Beyond the Stethoscope: Educating Our Way to Healthcare Justice

Guest Contributors: India Willis and
Natasha Crooks
Nursology.net posts supporting DEI

As diversity, equity and inclusion (DEI) initiatives face unprecedented rollbacks across academic and healthcare institutions, the responsibility of Black nurses to educate and advocate has never been more critical. In an era where systemic barriers are being reinforced rather than dismantled, our role as educators becomes a form of resistance—a lifeline for communities persistently marginalized by healthcare systems.

In a healthcare system where Black women are three to four times more likely to die from pregnancy-related complications than white women, I found myself reflecting on the power of education during a recent community health workshop. “You’re a great teacher!” These words, spoken after co-facilitating a three-part study on pre-exposure prophylaxis (PrEP) for Black women, would transform my understanding of healthcare advocacy.

I, India Willis, was invited by Dr. Natasha Crooks to facilitate this group care study because of my expertise in HIV treatment and prevention, my identity as a Black woman and my status as a PhD student. What began as a research opportunity quickly became something much more profound. During our final session, I realized that my role extended far beyond my professional titles—nurse practitioner, HIV specialist and gender-affirming care provider.

Shortly after the workshop’s conclusion, a participant pulled me aside with a story that crystallized the true impact of our work. With tears in her eyes, she shared how the workshop had changed her family’s approach to healthcare. Her mother had been battling breast cancer but had delayed seeking treatment until “the cancer was leaking out.” Through our discussions about medical advocacy and communication, she felt empowered to support her mother’s treatment journey.

“I hear your voice in my head,” she told me. “I know I have to continue advocating for my mom.” She explained how our conversations about PrEP and medication helped her understand that not all treatments are harmful—that her mother’s chemotherapy was likely the reason she was still alive.

As a nurse practitioner, a significant part of my job has always been patient education—explaining diagnoses, reviewing lab results and discussing treatment options. But something shifted in my understanding. I realized that as a Black woman, I carry a responsibility beyond clinical interactions, which is to teach Black women how to navigate a healthcare system that was not designed for them.

The statistics are stark and unforgiving. Black women face disproportionate challenges in healthcare, including higher maternal mortality rates, with the 2020 rate for Black women (55.9 per 100,000) more than three times that of white women (18.1 per 100,000). Their chronic pain is routinely dismissed, and they encounter significant barriers to HIV prevention and treatment. Despite making up only 12% of the U.S. population, Black people account for 37% of estimated HIV infections, with Black women comprising 50% of HIV diagnoses among women in 2022. These are not just numbers—they reflect the lived realities of systemic neglect and marginalization.

With the erosion of DEI programs, Black healthcare providers must step into the breach. We are now more than ever responsible for teaching not just patients but clinicians in-training about culturally competent care. The cutting of DEI initiatives may limit the number of Black students coming through nursing schools who often advocate, highlight and address the healthcare needs of people of color. Our lived experiences, understanding of medical mistrust, and ability to translate complex medical information are now critical tools for education and transformation.

Removing my researcher and clinician hat and simply showing up as a Black woman teaching other Black women, I’ve discovered something powerful: My education and experience are tools—not just for research but for community empowerment. My role is to empower and encourage Black women to prepare for a healthcare system that has historically failed to take their pain seriously. I get to translate complex medical information into accessible knowledge that helps others advocate for themselves.

Ironically, neither my research training nor my clinical education prepared me for this approach to knowledge sharing. As a Black woman, I feel a profound duty to teach, illuminate paths of understanding and provide the kind of education that can literally save lives.

The solution is not simple, but it begins with education and community empowerment. Dr. Marsha Fowler’s work on Nursology.net, highlights the dual responsibility of education and advocacy. Nursing ethics emphasizes that moral practice includes confronting systems that perpetuate inequity, while the site’s political activism resources document how nurses have historically mobilized to address healthcare disparities. Within this context, healthcare institutions must be held accountable, community health workers must be valued and compensated, and most critically, Black women must be positioned as experts in their own health experiences.

