Contact: Mary Boyle, mboyle@aarp.org

Five outstanding nurses with very different specializations have been selected as recipients of the 2024 Equity-Minded Nurse Awards from the AARP Center for Health Equity through Nursing^SM and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation. The award program supports the Campaign’s vision that everyone in America can live a healthier life, advanced by equity-minded nurses as essential and valued partners in providing care and promoting health equity and well-being.

The awards are given in five categories, and each is generously co-sponsored by a national nursing organization named below. Each awardee will receive a $1,000 prize and paid travel to and recognition at an awards dinner in Baltimore on Sept. 10 before a national audience of nurse educators.

The awardees are:

Wei-Ti Chen, RN, PhD, FAAN of the UCLA School of Nursing is the recipient of the 2024 Equity-Minded Nurse Leader Award. Co-sponsored by the American Organization for Nursing Leadership, this award recognizes a catalyst for change at the systems or organization level that addresses and dismantles policies and structures that contribute to disparities and inequities and contributes to an overall climate of inclusion that encourages the institution to focus on community needs.

Chen’s research is directed toward the development and dissemination of tools to improve health care and quality of life of underserved or stigmatized groups, such as people with HIV/AIDS, Tourette Syndrome, and mobile populations. She continues to identify the best approaches for developing suitable, effective and sustainable health policies in the area of HIV care. Chen is one of the first nurse scientists to conduct HIV intervention research with Asians both in the U.S. and in Asia (Taiwan, China, Myanmar and Thailand). Read more. 

Selena Gilles, DNP, ANEF, FNYAM, FADLN, FAANP, FAAN, of the New York University Rory Meyers College of Nursing is the recipient of the 2024 Equity-Minded Nurse Practice Award. Co-sponsored by the National Commission to Address Racism in Nursing/American Nurses Association, this award recognizes a nurse whose work with patients, families and/or communities exemplifies efforts to reduce health disparities and advance health equity.

Gilles has been an adult nurse practitioner for 14 years, specializing in neuro, pain management and addiction medicine. She is regarded as a leader and prelicensure nursing education expert, with a focus on preparing entry-level professional nurses to practice across a variety of settings in the spheres of wellness/disease prevention and chronic disease management. She has strong community advocacy and passion for global health, participating in seven medical missions. She has published articles on such topics as the value of including reproductive justice in nursing curricula, the role of nurses educating patients about opioid overdose harm prevention and using community-based models to increase vaccination rates in marginalized communities. Read more.

Sabrina Jamal-Eddine, PhD, RN, a postdoctoral researcher at the University of Illinois Chicago (UIC), is recipient of the 2024 Equity-Minded Nurse Rising Star Award. Co-sponsored by the National League for Nursing, this award recognizes a student or early career individual whose contributions show promise for ongoing impact in reducing health disparities and advancing health equity.

Jamal-Eddine is a nurse scientist and interdisciplinary disability justice scholar. Her doctoral research explored the use of critical narrative pedagogy to educate nursing students about disability, ableism, and disability justice in the context of health care, and she will advance this research through her postdoctoral fellowship. She serves on the board of directors of the National Organization of Nurses with Disabilities (NOND) as well as UIC Chancellor’s Committee on the Status of Persons with Disabilities. Jamal-Eddine’s long-term goal is to found an interdisciplinary, applied public-humanities community-engaged healthcare equity center in a university. Read more.

Robert Lucero, PhD, MPH, RN, FAAN, FACMI, UCLA School of Nursing is the recipient of the 2024 Equity-Minded Nurse Research Award. Co-sponsored by the American Academy of Nursing, this award recognizes a nurse researcher whose scholarship advances the science and the body of knowledge that advances health equity. The research or scholarship of this award should be or have the potential to be disseminated widely as best or promising practices.

Lucero’s research focuses on improving health outcomes of vulnerable populations using innovative health systems and informatics approaches. Two of his focus areas are enhancing the quality of care for hospitalized older adults and improving self-management of chronic health conditions among Hispanic, African American and LGBTQ+ populations. His research is leading the way to inform infrastructure development for data-driven knowledge generation that serves as a model for organizations across the United States to improve the quality of care for hospitalized older adults. Read more.

M. Rebecca O’Connor, PhD, RN, the University of Washington School of Nursing, is the recipient of the 2024 Equity-Minded Nurse Educator Award. Co-sponsored by the American Association of Colleges of Nursing, this award recognizes a nurse educator whose efforts demonstrate excellence in diversifying the nursing student body, inclusive teaching/learning practices, and whose teaching and/or curriculum design include topics that lead to the graduation of equity-minded nurses.

O’Connor is an associate professor in the University of Washington School of Nursing (SON), and an inaugural Betty Irene Moore Nurse Leaders and Innovators Fellow. Her research, teaching, and service reflect her commitment to addressing bias in nursing and beyond. She collaboratively designed and leads the Implicit Bias Clinical Education Program (IBIAS^TM) to develop bias-interrupting habits among future nurses, implicit bias training for interdisciplinary health sciences students, faculty, and research teams nationally, and an Anti-racism and DEI Teaching Institute for SON faculty. O’Connor received the Excellence in Promoting Diversity Through Teaching Award in 2016, 2018, 2019, and 2021 and Excellence in Graduate Teaching Award in 2022. Read more.

Antonia M. Villarruel, PhD, RN, FAAN, Professor, and the Margaret Bond Simon Dean of Nursing at University of Pennsylvania School of Nursing, who chairs the Campaign’s Strategic Advisory Committee, said the following about the award and 2024 honorees:

“Dismantling the structural barriers to equitable health care for all people continues to be one of nursing’s top priorities. Each awardee takes a unique approach to this challenge in their work, and it is such an exciting cohort this year!  We are pleased to partner with national nursing organizations to recognize the many different ways in which nurses, and nursing, advance health equity. Education, practice, and research are synergistic in nursing. We benefit from experienced, courageous leadership and we need passionate rising stars to keep moving us forward. We are fortunate to have these five extraordinary nurses in our ranks, and I am grateful for their contributions.”

Villarruel will recognize and celebrate the five awardees at the Hyatt Regency Baltimore Inner Harbor. The dinner is part of a two-day workshop hosted by the AARP Center for Health Equity through Nursing on mentoring for success for schools of nursing.

