11 minute read
Making Political Change through the Eyes of a Nurse: Congresswoman Lauren Underwood Advocates for Communities
BY JULIA QUINN-SZCESUIL
Congresswoman Lauren Underwood, MSN/ MPH, RN, is serving in the Illinois 14th Congressional District during a time like no other. During her current term, which began in January 2019, Underwood has seen a shift in administrations after contentious elections, social upheaval as the nation addresses racism and racial disparities, and a global pandemic unlike anything the world has seen in 100 years.
But when Underwood began her run as a Democrat for the seat in the 116th U.S. Congress, she knew making change was a priority and that her professional background in nursing would give her the expertise needed to help her community. With a BSN from the University of Michigan and an MSN/MPH from Johns Hopkins University, Underwood’s passion for health care led to her earlier service as a senior advisor at the U.S. Department of Health and Human Services (HHS) during the Obama administration. Her work to help communities with disaster preparedness and public health emergencies would be put to direct use then as she worked on the Flint water crisis and now as she works during the COIVD-19 pandemic.
Underwood works with many committees, but her particular passion for maternal health led her to launch the Black Maternal Health Caucus alongside Congresswoman Alma Adams (NC-12) to call attention to the profound disparities in maternal health.
Your roles with the Obama administration included work on infectious diseases, natural disasters, and vaccines. That seems like a blueprint for working in current times. How did that preparation shape your work as a Congresswoman?
There’s the obvious topical connection given the pandemic, but what I took away from that job with the Obama administration is how the federal government can be helpful to a single community. That’s something I think people know in abstract—the idea that a town can be hit by a flood or a tornado or a water crisis like in Flint. There are resources, there are experts, and there are people who care about their fellow Americans and are willing to drop everything and come to their assistance. That’s so powerful. Where I am from, a lot of people see government as a nuisance or something that has to be tolerated. What I saw in that role is how government, especially when it is well done and well run and people at all levels work together, can be a great help to people in both good times and bad. When we talk about disaster preparedness and response, preparedness comes first. You want to have things in place should something catastrophic happen. So, we are working in communities in good times and bad. We are augmenting their capacities and resources and that’s similar to the job I have now.
How do your two roles— as a nurse and as a politician—combine?
I spent my career working to connect people with highquality health care coverage, reduce disparities, and help people live their healthiest lives. That’s the work I have done with every single role that I have had and that mission continues forward from this position in Congress. I have an opportunity to not just help my community and to help them be healthier, but to make an impact for the whole country. That’s something I don’t take lightly.
And so what’s happened with this maternal mortality disparity is that it feels like as Black women, we all know someone. It’s our sister, our best friend, our sorority sister, someone who goes to our church, the girl who lives around the corner in our neighborhood, who have these devastating and difficult experiences during delivery or postpartum period. Severe morbidity or they die.
This American Rescue Plan includes one of my bills, the Healthcare Affordability Act, that says that no American would pay more than eight and a half percent of their income on health care premiums for Obama care plans. Even before the pandemic, people couldn’t afford their health care. It was too expensive. They couldn’t afford their prescription drugs or see a provider or get a procedure they needed. That premium price was that first health care dollar that most folks spent every month.
Now we’ve created some significant savings, and it’s good because that’s part of what I came here to do. Two years into this job, we’ve gotten it done. It’s for two years, and we’re going to try to make it permanent. That was something we had lots of conversations about in my community. People are very anxious about that kind of relief.
Affordability and access are both a primary focus for you.
A lot of people, even within the political space, don’t understand how much access to health care matters. Within that umbrella you have linguistics of compatibility and cultural competence. There are questions of is there a clinic nearby? Can you get there? Can you afford it? Now our conversations around health care is who pays for it all. If we’re going to be really serious about this work around ending disparities, we have to be much more comprehensive in our thinking.
We have been laser focused on this work in the maternal health space that I do. We are trying to end the disparity in maternal mortality and that has to be a comprehensive approach. We are making good progress.
Can you please talk a little more about your passion for maternal health?
I went to Hopkins for graduate school and one of my good friends, Shalon Irving, from the program ended up expecting a daughter in January 2017. When I was finishing out my service in the Obama administration, she was having her baby. Three weeks later she died. In our clinical training, at a very high level, we learn about the disparity, but I was really taken aback. She was working at the Centers for Disease Control and Prevention. She had her doctorate. She was working on health disparities. She was doing everything right, and we still lost her. I knew if I were to get elected, this was something I wanted to work on.
There must be many experiences you share with people in this country and that must make you feel connected to the people you are serving.
