P. (2000). Levels of racism: A theoretic framework and a gardener’s tale. American Journal of Public Health, 90(8), 1212. 10.2105/ajph.90.8.1212
Khazanchi, R., Evans, C. T., & Marcelin, J. R. (2020). Racism, not race, drives inequity across the COVID-19 continuum. JAMA network open, 3(9), e2019933-e2019933. 10.1001/jamanetworkopen.2020.19933
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an unrecognized health disparity population. American Journal of Public Health, 105(S2), S198-S206. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2014.302182
Ndugga, N., Pham, O., Hill, L., Artiga, S., Alam, R. & Parker, N. (2021, Apr. 21). Latest data on COVID-19 vaccinations race/ethnicity. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/.
Restar, A. J., Sherwood, J., Edeza, A., Collins, C., & Operario, D. (2021). Expanding gender-based health equity framework for transgender populations. Transgender Health, 6(1), 1-4. https://doi.org/10.1089/trgh.2020.0026
The Sullivan Commission on Diversity in the Healthcare Workforce. (2003). Missing persons: Minorities in the health professions. SullivanReport-Diversity-in-Healthcare-Workforce1.pdf