The Campaign defines equity-mindedness as so deeply understanding and embracing health equity, social justice, anti-racism, and cultural humility that these concepts emerge as normalized, automatic and default thought processes no matter the setting or the group of people they work with.

The Campaign wishes to acknowledge the thought leadership of Piri Ackerman Barger, PhD, RN, FAAN, associate dean for Student Affairs and Health Equity, Diversity and Inclusion and clinical professor at the University of California Davis Betty Irene Moore School of Nursing, for her role in shaping the Campaign’s equity-minded nurse initiative as its health equity senior fellow.

Learn about the Equity-Minded Nurse Initiative.

Meet the 2023 Equity-Minded Nurse awardees.

Learn about the awards.

The AARP Center for Health Equity through Nursing (A-CHEN) was founded to align nurse leadership and consumer voices to end structural barriers to health and well-being. It serves as a vehicle for change, hosting specific programs and activities that align with AARP’s health equity priorities.

The Future of Nursing: Campaign for Action is a national initiative of AARP Foundation, AARP and RWJF, guided by the National Academy of Medicine’s evidence-based recommendations on the future of nursing 2020-2030, Charting a Path to Achieve Health Equity, which explores nursing’s pivotal role in advancing health equity. The Campaign includes Action Coalitions in many states and the District of Columbia and a wide range of health care professionals, consumer advocates, policymakers, and the business, academic, and philanthropic communities. The Center to Champion Nursing in America, an initiative of AARP Foundation, AARP and RWJF, serves as the coordinating entity for the Campaign.

Learn more at www.campaignforaction.org. Follow on Twitter/X at @Campaign4Action and on Facebook.

Thank you to our co-sponsors:

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The digital divide has significantly narrowed over the past decade. What was once thought of as entertainment for younger generations has now become the leading modality for communication with others. We use technology for entertainment, accessing news, education, dating, friendship, keeping in touch – you name it. We do this through the use of smartphones, tablets, computers, gaming, etc. to stay in touch with the world around us. As a society, we have evolved from letters to email, from calling to texting, from asking a clinician to consulting with Dr. Google.

In 2023, Statista reported that internet use was greater than 86% in adults ages 65+ and in those with annual incomes less than $30,000. AARP published a study in 2019 that found ethnic and racial minorities ages 50 and up used technology daily. Specifically, they used online gaming to maintain mental sharpness and for personal entertainment. In 2021 a separate poll found that adults perceived many benefits to online gaming, such as connection with others, meeting new individuals, staying in touch, and for online community building.

With all of this data on the uptake and benefits of technology across age, heritage, and economic status, how can nurses leverage this to benefit patients and individuals in the community? How can it be harnessed to advance equity for persons who have access to technology, but have not had opportunities or an interest to participate in research?

In 2019, leaders in nursing, bioethics, medicine, and public health developed an e-Health framework for using technology in empowering, non-stigmatizing, ways. The framework goes over five steps towards use.

The first step is to use a technology that is common in the community, such as a laptop, tablet, or smartphone. This is important because if you use a new technology or one that is not easily accessible because of price, like a VR headset or popular gaming console, this may create barriers for individuals financially or not be of interest to a certain age demographic. Keeping the technology simple and accessible will ensure that others are comfortable using it (from their prior experiences) and that it is accessible after the study (so people can continue to benefit after the study ends).

The second step is to ensure anonymity. Even though we use technology for almost everything, individuals still value privacy. This can be especially important for individuals who have chronic illnesses (diabetes, HIV, heart disease, etc.), or are from backgrounds that are marginalized and experience social stigma.

The third step is co-presence, or the ability to feel close with others online although you are physically apart. This is important because it is a symbol of deepening engagement with others online.

The fourth step is self-disclosure, which stems from the feeling of co-presence where an individual can share parts of themselves with others in a meaningful way.

The fifth step is social support. That is, the potential gains associated with the safety of anonymity, deepening engagement, connection with others, and the building of community.

All of these steps are designed to make engagement with technology in research easy and engaging. The most important step prior to using the framework is to assess your positionality in that community, to earn trust, and be trustworthy as a research partner.

S. Raquel Ramos, PhD, MBA, MSN, FNYAM, FAHA, is Associate Professor of Nursing and Public Health at Yale School of Nursing. She is also recipient of the 2023 Equity-Minded Nurse Research Award, which was co-sponsored by the American Academy of Nursing.

Lead photo credit: (c) GETTY IMAGES: RichLegg

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The opposite of equity in practice is inequity in practice.

Once I began to understand the ways that groups of my patients were affected by various rules, expectations, stereotypes and historically racist policies, I also began to see inequity in practice. 

Once you see it, you can’t unsee it.

Come with me as we follow a patient who is 17 minutes late to their primary care appointment. We’ll look at it from the point of view of various folks in the clinic that day. 

The Patient

On its face, it’s a rather classic American reasoning of “personal responsibility,” until you learn about transportation challenges that some patients face trying to get to their appointments.

Imagine living a short distance from a major health facility, but you have mobility challenges and can’t drive yourself and instead rely on a transportation service to get you to your medical appointments. So you call the transportation provider that your insurance pays for and hope they will be able to accommodate a primary care appointment you just scheduled. They can. But you have to be ready two hours ahead of the appointment and you also can’t have any plans after the appointment because you can’t get a ride home until you call after the appointment and then that depends on everyone else’s rides in the region that day. 

Now imagine you accept you will have a day of lost work and you will pay someone to care for your children, all for a 20-minute primary care visit. And then your transportation to that appointment comes 2.5 hours late. Even though you said you would be ready at 10 AM. And you get to your appointment, through no fault of your own, 17 minutes late because it also takes many minutes to shuffle with your walker through the big hospital where you were dropped off to the clinic.

The front desk calls your provider to say you are there late, and your provider says they won’t see you. Front desk staff says you broke their attendance rule and you won’t be seen. And it was loud enough for the people in line to hear. So now you are embarrassed, out of time and money and won’t have a follow-up appointment to show for it. It’s too bad about your medication refills you planned to talk about. Oh, and you remembered it’s been a while since you had a mammogram, and you know there’s a little new lump in your breast. 

