Understanding Social Systems of Health (With Dr. Clariana Ramos)
Joe Gaccione 0:02
Welcome to Vital Views, brought to you by UNLV School of Nursing. This is Joe Gaccione, host and UNLV Nursing communications director. UNLV School of Nursing is excited to welcome several new faces to our faculty roster this fall. Today's guest is one of those new educators, Dr. Clariana Ramos de Oliveira. She is an assistant professor who came from Harvard T. H. Chan School of Public Health. Dr. Ramos brings an abundance of insight on mental health, global health, and community nursing. Her work and research have taken her around the world in countries like Brazil and Pakistan, just to name a few. Dr. Ramos, thanks for coming in.
Clariana Ramos de Oliveira 0:38
Thank you so much. It's a pleasure to be here today.
Joe Gaccione 0:41
Now you've been in Las Vegas for a few months now. How has it been acclimating?
Clariana Ramos de Oliveira 0:45
Oh my gosh, Las Vegas is a beautiful city, the community is so warm, and I'm feeling so welcomed here. The nature surrounding the city is so beautiful as well, I'm so happy like, to learn more about this side of the coals, they, I came from Boston, so east side, and I am so surprised seeing all like, the nature around here. So beautiful.
Joe Gaccione 1:10
Good. Now, your skill set and background are unique in that you have a strong mixture of both nursing and public health, and in medicine and health, there are going to be overlaps of different practices, different areas of research. But when it comes to concepts, how do public health and nursing go hand in hand? How do you integrate the two?
Clariana Ramos de Oliveira 1:29
This is a great question, because like, when we decided to go to nursing like, to go to nursing school, we have like, in mind that to have only individual level patient and care. So, we are thinking about hospitals, we are thinking about individual treatments, and like, as nurses, we needed to open our eyes to see like, more broadly. So like, to try to connect our knowledge with the community. And this is about like, public health in community, community nursing is when you are not considering only individual level, but how we can expand our view and try to integrate our care and the community level. So, how we can prepare an intervention, a program to impact our community, the community that we've been working with? So, this is community health nursing, and as nurses who have like, so, have this holistic view, this holistic knowledge that it is so important for public health. So, I'm very happy to, to teach and to have this contact with the students in the community health class that I can show to them, that I can inspire them to open their eyes for something beyond the hospital to try to, to help them to see that they can be leaders in the community and public health field.
Joe Gaccione 2:57
When we say holistic, what does that mean for the general public when we use that term to describe nurse education?
Clariana Ramos de Oliveira 3:03
I think like holistic thinking as a nurse, we have like this, so many courses and disciplines that we will connect the biological health. We are going to learn about like, disease, but also like, how to improve and to help individuals and like, in their community to improve their health. So, you're going to learn about not only treatments, but also like, during the community health class about epidemiology. So, how to investigate disease and health in the community. We are going to learn about pathology and medicines, but we are going to learn also how to research in different contexts, in different populations, considering the culture of that population, considering the individual, but also the family, and the policies of that community, that environment, that these families are living right now. So, for me, this is the holistic view, like considering different systems in our health, in our community
Joe Gaccione 4:19
And talking about different systems and different populations, we mentioned before you've been around the world. What are some of the areas that you visited and can you talk about the people you've met, the trends you found when in terms of, excuse me, when it comes to public health and nursing?
Clariana Ramos de Oliveira 4:32
Oh yes, this was such a great experience for me visiting Pakistan, Tanzania, Brazil is my home country so, of course, I've been working there as well, but also US, Nepal I had the opportunity to work there, as well. And these experiences opened my eyes for my own culture, own beliefs, and also like some misconceptions that we have based on the places that we grew up. So, I think this experience helped me also to formulate better research questions, helped me to be a better human being. And that is something that I really want to provide for my students, to go to different places, to open their minds, their worldviews, and try to invest more time learning from others, and the other, and others, when I talk about others, not only nurses but like, with the community. Talking about nursing, it's so good when you see you have different perspectives about like, one treatment, for example. So, when I went to Tanzania, I could see like, how nurses, they deal with community health there. Being in a place, for example, in the area that I visited in Tanzania was a poor area, or a rural area, with a low, a low resource area. So like, how they could be creative in the middle of a place that they don't have a lot of resources, they don't have a lot of money. And sometimes we are so comfortable here in US that you will have the resource in most places because here, we have inequities, we have like, poverty as well, and we need to be aware of that and prepared, but being like in different place, I could see that, okay, we needed to be flexible, we needed to learn from others, and we needed to try to be creative in our own practices.
Joe Gaccione 6:36
One of your specialties is mental health. Do you find that some countries, including our own, value mental health more than others? Or do you think there's a global inequity when it comes to mental health awareness?
