How can churches promote health equity in African American communities?
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How can churches promote health equity in African American communities?
Following centuries of injustice, many African Americans mistrust medical institutions. Dr TanYa Gwathmey co-leads the Triad Pastors Network, a partnership between churches in North Carolina and the Maya Angelou Center for Health Equity at Wake Forest University School of Medicine, USA. She believes that health education is better received by African American communities when it is delivered by trusted faith leaders.
Talk like a health promoter
Chronic condition — a long-lasting medical condition that requires ongoing care
Congregation — a group of people who gather for religious worship
Demographics — the make-up of a population, including age, gender and socioeconomic status
Health disparities — differences in health between groups of people, often caused by factors such as unequal access to care, leading some groups to have worse health outcomes than others
Health equity — when everyone has the opportunity to achieve their best health outcomes
Health promotion — efforts to improve health and prevent disease through education, community involvement, and interventions that encourage healthy behaviours
African Americans experience higher rates of chronic conditions, such as heart disease and diabetes, and have shorter life expectancies than other populations in the US. These health disparities are not random – they are rooted in a long history of systemic racism, unequal access to quality healthcare, and generations of mistrust in medical institutions. The result is a serious public health crisis that continues to affect millions of African Americans today.
While health education can improve health outcomes, how can it be delivered to those who do not trust healthcare organisations? Dr TanYa Gwathmey, a researcher at the Maya Angelou Center for Health Equity at Wake Forest University School of Medicine, believes the answer lies within the communities themselves – when faith leaders oversee the health education their congregations receive, community members trust the information.
Why is mistrust in healthcare common among African American communities?
“Throughout history, African Americans have not been treated fairly or humanely, especially regarding healthcare and medicine,” says TanYa. “In the past, researchers experimented on African Americans to examine health conditions or test drugs.” One of the most infamous examples of this mistreatment is the Tuskegee Syphilis Study. For over 40 years, hundreds of African American men with syphilis were deceived by researchers who withheld treatment from them. The men believed they were receiving proper medical care, but in reality, they were being used to observe the natural progression of the disease.
“Cases such as the Tuskegee Syphilis Study have caused many African Americans to lose trust in the healthcare system,” explains TanYa. As a result, many African Americans are hesitant to seek medical help when they need it, and they often avoid participating in research studies that could lead to new treatments and better understanding of medical conditions. This has serious consequences, contributing to the fact that African Americans have the lowest life expectancies and worst health outcomes for many diseases compared to other racial groups.
How can faith communities promote health education?
The Triad Pastors Network (TPN) is a partnership between the Maya Angelou Center for Health Equity and Christian faith leaders from African American communities in North Carolina. The goal of the TPN is to improve the health of these communities by addressing their specific needs through trusted local churches. “Through our partnerships with churches, we ensure that health information is shared in a way that is easily understood by everyone, even if they don’t know very much about science or medicine,” says TanYa. “We identify ways to apply this information so that community members can develop and maintain healthy behaviours in ways that fit with their needs and lifestyles.”
The churches involved in the TPN vary in location (rural, urban and suburban), size, congregation demographics, and style of worship. A key strength of the TPN is that health education is adapted to the unique health needs of each community it serves. “Each faith leader tells us the specific needs of their church and the health conditions that are most prominent in their community,” explains TanYa. “We use this to develop educational resources about different health conditions and activities to help churches to share the information with their congregations.”
The TPN takes a community-driven approach to health promotion by empowering local church members to become health leaders. Each church designates one or two individuals to serve as health ambassadors. “The health ambassadors attend a year-long programme that helps them develop a health ministry within their church,” explains TanYa. “They share health information with their fellow church members through various health promotion activities, including workshops, seminars with expert speakers, health fairs, and groups that emphasise healthy behaviours, such as walking, dancing, and nutritious cooking.”
In addition to faith leaders and church members delivering tailored health education to congregations, the TPN also conducts surveys to understand the wider healthcare needs of African Americans in North Carolina. “For example, our surveys indicated that women were much more likely to get vaccinated against COVID-19 than men, and young adults tended to have more hesitancy regarding vaccination due to lower levels of trust in public agencies,” says TanYa. “These results highlight that the healthcare community must spend more time and effort developing trust with African American young adults and men of all ages in order to encourage future vaccinations.”
Why are churches more effective than healthcare settings?
Churches hold a unique position of trust within many African American communities, making them an ideal setting for delivering health education. Unlike healthcare centres, which have historically been associated with mistrust, churches are seen as safe spaces where people seek guidance, not only for their spiritual well-being but also for their physical and mental health. People are much more likely to accept information that is delivered by trusted faith leaders or fellow church members than by faceless government healthcare organisations.
The success of the TPN offers hope that similar faith-based partnerships across the country could help rebuild trust between healthcare systems and African American communities. By developing these relationships, health education delivered by faith leaders and community members will hopefully increase access to healthcare, reduce health disparities, and ultimately, achieve health equity for African Americans.