Perspective: the NP sitting next to the provider not practicing equity

Now that we’ve imagined a very real scenario, come with me to the ‘other side’ where I found myself as the nurse practitioner sitting next to the provider who was saying they wouldn’t see the patient. What can I do in this situation when I am aware of inequitable and unfair practices and my colleague either doesn’t know or – even worse – doesn’t care?

Wow. If I say something I might get berated, punished, scolded, or lose my job. If I lose my job my kids won’t have health insurance. Is it worth speaking up? Telling the more senior, male physician that he should see the patient even if they are late? 

Let’s consider together that the physician has won accolades for caring about diversity, equity and inclusion. He has grants from the NIH that support his career. What are the risks to me and my career and my children if I advocate for an impoverished patient who arrives late? I think we all know. The risks are so high that it is impossible to consider. 

Perspective: the staff supporting the inequitable provider 

You know what hurts? Seeing someone being turned away from care because they were late. And here I am looking at the provider I work for and I for sure know that he said ‘no’ to that patient. He’s got other priorities. Like hobbies, getting home to his family, and working on those grants I hear a lot about. But I should be quiet. I only make $15 an hour. I can’t afford to lose this job. I won’t be able to afford my child’s medicine if I lose this job. 

Perspective: an NP working to provide equitable care for my patients

When it’s understood that some folks don’t receive the same care as others and your patient shows up 17 minutes late, you learn new patterns of work. You create new strategies to ensure your patients can receive care. You demonstrate equity in practice. You advocate for policy change. 

Here’s how I think about it:

First: I ask my medical assistant (MA) how this patient gets to appointments. If the answer is they rely on public or shared transportation, see the patient. If they come on their own, move to the next concept. 

Second: I evaluate if this patient is one who might be affected by inequity in practice. For example, does this patient belong to a marginalized community? If the answer is yes, see the patient. If they do not belong to a marginalized community, move to the next concept.

Third: The last time I saw this patient, did we arrange a time-sensitive follow-up? If the answer is yes, see the patient. If the answer is No, walk out and see the patient in the waiting room. Explain the policy, the challenges, and ask for their help in managing how the clinic serves everyone. More often than not, something can be worked out. 

Do the next right thing. Always. And expect the same of your colleagues.

Meet your patients, know your patients. Believe in them. Advocate for them. Commit to breaking inequities. One appointment at a time. 

Kelly Ayala, DNP, APRN, RN, is a Wisconsin-based Nurse Practitioner and Serial Nurse Innovator. She is also the recipient of the 2023 Equity-Minded Nurse Practice award, which was co-sponsored by the National Commission to Address Racism in Nursing/American Nurses Association.

Lead photo credit: (c) GETTY IMAGES: Edwin Tan

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My health equity journey can be summed-up in the expression, “I am my sister’s (brother’s) keeper.” This phrase characterizes both the privileges and responsibilities that I hold, which are foundational to my leadership style and role as a nurse. As a Black woman, nurse scientist, and educator, my personal experiences surrounding racial and systemic inequities drive my commitment to change. My worldview is informed by an intersectional perspective, underscored by an intrinsic appreciation for differences among all people. Consistent and intentional reflection of the ways that I “show-up” in the world are inherent to my identity, rooted in a duality of both privilege as a nurse scientist and educator and oppression as a woman of color.

However, if I can speak truthfully, this duality has at times made me question my role in the nursing profession. While working in a profession that I wholeheartedly love, I have had to wrestle with the reckoning of what it means to be a nurse serving in a space that is at times mired with the medicalization and stigmatization of the human condition. This is where the practice of reflection becomes so important for me. In such moments, I reflect on my “why” and the important roles of nurse leaders and health equity advocates.

“What made you want to become a nurse?” It is a common question for those in our field and often shapes the ways in which we choose to apply our passion. Nursing had always been on my radar as a career option, but as a teenager, nursing became a calling. In 2008, the PBS network premiered the documentary series Unnatural Causes…. Is Inequality Making Us Sick. The entire documentary was impactful, but it was the segment, When the Bough Breaks, that really struck a chord with my teenage self. In this segment, the documentarians examine the factors that contribute to the maternal and infant mortality gaps between Black and White Americans, then considered a public health mystery. While in the documentary, they broke down many of the contributing factors to the disparity, including social determinates of health (SDoH), I still had a difficult time comprehending why those disparities existed based on race alone. It frustrated me to hear that as a Black woman, regardless of how much education I attained, I am more likely to die during the perinatal period and my child would be more likely to die than our White counterparts.

So, what made this issue clearer to me? Racism. The concept of racism was an issue that was very clear to me. Growing up in a diverse, military city exposed me to various perspectives, but racism was still pervasive in my small town. There are experiences of racism that will live in my memory forever.

When the concept of racism was discussed in the documentary as a precursor to structural violence, or the proliferation of less optimal SDoH, and as a contributor to disparate maternal and infant mortality rates, it sparked my consideration of how I might be able to help reduce the disparities that I had become so passionate about. It was then that I affirmed that I wanted to become a nurse. I firmly believed, and still do, that nurses have the power to reduce and eliminate health disparities across populations. However, as I eventually grew in my role as a nurse, I quickly learned that nurses also have the power to uphold and contribute to the same disparities I wanted so badly to decimate.

Nurses have always been leaders in healthcare. We stand uniquely positioned to either take an active role in working toward health equity and supporting those with historically marginalized identities or remain silent and contribute to the health disparities plaguing our society. In exploring the history of nursing, I learned that as both a profession and as individuals, we have always had to work to resist bias and stigma, often in opposition to the larger societal context. For example, over the last few decades, nurses have played a crucial role in reducing the stigma related to HIV/AIDS, contributing to improvements in care. In contrast, we have yet to adequately reckon with our participation in some of the biggest health atrocities in the United States, including the unwanted or unconsented sterilization procedures forced upon Black and Brown women in the 20th century.

