In an earlier post, I marveled about Twitter and all the great things that have happened to me post-Twitter. It blows my mind how much information there is out there on the internet…which is how I found Rachel Safeek. Being the public health, upstreamist, social determinants of health geek that I am, I ran a Google search on “health disparities Duke” preparing for a trip down to Durham for one of my consulting projects. Lo and behold, there were pages and pages of interesting websites, one of which was Rachel’s blog, blue devil banter. Her perspective and activism was something that I wanted to bring into this blog. What I value so much in activism and community mobilizing is that anyone and everyone has a voice – whether it’s a solo one or an army of voices – each and every one of us has a voice.
“Never be afraid to raise your voice for honesty and truth and compassion against injustice and lying and greed. If people all over the world…would do this, it would change the earth.” — William Faulkner
So without further ado…
Founder, Fight Stigma Campaign
Duke University 2013
Program II: Health Policy, Human Rights, and Health Disparities
Me: How did you end up doing the work that you’re currently doing? Student to activist to working at Duke.
RS: I first began working with HIV prevention and advocacy while studying global health as an undergraduate at Duke. I became interested in the various socio-economic factors that predispose women to HIV. My interests led me to spearhead a seven-month research project in Salvador, Brazil, investigating how violence (domestic, sexual, etc.) and economic vulnerability predispose women to HIV and other sexually transmitted infections.
Following my work with HIV, I joined and later became Director of an HIV testing program that offered free, rapid HIV testing at various locations in Durham, North Carolina, including Duke University Campus, Durham Technical and Community College, and El Centro Hispano, a resource center catering to predominantly Spanish speaking populations.
While engaging in HIV prevention work, I observed the manner and degree to which stigma was associated with HIV. Moreover, overall sexual health served as a deterrent for many seeking HIV testing and/or medical treatment after sexual assaults, and openly discussing safer sex behaviors. This led me to found my organization, the “Fight Stigma Campaign” (FSC). The initiative was launched as a social media-based photo-campaign dedicated to educating the campus community about HIV/AIDS and encouraging HIV testing and open discourse surrounding safer sex, particularly among young adults.
After working with HIV prevention and advocacy for a year, I then turned my focus to HIV treatment. Currently, I am working as a Clinical Research Coordinator for the HIV drug trials at Duke Medicine, in which I oversee the enrollment and progress of patients in HIV drug studies at Duke. While I am now focused on the treatment end of HIV, I still dedicate significant time and effort to advocacy efforts for the FSC, all while I applying to medical school. I hope to one day continue to work with issues related to women’s health and infectious disease as a medical doctor.
Me: What inspires you on a daily basis, especially when things get hard?
RS: As a Latina woman who represents diversity in healthcare, I am deeply motivated by a desire to give back to my community. Everyday, I have the privilege of engaging patients from a wide array of socio-economic and racial/ethnic backgrounds. These clinical experiences have afforded me the opportunity to observe first-hand the manner and degree to which racial/ethnic minorities are disproportionately affected by negative health status. Each individual interaction motivates me to continue along my trajectory of working with underserved communities—many of whom represent members of my own community—currently as a clinical research coordinator and HIV prevention worker, and later on, as a medical doctor.
Me: What do you think it will take for our healthcare system improve? What do you think it will take our society’s health outcomes to improve?
RS: From a human rights standpoint, I believe that before health disparities can be adequately addressed, we must first acknowledge health as a human right. By ensuring individuals that they have a right to health, communities can mobilize to demand this right, raising awareness to the various socio-economic factors that prevent communities from attaining optimal health status. These socio-economic factors, including education level, access to healthcare facilities, transportation barriers, and poverty must be addressed in order to improve health care in our nation. I believe that these conditions stand a higher chance of being addressed if we can empower communities to vocalize their concerns by affording them the right to optimal health.
Me: In the health policy world, what do you think is the next big opportunity and how does this compare to the actual need of the population? What I mean is that sometimes Congress and the needs of the public aren’t always on the same page…
RS: I think we can all agree that the Affordable Care Act represents a tremendous forward stride, in terms of affording individuals access to care. However, beyond health care coverage, there are still a multitude of factors that predispose populations to poor health, including lack of transportation to health care facilities, lack of access to sustainable nutrition, poverty, low socio-economic status, etc.
One prominent issue in healthcare that I believe is often overlooked is the lack of representation of minorities in healthcare settings. Having physicians and other healthcare workers of diverse backgrounds is necessary for appealing to the culturally-specific needs of patients.
According to the AAMC (Association of American Medical Colleges), African Americans, Hispanics, and Native Americans make up 25% of the U.S. population, but only account for 6% of doctors. Increasing the number of physicians from racial/ethnic minority backgrounds ensures the delivery of culturally competent and sensitive care, thereby fostering a sense of trust between patients and their providers and increasing patient safety and satisfaction. Minority physicians have also historically been linked to working with patients from underrepresented and marginalized groups, who often represent a large fraction of the sick population, further highlighting the importance of adopting progressive policies that encourage and aid minorities in their pursuit of careers in healthcare.
Me: What are the current needs in Durham, as they relate to social determinants of health (ie SES, poverty, access to care, transportation, safety, etc.)?
RS: Durham, North Carolina, home to Duke University, is uniquely nestled in the Research Triangle Park (RTP), which is renowned for having the highest concentration of MD’s and Ph.D.’s in the world. While boasting this impressive statistic, the city’s high yield of educated individuals also creates a gradient of educational disparities within the area. As a result, there are tremendous racial and socio-economic disparities between the faculty and students of Duke University and the rest of the city.
Duke University Medical Center, nationally ranked as one of the top 10 hospitals in America, plays an instrumental role in affording individuals in Durham County and surrounding counties and states top-notch care. Also, Duke University, as a whole, is the largest employer in the county. However, while the University affords Durham locals various job opportunities, I believe a disparity still exists. Like most of America, the large racial minority population does not comprise the majority of the decision makers who determine how resources are allocated. While there is some representation on boards, this is not enough. In the end, the decision-makers are the ones who control resource allocation, who drive change and make improvements to benefit the community, especially in healthcare.
I believe there should be more progressive policies that aid those of disadvantaged socio-economic backgrounds and under-represented minorities in their pursuit of higher degrees to help diminish the gap in racial/ethnic disparities in education and health.