Dr TanYa Gwathmey
Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, USA
Fields of research: Health promotion, health education, health disparities, cardiovascular health
Research project: Working with churches to deliver health education to African American communities
Funders: The Duke Endowment; US National Institutes of Health (National Institute of Aging, National Institute of Diabetes and Digestive and Kidney Disease, National Institute of Child Health and Human Development, National Institute of General Medical Sciences)
Reference
https://doi.org/10.33424/FUTURUM551
This educational material has been produced by Wake Forest University School of Medicine in partnership with Futurum and with grant support from The Duke Endowment. The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits.
About health promotion
Health promotion involves raising awareness of health issues and encouraging communities to take preventative action before illness strikes. It aims to normalise conversations about health, making it easier for individuals to seek information and resources that help them lead healthier lives. By focusing on education and prevention, health promotion aims to reduce the incidence of disease and improve overall well-being. This is particularly important in underserved communities, where access to healthcare can be limited, and where mistrust of medical systems may prevent people from seeking care.
For TanYa, health promotion is deeply personal. “I spent much of my childhood watching my mother take care of family members who needed medical care,” she says. “It wasn’t until I was about 11 that I realised she was not actually a nurse. Many of my family members did not have access to healthcare or did not trust healthcare professionals, and consequently, I saw many of them die at young ages.” This motivated TanYa to dedicate herself to improving health outcomes in underserved communities. Now, as a researcher, she focuses on addressing the social factors that prevent people from getting the care they need.
Pathway from school to health promotion
There are many pathways to a career in health promotion, depending on the role that most interests you. The qualifications and experience needed for pursuing different roles vary widely. “This means that health promotion is open to everyone who has an interest and commitment,” says TanYa.
If you are interested in biomedical science, study biology, chemistry, and maths at school. Study biomedical science or a related degree at university and take courses in cellular and molecular biology, biochemistry, and organic chemistry.
If you are interested in public health, study a degree in public health and take courses such as biostatistics and epidemiology.
Many community health worker roles do not require a university degree. Look for internships and shadowing opportunities where you can train while working.
Look for summer internships and volunteer opportunities in healthcare settings to gain practical experience. For instance, the Maya Angelou Center for Health Equity offers internships for students to explore health equity work. As TanYa says, “There is no better way to find out what appeals to you than simply trying it!”
Explore careers in health promotion
Careers in health promotion include clinical roles providing healthcare to patients, formal and informal teaching roles providing health education, academic research positions discovering more about health disparities, and community health worker roles.
Achieving health equity for everyone requires collaboration between people with a wide range of different skills. “Whether you are outgoing and enjoy interacting with others, analytical and prefer studying and analysing research, passionate about working with data to track trends and outcomes, or creative and enjoy designing materials to communicate health information, there is a role for you in health promotion,” says TanYa.
Explore organisations such as the Office of Disease Prevention and Health Promotion, the Global Health Council, and the World Health Organization to find articles, educational resources and careers advice about health equity, public health and health promotion.
Meet TanYa
As a teenager, I was very interested in reproduction and wanted to become an obstetrician (someone who delivers babies). Once in college, I was exposed to the concept of research and had the opportunity to work with a neonatologist (a doctor who cares for babies who are born early or with medical problems) who studied hypertension (high blood pressure) in newborn babies. We also explored hypertension in sheep, as an animal model. This translational research was mind-blowing to me and solidified my interest in becoming a biomedical researcher.
My oldest sister, who worked as a nurse for many years, inspired my interests in science and healthcare. While my original intent was to become a clinician, my involvement in research quickly became important to me and caused me to shift my career aspirations. As I recognised opportunities to apply my research experience to communities that resembled my family and loved ones, it became clear that I needed to serve as an advocate for those who didn’t have a good understanding of health or the ability to access it. The testimonials from our TPN community partners regarding how their learning experiences have impacted their health is what continues to drive me to do this work. There is nothing more satisfying.
While academic promotions, recognitions, and awards are truly appreciated, my proudest career achievements are being awarded funding support to carry out my work with our community partners. I am fortunate to see the immediate impact of my work and how it has changed the lives of people that I know. My hopes are that I can continue to broaden the areas of reach, and that my work will be continued by others long after I am gone.
Some of my favourite activities include cooking (I love creating new recipes), interior design and decorating (using my creative side), and any beach or water-related activities (especially snorkelling).
TanYa’s top tips
1. Find good mentors. I have learned so much from the different mentors throughout my career. There is not one person who can teach you everything, but you can learn many things from those who have been where you would like to go. You may find advocates in places that you least expect.
2. Stand firm when you find something you enjoy doing. There will be plenty of obstacles that you encounter along the way. Make up your mind to stay the course, even when things get challenging, or others begin to doubt you. Anything worth having is worth working for!
Do you have a question for TanYa?
Write it in the comments box below and TanYa will get back to you. (Remember, researchers are very busy people, so you may have to wait a few days.)
Learn how faith communities in different countries respond to health crises:
www.futurumcareers.com/faith-healing-and-medicine-in-a-time-of-covid-19
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