While we cannot go back and change the past, we can work to ensure that the future of nursing continues to grow not only in number but more importantly in the culture of care that we hold so dear. The only way to upend these behaviors is to acknowledge our history and recognize that even some of our current practices, policies, and mindsets as providers and organizations are rooted in principles of paternalism and colonization, or the act of subjugating another group. To achieve health equity, we must explore issues that cause structural violence, or harm rooted in racism, classism, genderism, and other forms of discrimination, within ourselves and our systems and communities. A few practices that I intentionally center include:

1. Continually assessing my own assumptions and challenging my own biases, with knowledge that failing to do so can have lasting implications on the health and wellbeing of the people that I serve.
2. Upholding the self-practice of accountability, wherein I can acknowledge the potential impact my actions or words can have on someone, regardless of my intent.
3. Mentoring and collaborating with students from diverse backgrounds, with the intent to provide students with positive and welcoming experiences in nursing practice and science. I believe feeling welcomed as their whole self is the first step in the students empowering our patients to feel the same way about their healthcare experience.

As we consider the role that nurses play in contributing to the current and ongoing maternal and infant health crisis, we must come to terms with the history of the field and consciously choose not to perpetuate it. Otherwise, we risk jeopardizing not only our profession but more importantly, the lives we strive to care for every day. We must strengthen our resolve by pushing one another to reorient ourselves toward pursuing equity and justice in health and health care. We must continue the self-reflective work of examining who is omitted, ignored, erased, silenced, and harmed by our practice and recommit ourselves to more inclusive endeavors.

Kelly McGlothen-Bell, PhD, RN, FAWHONN, is an Assistant Professor at UT Health San Antonio, School of Nursing and the recipient of the 2023 Equity-Minded Nurse Rising Star Award, which was co-sponsored by the National League for Nursing.

_{^{Lead photo credit: (c) GETTY IMAGES: FilippoBacci}}

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The AARP Center for Health Equity through Nursing^SM (A-CHEN) and the Future of Nursing: Campaign for Action, with support from national nursing organizations, is pleased to open a call for applications for the Equity-Minded Nurse Awards Program to recognize nurses who are helping lead the way to health equity through practice, education, research, or leadership. We hope you will consider applying, nominating someone, or sharing word of the program with others who may be interested.

Five awardees in separate categories will receive $1,000 each, plus paid travel to a reception Sept.10 in Baltimore, where they will be recognized before an audience of national nursing leaders and educators at Coppin State University.

A-CHEN and the Campaign launched its equity-minded nurse initiative in 2022 as part of work to implement recommendations from the National Academy of Medicine report, the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. We chose the first cohort of equity-minded nurses last year, defining equity-mindedness for nurses as so deeply understanding and embracing health equity, social justice, anti-racism, and cultural humility that these concepts emerge as normalized, automatic and default thought processes no matter the setting or the group of people they work with.

A-CHEN is a vehicle for change and a national resource for advancing health equity. The Campaign is an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation building a healthier America through nursing. The co-sponsoring nursing organizations are: The American Academy of Nursing, the American Association of Colleges of Nursing, the American Organization of Nursing Leadership, the National Commission to Address Racism in Nursing/ American Nursing Association and the National League for Nursing.

Individuals can apply or nominate others for an award now through April 30. A-CHEN and the Campaign will convene reviewers for each award category to evaluate applications and select finalists.

The award categories are: 

• The Equity-Minded Rising Star for student or early career nurses whose contributions show promise for ongoing impact in reducing health disparities and advancing health equity. This award is co-sponsored by the National League for Nursing.

• The Equity-Minded Practice Award for a nurse whose work with patients, families and/or communities exemplifies efforts to reduce health disparities and advance health equity. These efforts demonstrate potential for impact and serve as a best or promising practice. Co-sponsored by the National Commission to Address Racism in Nursing / American Nurses Association.

• The Equity-Minded Research Award for a nurse whose research contributes to the science and body of knowledge that advances health equity. The nominee is expected to have leveraged their role as an experienced and capable researcher to drive change and to inform healthcare practice and/or policy. Co-sponsored by the American Academy of Nursing.

• The Equity-Minded Educator Award for a nurse whose efforts demonstrate excellence in supporting a diverse nursing student body and inclusive teaching/learning practices, and whose teaching and/or curriculum design include topics that lead to the graduation of equity-minded nurses. Co-sponsored by the American Association of Colleges of Nursing.

• The Equity-Minded Leader Award for a nurse serving as a catalyst for change at a systems or organization level. Their work addresses and   dismantles policies and structures that contribute to disparities and inequities, helps create an overall climate of inclusion, and encourages the institution to focus on community needs. Co-sponsored by the American Organization for Nursing Leadership.

For more information about the awards program, please see the frequently asked questions on the Campaign’s website.   We thank you for your interest and hope you will consider applying or nominating someone.

About the Authors:

Reinhard is senior vice president and director of AARP Public Policy Institute and chief strategist for the Center to Champion Nursing in America and Family Caregiving Initiatives.

Villarruel is chair of the Future of Nursing: Campaign for Action’s Strategic Advisory Committee and Professor and the Margaret Bond Simon Dean of Nursing University of Pennsylvania School of Nursing.

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I am fortunate enough to have the opportunity to share my thoughts about the importance of the Social Determinants of Health (SDoH) framework and advancing health equity. So, what is this and why does it merit discussion?

Most experts and organizations identify SDoH as the core conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. These external or contextual conditions exert influence over the resources, options, barriers and facilitators that individuals, groups and populations encounter across the life span. KFF (formerly Kaiser Family Foundation) provides an excellent description of some categories that comprise these contextual factors, which include economic stability, physical environment, education, food, community and social context, and healthcare. The World Health Organization specifically includes genetics and gender. Contextual factors are driven by systemic influences such as economic policies and systems, development agendas, social norms, social policies, racism, climate change, and political systems. Increasingly, war and civil unrest have been examined as important influences on health and quality of life worldwide (Penderson D, 2002; Wiist WH, et al, 2014).

Now that we’re on the same page regarding what SDoH is, I think a better way to understand what this looks like is through an individual life and how it impacts communities. I’ll use my life and the impact on the community with which I am most familiar.

