Reflecting on my life and career, the song "Against All Odds" by Tupac Shakur comes to mind. His lyrics resonate deeply with my experiences of trials and triumphs. As I step into my new role as Deputy Commissioner of Clinical Services during National Nurses Month, I am reminded of my journey. Joining the City of Milwaukee Health Department (MHD) was not just a career move; it was a commitment to fighting systemic racism and improving the health of my community.
Born and raised in the City of Milwaukee, I am a proud graduate of Milwaukee Public Schools.
In high school, an encouraging teacher recognized my talent for medical biology, setting me on a path toward a medical career. Simultaneously, my life took a dramatic turn when I became pregnant at 16. The experience was challenging, marked by the painful impacts of racism and ageism. But it was also transformative.
Pregnancy and Motherhood at 16
When I suspected I might be pregnant, I went directly to our school nurse, whom I’d developed a strong bond with. She encouraged me to take a pregnancy test in the office, which is
when I learned I was pregnant. I remember crying so hard, that I couldn’t think straight. The nurse helped me understand my life was not over, but just beginning a new chapter. While my parents were initially disappointed, they embraced and supported me through my pregnancy. With their help, I balanced pregnancy and school and graduated with my class. 
It was through my teen pregnancy that I had my first interaction with MHD. Upon enrolling in a prenatal care coordination program (PNCC) at the University of Wisconsin-Milwaukee Silver Spring Neighborhood Nursing Center, an MHD community partner, I met the nurse who would become my life mentor, Bev Zabler. She taught me about infant care, like infant massage and the importance of breastfeeding, developmental milestones, and bonding with my newborn. Bev also was the one who encouraged me to pursue a career in nursing.
My pregnancy was considered high-risk, and I went into a difficult and painful labor four weeks early. After giving birth to my beautiful son, doctors kept him in the ICU until his breathing regulated. I took him home several days later and started navigating young motherhood, school, and planning my future. With the loving support of my parents, and Bev’s mentorship and encouragement, I decided to pursue a career in nursing.
Pursuing Nursing
After graduating from high school in 2001, I dove headfirst into my goal of becoming a nurse. It was tough, balancing motherhood and my nursing courses at MATC. I became pregnant again three years into my education, compounding the difficulty and delaying my degree. But I pushed on, determined to graduate.
In 2006, while pursuing my degree, I returned to MHD for an internship working with PNCC nurses and pregnant teens. The experience profoundly deepened my understanding of social determinants of health and allowed me to witness firsthand the importance of a support system. Many of the young mothers MHD assisted were going through similar experiences to mine, but without the help I had at home. This experience highlighted the crucial role of support systems and underscored the disparities faced by young parents who
lack such resources.
With help from my parents, extended family, friends, and incredible instructors, I graduated from MATC in 2009. During my pinning ceremony, I delivered our class's speech. I remember hearing my 9-year-old son and 4-year-old daughter proudly cheering in the crowd, “That’s my mommy!” It was a moment I’ll never forget.
Experience Fuels Advocacy
Early in my career, I witnessed firsthand the pervasive impacts of racism within the healthcare system. The underrepresentation of Black, Indigenous, and other people of color (BIPOC) individuals in nursing staffs was stark and mirrored the broader deficiencies of the nation’s healthcare system. According to the American Association of Colleges of Nursing, less than 10% of nurses in the U.S. are BIPOC, and only 6% of them are Black. BIPOC representation dwindles further up the hierarchy. A study of healthcare leaders found that merely 8% of individuals on hospital boards and in executive leadership positions are Black.1 In the state of Wisconsin, less than 3% of physicians are Black.2
This lack of diversity in healthcare leads to clear and detrimental outcomes: poorer health and higher mortality rates among underrepresented minority groups, pervasive racism in the workplace3, and a predominantly white-centric approach to medical practice.