Absolutely. We see these examples all the time. And I am just talking about the maternal health space, not even the larger challenges that we know have been persistent. The latest topic of conversation outside of politics has been Meghan Markle and her interview. I was watching that interview and watching her talk about the suicidal thoughts she had while pregnant. Here’s this Black woman with great health care and with so much privilege in the world, and she can’t get access in a time of crisis. In my state of Illinois, mental health, suicide, and substance use disorders are the numberone cause of maternal death. And in my state, Black women are six times more likely to die of a pregnancy related cause than white women. And so I am watching this and…talk about near miss. For every death, there are 70 near misses. This is another example. And so what’s happened with this maternal mortality disparity is that it feels like as Black women, we all know someone. It’s our sister, our best friend, our sorority sister, someone who goes to our church, the girl who lives around the corner in our neighborhood, who have these devastating and difficult experiences during delivery or postpartum period. Severe morbidity or they die. It’s something we have all dealt with in isolation, but when you look at the numbers, it’s so prevalent across our community.
Now that we are in a different administration, how will things change?
In the last six weeks, I have seen a dramatic shift in what it means to legislate. With this American Rescue Plan on COVID relief, there was a Senate that was anxious to get their hands on the bill, and a president that was excited to get it signed. It was a fundamentally different experience than what I have had in the last two years. That has changed things. We are now legislating with the expectation that things will have a strong path forward, which is very exciting.
After a pandemic that has had a swift and crippling impact on so many families economically, we know we have a lot of work to do to help folks recover. We have a lot of work to do when it comes to crushing the virus, helping people with a persistent form of the disease, making sure we have true equity in vaccine distribution, and making sure that those who are pregnant or postpartum have access to a vaccine, and making sure kids do, too. There are a lot of COIVD health care disparities that remain and there’s a tremendous opportunity with the recovery package and what it really means to help rebuild our communities. You heard [President] Joe Biden talk about building back better. What does that mean concretely for a community in Northern Illinois? That’s my job. My job is to imagine it and put it in place so that my community can benefit and go to work. That’s exciting to me.
It must feel gratifying to do the job you wanted to do.
There’s something pretty incredible about our system of government that a regular person, a nurse, can get on the ballot, earn the support of her community, and get elected to the Congress. That’s extraordinary. I’m not saying I am extraordinary, but that my story is possible. Then to have the opportunity to serve in a once-in-a-century pandemic and help shape the way we respond and not leave folks behind. I can make sure I help our communities. This is a great honor and something I don’t take for granted, especially recognizing how few people like me there have been in these roles.
As a nurse, working through a pandemic, how has that influenced the way you see all the struggles in your community and in the nation?
In health care circles and nursing circles they talk about health in all policies and that’s how I view my work. In my first term I was assigned to three committees. Educational labor, which is K-12, higher education, labor unions, worker protections, and employer-sponsored health care. I was assigned to Homeland Security where I did FEMA and cyber security. And then I was assigned to Veteran’s Affairs. Outside of the very narrow employer-sponsored health care responsibilities, nothing else was about health
care. I found a way to work health care issues into literally everything I did. Everything. President Trump signed into law electronic medical records along the southern border to make sure kids weren’t dying in custody, particularly of these preventable illnesses like you saw over the course of 2019. We got a number of veteran’s bills signed into law. This year, I am assigned to the Appropriations Committee responsible for agriculture and rural development and the Food and Drug Administration, but also the whole department of Homeland Security. What my wish list looks like and the changes we want to make is to make sure that everybody had a chance to live healthy, well lives. Period. That’s what I am here for. I have found if you are creative and persistent, we can get it done.
What would you say to nurses who want to follow a path similar to yours?
Yes! We need you. We need more nurses in Congress. We need more nurses in elected office. If you want to be in an appointed position, that’s great. I recognize not everyone can quit their job, run for Congress for two years, and then do this full time. It’s not something that’s accessible to everybody, but every community has a health department and that health department is overseen by a structure or entity—oftentimes it’s a county board or a board of health. Those individuals are either elected or appointed.
Every nurse has the experience and expertise to be of value to that type of oversight. Oftentimes, these roles are compensated and flexible. They are close to home and have tremendous local impact. We have seen the effects systemic underinvestment in local public health during this pandemic. If we are going to move forward, we need to have people who have a great understanding of communities and populations and improve their health status. Who better to do that than America’s nurses?
Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.
The JoAnn McGrath School of Nursing and Health Professions at Alverno College has been committed to educating diverse, highly skilled caregivers since 1932.