In 1951, I was born to a family with a young mother and father and ultimately nine children. My neighborhood, with one of the highest population densities in an urban city, included only Black residents. The community resources (stores, employment opportunities, public transportation) were limited.  A comprehensive health care center was not established until 1968 (which helped to replace the hospital emergency room outside the neighborhood as our primary source of healthcare). Racial discrimination was an accepted part of our daily experiences; some stores, recreation venues and communities were off limits to Black residents. Industrial, often polluting businesses were commonly placed within this community. So, many of the factors that are now established as SDoH influences were part of my and my family’s life and had significant impact on our opportunities, health, and wellbeing. One of my sisters died as a result. The context in which we lived directly influenced the late identification and severity of her chronic illness, the resulting disability, and subsequently her early death.

If you think ‘that was a long time ago,’ you’re right. It was. However, examining this same community more recently demonstrates that progress is slow. Data from 2017 show that there are still significant differences in income, morbidity and mortality between residents of my former, primarily Black community and the more affluent communities in the same city. Resources are significantly less and industry continues to be a concern related to its impact on environmental health. The first hospital within the community is only now being built. It will open soon. An excellent discussion of the impact of SDoH on my community (and two others) is presented in the 2008 PBS documentary series Unnatural Causes…. Is Inequality Making Us Sick?.

If we have this body of evidence available to us as health care providers, what are our opportunities for change (practice/service provision, advocacy, research, and education) and what should our obligations be to the populations we serve and our society at large?

A critical paradigm shift is needed. Healthcare provider education must include SDoH and the differences experienced by populations (historically and contemporaneously). This approach not only validates the importance of this framework to care delivery; involvement in learning such as this also serves as a lens to better understand the reality of inequity and the structures that perpetuate this inequity.

Health care provider organizations have long prioritized advocacy as part of their mission. However, much of that advocacy has been directed toward issues that address the perspectives of the profession (to better serve their identified population or to advance their profession). Fewer efforts are directed toward economic policies, social norms, and political systems that perpetuate negative influences on health, behavior, and wellbeing for the larger society.

Nurses are the largest group of healthcare providers and they hold great potential for elevating and teaching SDoH and advocating for change to address those factors that result in disparate health outcomes. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (National Academies, 2021)explores how nurses can work to reduce health disparities and promote equity. This document and the evidence supporting the importance of the SDoH obligate nursing (and other professions) to be informed at all educational levels and tie their efforts to that knowledge.

It is past time to examine our theoretical underpinnings to determine how they do – or do not – consider external influences on individual or population behaviors and outcomes. Theory without context has limited utility for practice or research.

We need to examine our language. Does it absolve contextual influences and focus on the individual in unintended ways? If we call out and advocate for change in underlying causes, could we lessen the need for “building resilience” in affected individuals and communities? Are we teaching people to better bear a burden to the exclusion of putting our energies into relieving that burden? Understanding SDoH requires us to do both.

To make this paradigm shift, providers must be taught how to take risks, and be supported in doing so. We must expect those who teach to model behaviors that recognize SDoH and inequity. Nursing has been cautious in speaking out – to the systems to which we belong, to those who enact policies, and to political systems. Health is affected by all these. We cannot be silent and still lead. Join me in speaking out.

Vicki P. Hines-Martin is Professor Emerita at the University of Louisville School of Nursing and the recipient of the 2023 Equity-Minded Nurse Leadership Award, which was co-sponsored by the American Organization for Nursing Leadership.

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How can we make real progress on critical health care priorities like advancing health equity, diversifying the nursing workforce, mitigating the workforce crisis through the recruitment and retention of nurses, and elevating the concept of equity-minded nurses?

“One way is to bring nurses and their champions together to brainstorm solutions to these issues — because nurses are natural problem solvers,” says Susan Reinhard, senior vice president and director, AARP Public Policy Institute and chief strategist, Center to Champion Nursing in America and Family Caregiving Initiatives.

“Then, we can help them create specific action plans to make those solutions a reality.”

That was the thinking behind the AARP Health Equity and Nursing Summit: Turning Commitments into Action, held Oct. 31-Nov. 1 at AARP in Washington, D.C. Hosted by the AARP Center for Health Equity through Nursing^SM (A-CHEN) and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation, the event brought together leaders from around the country to create health equity action plans for their workplaces, communities and networks. More than 150 summit participants were drawn from nursing, health care delivery, business, unions, social services, social justice and consumer organizations.

The conference opened with singer-songwriter Tad Worku, FNP-BC, an emergency department nurse who brings together song and health care to inspire and heal. Worku set the tone for the conference, speaking and singing about finding his purpose in nursing and serving others. He shared his story of leaving a promising career in music, working with musicians and producers who created hits for stars like Beyoncé and Kelly Clarkson, and on the brink of signing a major touring contract for his band, but feeling a lack of meaning his life. So he turned to nursing, and has since combined his two passions of serving others through nursing and singing, and never looked back.

Then attendees rolled up their sleeves and began to hone their plans in interactive workshops that included Becoming an Equity-Minded Nurse, Progressing Seamlessly in Nursing as a Career to Achieve Financial Security, Effectively Addressing the Social Determinants of Health, and the Role Nurses Can Play in Informing the Public of Important Benefits and Services.

In these workshops, participants crafted specific health equity goals, along with metrics and timetables for achieving them. Goals include addressing structural racism to achieve workforce health equity, making health equity a strategic priority within participants’ organizations, developing a loan or debt-free program for rural and/or other underserved communities, increasing the number of American Indian nurses in particular states and creating a network of change agents that connects people, practice, and community partners to achieve health equity goals.

Because few goals can be accomplished alone, workshop members brainstormed potential allies and stakeholders who could help them achieve their objectives. For example, one workshop recommended engaging Historically Black Colleges and Universities’ schools of nursing in population-based approaches to achieve health equity and dismantle structural racism. Other participants decided that forging relationships with key leaders could bring along others who share their mission to advocate for health equity. And, since obstacles can arise in route to a person’s goals, workshop leaders helped participants anticipate educational, institutional and personal barriers that might prevent them from achieving their objectives and think of how to overcome them.

Participants also considered actions they could take to make their goals a reality. Examples included bringing their workshop discussions to their boards for further action, collaborating with their local college Diversity, Equity and Inclusion (DEI) organization, implementing cultural competence, diversity and inclusion training programs and workshops for nursing faculty, and deepening expertise in health care payment models to drive economic incentives for better health.