Clariana Ramos de Oliveira 6:49
Yes, I believe that we have this global mental health inequity for, for mental health, because in our society, we value more medicines, for example. When you go to the doctor, you're not expecting the doctor to say to you, “Oh, go, go to your house and do some deep breathing exercise, try to express more your feelings.” And so, you have this when you go to the doctor, when we go to the mental health health provider, a clinician, we are expecting to receive medicines, to receive like, something that is to solve our problem, right away. In mental health, is something that we need to, we have a lot of effort in our sight, to know like, to understand our feelings, to understand our emotions, and how to practice these strategies, this awareness daily. So, this is one point, like our society, this health tradition that we have in our society. But I think like right now like after, during, and, and we are still experiencing COVID-19, but like, during this pandemic crisis, we learned how important it is, the mental health, for us and for our health. For example, if we don't have good mental health, or if we don't, we're not taking care of our mental health, it will affect the way that our body will answer for some disease as COVID, as like infectious disease, as cardiovascular problems. So like, like, during the COVID, they could see, “No, we needed to take care of our, our body, but also our, our, our mind, also our feelings to be healthy,” and to try to be more aware that it’s not only about disease and medicines, but like, how our brain is connecting with our body and preparing to deal with the, I don't know, like maybe this virus or bacteria that that's trying to cause a disease in our body. So, I think like, after COVID, now we have this momentum for mental health. So okay, mental health is important, so how we can implement mental health care in our life during our daily basis life? Not only physical exercise, not only medicines, vitamins that we need to take, but taking care of our own emotions.
Joe Gaccione 9:19
It must be hard to diagnose mental health, whether you're a provider or your a family or friend who might recognize that in somebody, because it's not physical, obviously, you can't look at, you can look at a broken arm and say, “Okay, this is what you need to do.” There are steps that you know you have to do. But when it comes to mental health, there is no one path, there's no one size fits all, whether it's pharmacology or just rest or trying to be more physically active. It's not so set in stone. So it, it's, it sounds like it's difficult to keep that momentum going when it's not always easy to identify it.
Clariana Ramos de Oliveira 9:55
Yes, because it's not there. It’s inside us. So, how we can help people to identify emotions, how to help them to make it a priority in their lives as they are taking care of their physical health, their body, but like this is some, this is a good point. And also like for mental health, of course, you'll have medicine, but like to know like, all the, this more holistic approach, these treatments that are involving denote yourself, your self-awareness, your self-care, you trying to connect with your body, it's, it's harder because we are trying, all the time, are trying to delegate like to give like, this problem in the physician’s hands, in the nurse’s hands, they know like, to try to, you know, “This is not my problem, I'm here for you, doctor, nurse, therapist, to solve my problem.” So, when we can see that it's more difficult to convince them that they need to treat and take care of their mental health.
Joe Gaccione 10:58
When it comes to community health, what do you want the most important message to be for your students to take away?
Clariana Ramos de Oliveira 11:04
I think during the classes, I have been thinking a lot about that like, because community health and public health is so big, but I think like, the main message is that we need to learn about the social determinants of health, that our health is not only about our genetics, our biological system, but you have like, all the systems around us. When I'm talking about systems, I'm talking about family, I'm talking about our own community, the way that our community is, if you have like, the resources in our, in our communities to, to practice physical exercise, if we are feeling safe in our community, you know, this will impact our health. So, we have like family, community, and to have like, the politics will impact our health, our mental health and our life. So, I want to help them to, to teach them that you have like, much more to learn. And when we are trying to investigate a disease, when we're trying to prepare our care, our treatment plan, or our intervention with our patient, we need to investigate more. Not only the health history, but, “Okay, where the patient lives, do they have social support?” about like, trying to investigate about their community. The environmental health, nowadays, we've been seeing a lot of disease related with our food, not talking only about junk foods, but like, the way that we prepare our foods. So, all the bad products that we put like, to preserve our foods. So, this is very important to consider, and I want them to learn, you know, like, not, when you're talking, when we're talking about community health, we are talking about social determinants of health, and we are trying to investigate much more than biologic, biological and genetic factors, but all this world that we are involved, all these systems.
Joe Gaccione 13:14
That is all the time we have. Dr. Ramos, thank you so much for coming in.
Clariana Ramos de Oliveira 13:18
Thank you so much. It was a pleasure, and I hope my students and faculties and all like, the UNLV community, I hope we can connect more and we can create this awareness about mental health and public health, more and more, more in our community.
Joe Gaccione 13:35
Thank you for listening, everyone. Hope you have a great day.
Transcribed by https://otter.ai