Barbara Mawn, PhD’93, is one of 15 alumni to receive a 2020 Florence G. Heller Alumni Award. Throughout her exemplary academic and leadership career, she has served as professor and director of the PhD in Nursing Program at the University of Massachusetts Lowell, building on her professional background in pediatric nursing. In addition, she has served as a visiting professor at universities in Thailand and Northern Ireland, further influencing the educational preparation of nurses globally. She has received numerous awards for her work, including the American Nurses Foundation Medal of Recognition for Research (2000). She spoke to Kate Kaplan, Heller’s director of development and alumni relations, about how her passion for nursing led to her career addressing health disparities in the U.S. and around the world.
Kate Kaplan: How did you find your way to Heller?
Barbara Mawn: I was teaching at Boston University when they had a nursing school. I realized that I really enjoyed the stimulation and challenges associated with teaching after being a nurse in the field in the trenches for 12 years. So that's when I decided to apply for a PhD at Heller.
Having been a nurse, I had a relatively narrow field of study compared to some other types of disciplines. At Heller, I learned about the intersection of sociology, politics, and economics and how that impacted health policy, which became the focus of my doctoral studies.
KK: How would you describe your career?
BM: My career has included a blend of research and teaching. I've been director of the PhD Program in Nursing at the University of Massachusetts Lowell for over 12 years and prior to that, when I first started at the university, I was teaching public health nursing to undergraduates. I would try to help expose them to a broader view of patients, looking at some of the different bases for policies and how it impacts their health.
KK: Throughout this time, would you say there was one big question or one problem that you were trying to solve?
BM: The major problem I have researched is health disparities among various populations at risk. What motivated me was my nursing experience at Children's Hospital as a nurse in the Pediatric AIDS Clinic and then in the emergency department (ED) for over 20 years. Even up until 10 years ago, while I was a full professor, I still worked as an ED nurse on the weekends. And so that sort of sparked my interest into the issue of health disparities and the multitude of factors that impact it: race, ethnicity, gender, socioeconomic status, disability, and sexual identity. I've conducted numerous studies over the course of my career with different populations, always focusing on health disparities and health promotion.
My first studies were focused on children and families who were living with HIV infection and then I later moved to U.S. healthcare workers who experienced health disparities. I also looked at the health risks of workers from various sectors of the economy in Thailand. And now I'm looking at mental health outcomes among the Bhutanese refugees living the United States. I have also mentored numerous doctoral students who have examined a wide range of issues related to health promotion and health disparities.
I started to have an interest in looking at how other countries manage their own health and social systems. While I was a student at Heller, I was able to take a course that was offered through Boston College, which consisted of a two week visit to Cuba to examine their social and health care systems firsthand. After securing a tenure track teaching position, I started collaborating with interdisciplinary faculty from UMass Lowell, as well as in Thailand at Mahidol University and Naresuan University. We examined health risks in Thai workers in many sectors of the Thai economy, including health care workers and farmers predominantly. I've served as a visiting professor three times in Thailand, as well as in Indonesia and Belfast, Ireland. I’ve been privileged to be able to work collaborative with researchers from multiple disciplines across many nations.
KK: What's the link between health and racial disparities?
BM: We're living in a very interesting time to look at structural racism and its impact on health to try to break it down, bit by bit. There are many factors that are associated with health and racial disparities including socioeconomic status, health care access, lack of trust in health care providers, lack of diversity among health care professionals, and systemic racism in institutions and policies within our society. There's not going to be one thing that researchers, policy makers, activists or providers can do that's going to eliminate this problem. In my master's program, I did a nursing master's thesis on infant disparities and infant mortality based on race. It was a problem then in the 1970s and we still have that problem with higher mortality rates in non-white infants across the country and in Boston, so change is a slow process but we cannot give up.
KK: What kind of concerns do you have about access to healthcare, given the economy and COVID-19?
BM: Any progress that we've made in access to health care, I think that we've really lost a lot of ground in the four years of the prior administration. It's very frightening. During COVID, it's even been exacerbated even more. I'm starting to analyze a study now on Bhutanese refugees. This is a group that already has a lot of health disparities and, particularly, they have poorer mental health outcomes. As refugees, they have a history that can include torture and living in camps. Once resettled, they often have low-income jobs, but they do work, so it's concerning that they are having trouble with access to health care. When you look at all the people across the nation who have low-income jobs, or have lost their jobs as a result of the pandemic, and now they have to deal with no daycare, no job prospects—it's very concerning.
KK: Can you tell me about some of the research that you've done and its impact on policy?
BM: My work on HIV and families helped move forward the thinking in this area. My dissertation at Heller was an examination of lay women's views on mandatory testing of pregnant women with HIV infection in the 1990s. It was a time prior to routine prenatal testing screening, which is in place now. The women were ahead of their time. They broadly supported that every woman should be tested when they first show up in the prenatal clinic.
And at that time, they were just coming up with drugs that could help to minimize transmission in utero if given early. So, these women were eager to talk and approximately half of them actually had HIV themselves and the other half did not have it that they knew of, but they were predominantly low income and they were at risk, and they knew it. At that time, health care providers were just saying, “Well, if you think someone looks like they're high risk for HIV, then you should test it,” but they weren't saying, “Let's do everyone because we can't tell by looking at everyone.” I don't think that changed the policy, but it hopefully contributed to the eventual change that was to come.
KK: What's your advice to current students?
BM: I look very fondly back on my time at Heller. I was a single parent supporting my son when I entered Heller. I was able to have him go to daycare there and I was able to sort of close out everything else in my life and just focus on raising him and on my studies. If you rush through this, it doesn't lend itself to intellectual creativity or those “aha” moments that I was able to get while I was there. If you can manage it, I recommend not to do too much else during your period of study, I think you have to focus on yourself and those in your immediate circle of need, such as children or other dependents.
KK: Who were some of your mentors at Heller?
BM: Connie Williams was my dissertation chair. I was her first PhD student and she was a great mentor. Deborah Stone, who was a professor of public policy, also contributed significantly as a member of my committee. She had just published her book on policy. In her class, she starts out by saying, “When you write your research studies or any professional papers, make sure that your grandmother could read and understand it. To this day, I hear myself saying this all the time to my students – to write clearly and simply, so she was very influential. The last influential teacher and mentor was David Gil. He helped me to think outside the box and to continually challenge the status quo in the search for justice. He was very inspirational. Every professor at Heller I had was outstanding, but these three made a life-long impression on me.