While navigating motherhood and the demanding career of an overnight pediatric ICU nurse, I yearned for familial support. I often found myself educating my colleagues on cultural differences in care. As a Nurse Case Manager, I intervened when I overheard a Black patient being labeled as 'non-compliant' by her white care team. Upon speaking with her directly, I learned she didn’t feel the meds were working and worse, felt her doctor was ignoring her concerns. After helping connect her with a physician of color, I emphasized to my white counterparts the importance of truly listening to patients from all backgrounds.
By 2017, I had transitioned to public health nursing, focusing on the LGBTQ+ community and patients living with HIV. It was troubling to still witness ongoing racism and discrimination from healthcare professionals. Three years later, during the COVID-19 pandemic, the disparities in healthcare access became painfully evident once again. I treated and observed firsthand how BIPOC and marginalized individuals faced significantly higher infection rates and more severe complications. The Centers for Disease Control and Prevention estimates that some BIPOC populations experience hospitalization rates after COVID-19 infection more than three times higher than those of White populations.4 Social determinants of health played a central role in these disparities. Generations of systemic divestment in vulnerable BIPOC communities have resulted in significant gaps in infrastructure and resources.
In 2021, I watched my Native American Ho-Chunk husband suffer the effects of racism in healthcare when seeking dermatology care. Following months of discomfort and ignored complaints to his physician, we switched doctors and received the correct diagnosis and care he required. It was then that I learned firsthand the disparities in something as specific as dermatology, which is considered one of the least racially diverse specialties in medicine. Non-white populations cite a lack of culturally competent care and a barrier to accessing treatments for people with darker skin complexions.5
Joining MHD and a Call to Action
When I joined MHD full-time in 2023 as Director of Nursing, I was struck by its focus on addressing racism as a public health crisis and its potential to effect meaningful change. MHD's Racial Equity Initiative and commitment to becoming an anti-racist organization resonated with me deeply. Being promoted to the esteemed role of Deputy Commissioner of Clinical Services in 2024, I feel grateful to work for an organization that welcomes individuals of all backgrounds and values my expertise. Research indicates many nurses have confronted racism in their workplaces with little tangible change, but MHD is dedicated to supporting nurses and fostering diversity across all roles, including leadership positions. With its anti-racism policy and Equity Advisory Committee, MHD is integrating anti-racism as a central goal in its strategic plan. Addressing racism may be uncomfortable but is essential for the well-being of all individuals and communities. 
The emphasis placed on health equity in Healthy People 2030 is intricately linked to health literacy and recognition of social determinants of health.6 Factors such as structural racism and systemic bias can impact health literacy levels and perpetuate health disparities. Implementing measures to tackle these issues is essential for realizing health equity.
The need for improving diversity in nursing, and healthcare overall, is clear. Racial and ethnic minorities are more likely to return to and serve their underrepresented communities, bridge the cultural and linguistic gaps in patient education, and provide a broad and diverse cultural perspective to all conversations within nursing.7 Patients have reported feeling more comfortable when their healthcare providers share their ethnicity, race, and language, strengthening the trust between patients and nurses, and leading to patients more strongly adhering to nurses’ recommendations.
Now is the time to meet patients, families, and our community where they are, avoiding labels like "non-compliant" and addressing the root causes of health inequities such as racism, bias, stereotypes, and discrimination. These issues are deeply rooted in our history, organizations, and healthcare policy, necessitating more advocacy and understanding. Transparency is crucial in communicating with patients, and as medical and public health professionals, our priority is to positively impact the health and well-being of the people we serve.
To achieve this, we must take the time to understand the feelings of individuals, families, and communities; ask clarifying questions without judgment; ensure we have enough time for discussions, as patients often feel rushed; address our own biases, stereotypes, and privilege; read books by BIPOC authors to begin the process of unlearning ingrained prejudices; develop cultural awareness and sensitivity; create spaces of psychological safety; and utilize a trauma-informed, patient-centered approach by getting to know patients as individuals.8
This blog post is part of a recurring series within The Beat, aiming to spotlight the profound impacts of racism on public health. See below for more enlightening discussions on this critical issue.
Navigating the Labyrinth of Healthcare Disparities – A Personal Story by Erica Olivier