The larger environment in which summit participants must operate to achieve their health equity goals was considered as well. In another panel, Remaining Committed to Diversity, Equity and Inclusion, facilitated by Regina Cunningham, PhD, RN, FAAN, CEO, Hospital of the University of Pennsylvania, leaders from the nursing world, AARP and AARP Foundation examined how attendees could remain committed to diversity, equity and inclusion, given the current climate. They shared lessons they had gleaned from confronting racism in their own workplaces and personal lives.

Beverly Malone, PhD, RN, FAAN, president and CEO of the National League for Nursing, recounted how she dealt with racism overseeing a hospital maternal child unit. Her staff shared that a senior white physician on her unit was instructing the black staff not to touch his white patients. The staff said, “You told us you would make things different, so what do you plan to do about this?”  Because the offending physician was very high-ranking, she thought carefully about how to approach him.

Malone finally decided on an indirect approach. In private, she said, “Doctor, there is an unbelievable rumor going around that you told your black staff not to touch your white patients. It is so devastating that that rumor is going around.” He responded, “Oh my goodness, no, I would never do that!” Malone said, “I didn’t think that you would.”  Following their conversation, he never did so again.

Her takeaway?

“We have to find ways to share with people. Civility is very important, but it does not keep you from telling the truth. Whatever you need to do, do it. We must find ways to help others clean up their behavior.”

Ashley Darcy-Mahoney, PhD, NNP-BC, FAAN, a neonatal nurse practitioner and Robert Wood Johnson Foundation senior nurse scholar, shared a harrowing experience she had with a close friend who experienced health issues in her second trimester of pregnancy. Her friend, an African American woman, called Darcy-Mahoney complaining of dizziness and feeling unwell after her ob-gyn had instructed her to watch and wait in the face of these concerns. Alarmed, Darcy-Mahoney told her to go to urgent care to be assessed by a clinician. She also advised her friend to introduce herself and her husband with their professional titles (both formally referred to as doctor) to ensure that she was listened to and cared for with less bias. Her friend was treated for hypertension and delivered a healthy baby. Darcy-Mahoney explained

“All the things I had been taught about racism in health care manifested in this situation. I know the system and I wanted her to be safe in that system. For me, how we, in the maternal-child space, listen to people or don’t, have powerful implications on outcomes.”

As panelist Edna Kane Williams, MA, executive vice president and chief diversity officer at AARP observed about efforts to achieve health equity in the current climate, “This work isn’t for the faint of heart. Folks have lost the ability to be civil, persistent, and loud. And to persevere. It is not time to sit on the sidelines. Our way of life is being challenged every day. It is exhausting but so necessary. Whether you are a PhD, an RN, or a DNP – everybody can play a role – yet too many of us have decided to stay quiet.”

To make meaningful progress in advancing health equity, we must also consider those populations that have been most severely affected by racial inequity in health care. That’s why the summit hosted a panel entitled, “Health Equity Across Populations,” to lift up the voices of nursing leaders from LGBTQ+, Asian American Pacific Islander, and Black communities. These leaders highlighted health disparities experienced by the historically marginalized populations they represent and suggested steps we can take to improve health equity for them.

For Kelly Haviland, PhD, FNP-BC, TGNB-C, executive committee member of the Nursing Section of GLMA: Health Professionals Advancing LGBTQ+ Health Equality, the biggest priority is to ensure that we gather data pertaining to LGBTQ+ people for epidemiologic research. These data are needed so that we can understand the health status and care delivery experiences of LGBTQ+ people. Yet, the US Census doesn’t collect them, nor do many other national databases.

“We need to collect data in a consistent way in our electronic health records and do so in a safe, warm and welcoming way,” she said. “Educating nurses about LGBTQ+ health disparities is important, because, if you lack the data, you lack the proof to show that LGBTQ health disparities should be priorities.”

Jing Wang, PhD, RN, FAAN, President of the Asian American Pacific Islander Nurses Association, is committed to building diversity in the nursing profession through recruitment and mentorship. In her role as Florida State University College of Nursing Dean, she says,

“I focus on recruiting leaders from diverse groups and making sure that, as a dean, they are successful in their academic careers. I’ve learned so much from these leaders in my own career and had many mentors teach me how to become a leader and a dean. I was very shy and introverted when I started out, so if I can do it, anyone can.”

Sheldon D. Fields, PhD, RN, FAAN, president of the National Black Nurses Association, is optimistic about the prospects that we can dismantle racism in nursing. He says, “As a profession, nursing has a moral and societal obligation to ensure that we are training a workforce that mirrors the society that we are and are becoming. I look at nursing and ask, how did we get here for so long with the underrepresentation of people of color within this profession? Where did all the gatekeeping to this profession start and how do we dismantle it?”

“For the rest of my career I will do everything I can to diversify the nursing profession. Nursing has a moral and ethical obligation to address this lack of diversity, and we are simply not there yet. But we have finally found the road and we are on it.”

Adrianna Nava, PhD, MPA, RN, president of the National Association of Hispanic Nurses, envisions her organization becoming a national leader in Latino health — one that policymakers can look to for advice on Latino health issues. She is building a larger footprint in Washington and at the state and local levels. “Nurses need larger networks and leadership skill sets to be able to bring about policy change. Our organization is helping student and practicing nurses build both of those so we can impact our profession and the communities we serve,” she said.

The summit panelists are hopeful about the changes that nurses are leading to create greater health equity throughout our society. Yet, as Staci Alexander, MPA, vice president, AARP Global Thought Leadership, notes,

“Health equity remains elusive in this country more than two decades after the seminal study by the National Academy of Medicine, Unequal Treatment, was conducted. While we remain more committed than ever to achieving this goal, we need your help.”

Learn more about getting involved with the Campaign for Action.

_{^{Photo credits: Greg Kahn for AARP.}}

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Contact: Mary Boyle, Campaign for Action communications director, mboyle@aarp.org}

A nurse educator in Maryland who centers health equity in classroom innovations and program implementation.

A nurse practitioner in Wisconsin who thrives on solving big issues that patients face by using nurse-created and inspired solutions.

