Dr. Creshelle Nash was nearing the end of her medical residency 20 years ago, when surgeons removed her spleen. Doctors believed she had lymphoma, a type of blood cancer. However, as it turns out, she didn’t have lymphoma but rather a benign growth on her spleen, discovered during the splenectomy. That’s actually the good news. Unfortunately, removing her spleen placed Dr. Nash in a category of immunosuppressed individuals, so fighting infections is typically much harder.
She’s not complaining or disenchanted by her health status. As an African American woman, physician and public health practitioner, it informs how she educates, engages and fights for health equity alongside communities of color and the underserved.
Dr. Nash, MD, MPH, CHIE, one of our medical directors, spoke with Blueprint about the COVID-19 crisis, her thoughts on the new vaccines and her work toward quality healthcare for every Arkansan.
Because of COVID-19, we hear more about the need for equity in healthcare. Talk a little about what that means.
Dr. Nash: Equity in healthcare means everyone has the opportunity to be as healthy as possible. It means the removal of barriers that keep some people from being as healthy as others. Some barriers include lack of access to quality education, employment and housing. It encompasses judicial fairness, social and socioeconomic status, etc.
Throughout my medical and public health training, I’ve witnessed healthcare disparities, mainly how minority, rural and underserved populations have less access to care and receive lower-quality care. COVID-19 has uncovered and illuminated deep, long- term healthcare disparities, some more obvious than others. There are documented inequities in most health conditions, from cardiovascular disease to cancer to asthma and HIV.
It’s almost impossible to talk about healthcare disparity and its negative impact on people of color, particularly African Americans, without talking about the Tuskegee Experiment.
Dr. Nash: True. It’s easy to point to the 40-year long Tuskegee Experiment as an egregious, horrific example of healthcare mistreatment in research, and it was awful. It was unconscionable. Yet, there have been hundreds of years of medical mistreatment and denial of treatment for people of color and the underserved before and beyond Tuskegee. Since then, many individuals in clinical research, clinical practice, policies and programs are working to ensure this never happens again.
I share their passion, and we’re making progress. The Tuskegee Experiment should convict us to learn from the past as we address COVID-19. In this current crisis, black and brown people have higher rates of infection than white individuals. That’s due to many factors like the inability to social distance because of crowded and limited housing and the fact that many are essential workers who are overly exposed and under-protected. Minorities experience higher rates of hospitalization but are still more likely to die.
Ultimately, who’s responsible for eradicating disparities in healthcare among people of color and underserved populations?
Dr. Nash: We all are. And as healthcare providers and public health professionals, we must step up and own up to how we have prolonged and, in some cases, worsened healthcare inequalities.
It’s our responsibility as citizens and professionals to become solution-oriented. This crisis is our opportunity to improve our entire healthcare system. It’s how we honor our communities for whom the healthcare system was established. Likewise, each person has a role to educate themselves and speak up for those more vulnerable.
What are your thoughts on the COVID-19 vaccines and the reluctance of some people to get vaccinated?
Dr. Nash: I understand their reluctance. Yet, despite a healthcare system that has not always worked for people of color, many have bravely volunteered for the clinical trials! While working from home and researching the vaccine, I thought about others whose jobs require them to leave their homes. Eventually, I was no longer just researching for myself but in honor of them.
I want everyone to know that the COVID-19 vaccine science and technology are not new. The review processes were not skipped. They were simultaneous and not sequential, making everything faster. Safety-monitoring boards work closely with drug manufacturers. After I weighed the benefits and risks, I was satisfied enough with the data to recommend the vaccine to my father, mother and other family members.
What keeps you hopeful about the outcome of the COVID-19 vaccines?
Dr. Nash: My faith, primarily. Courageous communities helping those most affected and in greatest need inspire me. The vaccine is representative of the best medical science we have, and it’s becoming accessible to everyone. After receiving my shot, I attended an event in
Pine Bluff, talked to people and administered the vaccine to everyone who wanted it. Roughly 850 individuals were vaccinated that day.
How can healthcare providers persuade patients to take the vaccine when it’s available?
Dr. Nash: Share the scientific data about efficacy and safety, yes. But that alone won’t convince a person to get vaccinated. Demonstrating concern for people’s health and values is persuasive. That’s complicated when providers might be seeing patients every 15 minutes. But when patients are convinced that you care for and respect them, they are more open.
About Dr. Nash
Dr. Creshelle Nash, a native Arkansan, graduated from Hall High School in Little Rock.
She attended the University of Maryland School of Medicine in Baltimore and received her medical degree in 1994. She served her medical residency at The George Washington University School of Medicine and Health Sciences in Washington, D.C. and completed a residency in Primary Care Internal Medicine in 1997.
In 1998, she earned a master’s degree in public health from the Harvard T.H. Chan School of Public Health. She also completed the Commonwealth Fund Harvard University Fellowship in Minority Health Policy. Dr. Nash worked for the Clinton School of Public Service, the Fay W. Boozman College of Public Health and the University of Arkansas for Medical Sciences College of Medicine Department of General Internal Medicine.
She is a certified health insurance executive (America’s Health Insurance Plan Executive Leadership Program for Medical Directors). CHIEs help lead healthcare innovations and transformation within their organizations and communities.
Dr. Nash enjoys community advocacy, teaching and mentoring students.