As DEI initiatives face significant setbacks, with one of eight companies likely to eliminate or reduce these programs, the pressure to conform intensifies. However, as providers, we cannot conform. Ethical knowing and political activism frameworks validate what Black healthcare providers instinctively understand—that teaching marginalized communities to navigate hostile healthcare systems is simultaneously clinical practice, ethical imperative, and political resistance. To better support community health education programs, we must amplify Black women’s healthcare narratives and demand cultural competency training to continue in medical institutions. For Black healthcare providers, we must continue teaching, resisting, and healing.

Our health is our power. Our voices are our most potent medicine.

References

American Journal of Managed Care. (2025, February 7). The uncertain road ahead for health care after DEI rollbacks. https://www.ajmc.com/view/the-uncertain-road-ahead-for-health-care-after-dei-rollbacks

Centers for Disease Control and Prevention. (2005, April 8). Working together to reduce Black maternal mortality. https://www.cdc.gov/womens-health/features/maternal-mortality.html

Centers for Disease Control and Prevention. (2024, May 21). Fast facts: HIV in the US by race and ethnicity. https://www.cdc.gov/hiv/data-research/facts-stats/race-ethnicity.html

Crist, C. (2025, January 29). 1 in 8 companies say they plan to weaken DEI commitments in 2025. ESG Dive. https://www.esgdive.com/news/companies-to-weaken-dei-commitments-in-2025/738608/

Crowell & Moring LLP. (n.d.). After Trump executive orders, FDA removes diversity guidance from website. https://www.crowell.com/en/insights/client-alerts/after-trump-executive-orders-fda-removes-diversity-guidance-from-website

Health & Human Rights Institute. (2024, September 6). How systemic barriers and social drivers significantly impact health more than other factors. https://www.hhrinstitute.org/how-systematic-barriers-and-social-drivers-impact-health-more-than-other-factors/

Hill, L., Rao, A., Artiga, S., & Ranji, U. (2024, October 25). Racial disparities in maternal and infant health: Current status and efforts to address them. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/

Laguerre-Brown, C. (2024, August 21). The erosion of DEI in higher education: A threat to progress and national strength. Diverse Education. https://www.diverseeducation.com/opinion/article/15682252/the-erosion-of-dei-in-higher-education-a-threat-to-progress-and-national-strength

Ojikutu, B. O., Amutah-Onukagha, N., Mahoney, T. F., Tibbitt, J., Dale, S. K., Mayer, K. H., Wong, J., & Bogart, L. M. (2020). HIV-related mistrust and willingness to use PrEP among Black women in the United States. AIDS and Behavior, 24(10), 2974–2985. https://doi.org/10.1007/s10461-020-02843-z

Restar, A. J. (2023). Gender-affirming care is preventative care. The Lancet Regional Health – Americas, 22, 100544. https://doi.org/10.1016/j.lana.2023.100544

Sabin, J. A. (2020, January 6). How we fail Black patients in pain. AAMC. https://www.aamc.org/news/how-we-fail-black-patients-pain

Schumacher, S., Hill, L., Artiga, S., Hamel, L., & Valdes, I. (2024, May 7). Five facts about Black women’s experiences in health care. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/five-facts-about-black-womens-experiences-in-health-care/

Tohit, N. F. M., Rashid, S. A. Z. A., Fakuradzi, W. F. S. W. A., Zaidi, N. ‘A. A., & Haque, M. (2024). Exploring pathways from community involvement to empowerment in sexual and reproductive health: A public health perspective. Advances in Human Biology, 14(1), 20–25. https://doi.org/10.4103/aihb.aihb_112_24

University of Illinois Chicago. (n.d.). Development of a group PrEP care model. https://healthstudy.uic.edu/

Willie, P. R., & Dale, S. K. (2024). Black women’s sexual well-being in the age of pre-exposure prophylaxis (PrEP): A systematic review of the literature. Current Sexual Health Reports, 16, 122–131. https://doi.org/10.1007/s11930-024-00388-z

Wood, S. (2025, February 20). Dear colleague letter: DEI bans at colleges and what to know. U.S. News & World Report. https://www.usnews.com/topics/author/sarah-wood#google_vignette

About India Willis and Natasha Crooks

India Willis, MPH, MSN, FNP-BC, AAHIVS, is a board-certified Family Nurse Practitioner and PhD student at George Washington University. She holds dual master’s degrees in public health and nursing. India’s clinical and research interests focus on improving access to care for underserved populations, particularly in HIV prevention and treatment.