A nurse scientist in Texas passionate about ensuring that research evidence translates into policy and practice to support health equity for communities of color and those affected by trauma and substance use.

A nurse educator in Kentucky whose 30-plus year career has focused on community engagement to advance health equity.

A nurse researcher in Connecticut who leverages eHealth and community engagement to enhance cardiovascular health equity in gay and bisexual men with HIV.

These five accomplished nurses are the recipients of the inaugural Equity-Minded Nurse Awards from the AARP Center for Health Equity through Nursing^SM and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation that is building a healthier America through nursing. The awards are part of the Campaign’s work to implement the goals of the National Academy of Medicine report, the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, which explores nursing’s pivotal role in advancing health equity.

The awards are given in five categories and each is generously co-sponsored by a national nursing organization. The winners will receive a $1,000 prize each and paid travel to and recognition at the AARP Health Equity and Nursing Summit: Turning Commitments into Action, in Washington, DC, Oct. 31-Nov. 1.

The honorees are:

• Kamila A. Alexander, PhD, MPH, RN, Johns Hopkins School of Nursing, Baltimore, Maryland
• Kelly Ayala, DNP, APRN, BSN, Milwaukee, Wisconsin   
• Vicki Hines-Martin, PhD, MA(Ed), FAAN, University of Louisville (UL) School of Nursing; UL Health Science Center Office of Diversity & Inclusion; UL Center for Integrative Environmental Health Sciences; & School of Public Health and Information Sciences, Louisville, Kentucky
• Kelly McGlothen-Bell, PhD, RN, FAWHONN, UT Health San Antonio, School of Nursing, San Antonio, Texas
• S. Raquel Ramos, PhD, MSN, MBA, Yale University School of Nursing, West Haven, Connecticut

Kamila A. Alexander, PhD, MPH, RN, of Johns Hopkins School of Nursing in Baltimore, Maryland, is the recipient of the Equity-Minded Nurse Educator Award. Co-sponsored by the American Association of Colleges of Nursing, this award recognizes a nurse educator whose efforts demonstrate excellence in diversifying the nursing student body, inclusive teaching/learning practices, and whose teaching and/or curriculum design include topics that lead to the graduation of equity-minded nursing.

Alexander is an experienced educational leader and health equity scholar. Using innovative teaching methods and creative curricular programming, she aims to increase the number of nurses, scientists, and leaders who will transform health and advance equity. She is recognized as an outstanding mentor to a broad cadre of interdisciplinary students and fellows. Alexander’s community-engaged research promotes sexual and reproductive health equity through gender-based violence prevention and survivor-centered models for safety. She is a member of the inaugural cohort of Betty Irene Moore Fellowships for Nurse Leaders and Innovators.

Kelly Ayala, DNP, APRN, BSN, of Milwaukee, Wisconsin is the recipient of the Equity-Minded Nurse Practice Award. Co-sponsored by the National Commission to Address Racism in Nursing/American Nurses Association, this award recognizes a nurse whose work with patients, families and/or communities exemplifies efforts to reduce health disparities and advance health equity.

Ayala is practicing as the regional director for clinical operations for a heart health tech startup, currently in stealth mode. She is also co-founder of Streamline Flow, a solution for identifying, tracking and managing patients throughout their healthcare journey. A learn-it-all and healthcare nerd, she enjoys creating process maps and looking for patterns to improve care for patients, particularly those in underserved or marginalized communities. She finds meaning and joy in working alongside her patients to improve health rather than react or solely provide sick care. Her absolute favorite part of practice is de-prescribing with patients who have successfully improved their own health.

Vicki Hines-Martin, PhD, MA(Ed), FAAN, University of Louisville (UL) School of Nursing; UL Health Science Center Office of Diversity & Inclusion; UL Center for Integrative Environmental Health Sciences; & School of Public Health and Information Sciences, Louisville, Kentucky, is the recipient of the Equity-Minded Nurse Leader Award.  Co-sponsored by the American Organization for Nursing Leadership, this award recognizes a catalyst for change at the systems or organization level that address and dismantle policies and structures that contribute to disparities and inequities and contribute to an overall climate of inclusion that encourages the institution to focus on community needs.

Hines-Martin has been a faculty member at the University of Louisville School of Nursing since 1998 and her scholarship has focused on mental health, health equity, cultural diversity and community engaged partnerships. She conducts community-based participatory research with low income, under-served and multicultural populations and says community engagement is the mechanism through which she accomplishes most of her professional work.

Kelly McGlothen-Bell, PhD, RN, FAWHONN, UT Health San Antonio School of Nursing, San Antonio, Texas, receives the Equity-Minded Nurse Rising Star Award. Co-sponsored by the National League for Nursing, this award recognizes a student or early career individual whose contributions show promise for ongoing impact in reducing health disparities and advancing health equity.

A nurse scientist, McGlothen-Bell’s research focuses on examining the interplay between social context, policy and practice dissemination and implementation, and reproductive justice for substance-affected families. Through a practice lens, she became aware of how discriminatory health and social policies often take advantage of, rather than support historically marginalized people. Thus, she is passionate about addressing social and systemic injustices that create health inequities among communities of color and those affected by trauma and substance use.

S. Raquel Ramos, PhD, MSN, MBA, Yale University School of Nursing, West Haven, Connecticut, is the winner of the Equity-Minded Nurse Research Award. Co-sponsored by the American Academy of Nursing, this award recognizes a nurse researcher whose scholarship advances the science and the body of knowledge that advances health equity. The research or scholarship of this award should be or have the potential to be disseminated widely as best or promising practices.

Ramos’ research examines how user-centered design and technology-driven, behavioral interventions can enhance cardiovascular health equity in sexual minority men of color with HIV and at risk of HIV-related comorbid conditions. As a protocol nurse for the Multicenter AIDS cohort study, the longest running study on the life course of HIV in gay and bisexual men, Ramos observed the connection between HIV and cardiovascular disease risk.

