Parish Nurses Find Praise in African-American Communities
Wednesday September 1, 2004
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One Sunday after a service at the New Jerusalem Baptist Church in Cincinnati, Shantell shared her concerns with her church's parish nurse, Marsha Thomas, RN. Thomas was also concerned, and Jamar listened to her. She recommended that the couple go with her to the hospital immediately.
"As soon as we walked into the emergency room," Thomas recalls, "they suspected he was in full-blown AIDS."
Jamar did have AIDS, but his wife tested negative for HIV. Despite the diagnosis, Thomas says, "He is still living, and he is living every day to its fullest."
Across the country, nurses are taking their message of healing and wellness from clinics to congregations, and their message is ringing clear for thousands of people. Thomas says parish nursing is working especially well with African-Americans because, according to her, 75% belong to a faith community. In addition, Thomas says African-Americans are also more inclined to discuss their health concerns with someone from their own church.
Thomas, who is a member of the Black Nurses Association (BNA) of Greater Cincinnati, was the first African-American parish nurse in Ohio. In addition to serving as a parish nurse at the New Jerusalem Baptist Church, she is a parish nurse at the Greater New Hope Church and Presbyterian Carmel Church.
Thomas says churches are seen as "safe places" among African-Americans. "Church is the only institution that interacts with people from birth to death. If you can't talk at church - if you can't risk intimacy - where else are you going to do it?"
Edna Green-Perry, RN, a parish nurse at the Vermont Christian Church (The Disciples of Christ) in Flint, Mich., and a member of the Greater Flint BNA, adds that the church is the center of life for many African-Americans. "Almost everybody goes to church or has a family member who goes to church," she says. "The church is a unique place in the black community to dispense information."
Hushed Whispers
Many African-Americans don't like to talk about their own health, even with their own physicians. "We tend to speak in hushed whispers when it comes to our health," Thomas says. "We have a motto of 'whatever goes on in our homes stays in our homes.'"
African-Americans are especially reluctant to discuss cancer, she says. "You may have a family history of breast cancer, but your mother might not tell you that your grandmother died of breast cancer. Instead, she'll tell you that your grandmother died of 'female troubles.'"
Green-Perry agrees that talking about personal health issues is considered a major taboo among African-Americans. "We tend to be very secretive about our health," she says. "Even if someone has a terrible disease, they might tell their doctor they don't want to know about it."
As a result, African-Americans often ignore the early symptoms of disease and thus are diagnosed later than whites. This is one of the reasons African-American survival rates are often decreased and their mortality rates increased.
Compared with whites, Thomas says African-Americans wait longer for kidney transplants and are less likely to receive a kidney. Also, African-American men have a 20% higher incidence rate and a 40% higher death rate from all cancers combined than white men.
Such health disparities are influenced by socioeconomic factors. For example, Green-Perry says, because many housing projects are not located near grocery stores with a wide selection of healthy foods, many low-income people, a disparate proportion of whom are African-American, have poor diets.
Green-Perry remembers when she was a single mother living in the projects with her children. In order to buy healthy foods, she would walk several miles to a grocery store and push her food home in a cart - even in the dead of winter.
"I would spend one day grocery shopping and the next day cooking all of the food and freezing it so that my family would have access to healthy foods," she says. "But not everyone knows how to do that.
"I can cry when I see moms in the grocery store who don't have the nutritional background to purchase healthy foods for their kids. In certain stores, you won't see any young moms buying fruits or vegetables."
Other times, African-Americans don't have access to health care because they cannot afford health insurance or they don't know how to negotiate the system.
The New Face of Health Care
Parish nurses such as Thomas and Green-Perry are helping improve the health of African-Americans by encouraging them to become more actively involved in their own health. Parish nurses serve many varied roles, including personal health counselor, educator, volunteer coordinator, and negotiator.
"We represent the new face of health care," Thomas says. "Our job is to integrate the relationship between faith
and health."
Nine years ago, Thomas received a call from the New Jerusalem Baptist Church asking her if she would serve as the church's parish nurse. In 1999, she received the Image Maker Award and a grant from The Health Foundation of Cincinnati to help her expand the parish nursing program.
"Things really began to pick up after that," Thomas says. "I hired other nurses who shared my vision, and between the four of us, we worked at four churches in the inner-city."
When the grant ended, Thomas and her team continued to provide parish nursing. One of her main roles, Thomas says, is serving as a health resource. "Some people collect shoes, I collect information," she laughs. "I'm a walking referral source."
In addition to dispensing information, Thomas and the health team organize numerous health fairs and programs, including a youth-injury prevention program, diabetes screening, and an American Heart Association (AHA) program called "Search Your Heart." The church also has trained pastors on
faith-based AIDS prevention.
According to Candace Alexander, executive director of the AHA in Cincinnati, Thomas is an excellent volunteer and facilitator.
"Marsha is one of the most passionate people I know," Alexander says. "She is a very strong leader and an advocate for faith and wellness. Through her passion, she helps to strengthen the connection between faith-based organizations and wellness."
Green-Perry established a parish nurse health team ministry at Vermont Christian Church 10 years ago. The team began with seven members and has grown to include 11.
Five years ago, Vermont Christian Church became involved with an area-wide initiative called the Faith Access to Community Economic Development (FACED), which includes a faith-based health program. More than 40 churches in Flint, with congregations ranging in size from 2,000 to 3,500, are members.
The FACED team has a health calendar of events that includes CPR training; a "Stroke Sunday" screening; and an annual health fair with screenings for blood pressure, blood sugars, cholesterol, and body fat. Approximately 270 people attended the health fair this summer. The screenings are free and open to the public.
At Stroke Sunday, two people tested positive for extremely high blood pressure. One of them, a 36-year-old man, had a blood pressure of 226/154. "He was a dead man walking," Green-Perry says.
Even though the man knew his blood pressure was high, he said his physician had recently switched his prescription to a generic brand that made him ill. As a result, he stopped taking the medication.
Green-Perry called the physician and spoke with him about other options. "All it required on behalf of the physician was a simple phone call or e-mail to the insurance company documenting that the drug was not working,"
she says.
Thanks to Green-Perry, the patient was able to obtain medication that reduced his blood pressure without ill side effects. "I am trying to teach patients to advocate for themselves, and to understand that their health is only as good as their interest in their own health," she says.
According to Vermont Christian Church's pastor, Raumone Burton, the health team has made people more aware of their own health. "I've heard testimony after testimony from members who have said that if they hadn't had that screening, they'd be dead today," Burton says. Because of the health ministry team, they are still alive."
Burton says he is truly thankful to have Green-Perry. "She is one of the most caring, motivated, and dedicated people you have ever met. She is compassionate and warm, and she goes out of her way to make sure that people get what they need."
Many others are thankful for the work of parish nurses, as well. For the nurses, the most gratifying part of their work is knowing they are helping others.
"People are living. People are being diagnosed earlier. People are getting the treatment and the advocacy that they need. Lives are changed," Green-Perry says.
"I am an ordinary woman living an extraordinary life," Thomas adds. "I am truly blessed."
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