Antonia M. Villarruel, PhD, RN, FAAN, Professor and the Margaret Bond Simon Dean of Nursing University of Pennsylvania School of Nursing, who chairs the Campaign’s Strategic Advisory Committee, talked about the significance of this award and this inaugural cohort of awardees:

“There is a breadth of diversity among the awardees and the work they do that exemplifies the almost infinite ways in which nurses can and do advance health equity – every single day,” Villarruel said. “These outstanding nurses work in different parts of the country and with different populations, and each is clearly passionate about their work. It’s exciting how each honoree has found a unique way to weave together theory and practice, ideas and implementation. While they have been recognized in these five different areas, each of them is also a leader, educator, researcher, and practitioner in their own right – and they are all stars.”

Villarruel will join Susan C. Reinhard, PhD, RN, FAAN, Senior Vice President and Director, AARP Public Policy Institute and Chief Strategist, Center to Champion Nursing in America and Family Caregiving Initiatives, and Piri Ackerman-Barger, PhD, RN, FAAN, Senior Health Equity Fellow at the Campaign for Action and associate dean of Health Equity, Diversity and Inclusion, as well as a clinical professor at the University of California Davis Betty Irene Moore School of Nursing, to recognize and celebrate the five awardees during a reception at the AARP Health Equity and Nursing Summit on October 31 in Washington, DC.

The Campaign defines equity-mindedness as so deeply understanding and embracing health equity, social justice, anti-racism, and cultural humility that these concepts emerge as normalized, automatic and default thought processes no matter the setting or the group of people they work with. You can read more about its Equity-Minded Nurse Initiative at /issues/the-equity-minded-nurse/.

More information about the awards can be found at /equity-minded-nurse-awards/.

The AARP Center for Health Equity through Nursing (A-CHEN) is a vehicle for change and a national resource for advancing health equity. It stimulates, promotes, and replicates actionable solutions that eliminate disparities and create better opportunities for people to live their healthiest lives possible. 

The Future of Nursing: Campaign for Action is a national initiative of AARP Foundation, AARP and RWJF, working to implement the National Academy of Medicine’s evidence-based recommendations on the future of nursing. The Campaign includes Action Coalitions in nearly every state and the District of Columbia and a wide range of health care professionals, consumer advocates, policymakers, and the business, academic, and philanthropic communities. The Center to Champion Nursing in America, an initiative of AARP Foundation, AARP and RWJF, serves as the coordinating entity for the Campaign.

Learn more at www.campaignforaction.org. Follow on Twitter/X at @Campaign4Action and on Facebook.

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The National Academy of Medicine’s Future of Nursing 2020—2023 report, published amid the COVID-19 pandemic, is subtitled, Charting a Path to Achieve Health Equity. As the largest and most trusted segment of the health care workforce, nurses have the power to break down barriers to advance health equity for all, that report says.

The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and RWJF, has seized on that mandate and launched the Equity-Minded Nurse initiative as part of that effort.

The phrase “equity-minded nurse” was coined by the Center for Urban Education and highlighted by Piri Ackerman-Barger, PhD, RN, FAAN in the Campaign’s inaugural blog post in a series by and about equity-minded nurses. Ackerman-Barger is the Campaign‘s senior health equity fellow and associate dean of Health Equity, Diversity and Inclusion and clinical professor at the University of California Davis Betty Irene Moore School of Nursing.

In this Policy Now video produced by the AARP Public Policy Institute, Ackerman-Barger explains the concept: “An equity minded nurse is someone who has the knowledge, the skills, and the desire to make really significant change across health settings.” She also explains that a diverse nurse workforce will play a powerful role in advancing health equity.

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School nurses are often unrecognized and poorly understood by non-health and health professionals, including other nurses. The unprecedented events surrounding COVID-19 and the return of students from home into the classroom elevated the importance of school nurses in schools and public health, however our positions are tethered to fluctuations of urgency rather than sustained as a fundamental and critical position within schools.

The National Academy of Medicine’s Future of Nursing 2020-2030 report acknowledges the need for greater recognition and appreciation for school nurses. This often-unrecognized specialized practice of nursing holds powerful potential to optimize health outcomes for those who are underserved, impacted by social determinants of health (SDOH), and experience inequities in health and education. As a special education school nurse for the greater part of my 30 years of nursing, I affirm that we are front-line professionals poised to bridge critical resources to historically underserved students, families, and communities. School nurses are primed to address potential and actual complex health conditions and social needs through primary, secondary, and tertiary prevention. Although there are many unique aspects of school nursing, one of our invisible superpowers is health literacy, which requires an astute and humble nurse who is equity minded.

Health literacy is a central focus of the U.S. Department of Health and Human Services Healthy People 2030 initiative and is identified as an essential component to eliminate health inequities and disparities. Two essential parts in achieving health literacy are included in the following definitions:

• Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
• Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Equity-minded school nurses must read between the lines of how health literacy can be achieved. In addition to our clinical skills, some of the greatest assets we can infuse into schools are our ability to practice and teach concepts such as Cultural Humility, Shared Decision Making, and Person and Family-Centered Care in collaboration with school, community, health care, and family members. These concepts may be familiar to our ears but remain elusive in practice and are seldom acknowledged through charting/documentation, and billing, or evident in conversation with colleagues. These concepts are essential components to safeguarding access to culturally appropriate services and educational supports and opportunities for our diverse student population.

Improving student and family health and wellness is well within the purview of school communities. School nurses are also often faced with overwhelming caseloads, hours of “windshield time” between school/community sites, and multiple touch points within each day. What is typically left is insufficient time to practice nursing that is fully honoring of students, families, communities, and our ability to effect change. When school nurses are honored and recognized as indispensable partners in school and health systems, we create critical pathways for optimizing health outcomes in present and future populations of students and families. Sustainable partnerships and relationships can fill in the gaps that perpetuate inequities of our most vulnerable students and families.

To support efforts towards health equity and addressing SDOH, it is imperative that equity-minded school nurses authentically engage in self-reflection and cultivate a commitment to continuous learning. Mentorship and advocacy are also essential elements to support the well-being of school nurses as we build our visibility to co-create a culture where health literacy (our superpower)takes root and flourishes.

Yuuko Mabrey Johnson, MSN-Leadership, RN, CSN, is currently a PhD Student at the UC Davis Betty Irene Moore School of Nursing. She serves as co co-chair of the Practice Committee International Family Nursing Association and on the board of the School Nurse of California Foundation.

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