Dr. McCool is among the 1 percent of male midwives in the U.S. While he said he has not encountered gender-based barriers in his career, he realizes he is among the privileged - a Caucasian man living and working in the U.S. Dr. McCool is acutely aware of this when he brings his midwifery expertise to impoverished areas of Haiti, Botswana, Guyana, and India.
“You look around the world and in many places women are viewed as second-class citizens - or third - or fourth-class citizens - and those who care for them are not held in high regard either,” said Dr. McCool.
He and his midwifery colleagues work to learn about midwifery education in various countries with the goals of improving women’s health and of encouraging educated midwives to stay in their home country rather than leave for foreign shores where midwifery may yield a better income.
This is “vital work,” said Dr. McCool, and it is ongoing. “If you think of it as a revolution, it won’t happen. If you think of it as an evolution, that’s a more sustainable approach.”
No matter the geography, addressing health inequities requires a serious culture shift, said Assistant Professor of Nursing Bridgette M. Brawner, GNu’05, Gr’09, PhD, APRN.
A nurse scientist, Dr. Brawner studied with faculty at the Penn Nursing Center for Health Equity Research in her graduate and post-doctoral work. Her area of expertise is sexual health promotion in disenfranchised populations including HIV prevention among adolescents facing mental illness and substance abuse.
“The term ‘health inequity’ indicates that there are unfair, unavoidable differences in individuals’ health status and outcomes. In other words, the playing field is not level,” Dr. Brawner said. “Research demonstrates that most of these differences are rooted in inequities at political, economic, and educational levels, to name a few.
“Moving toward health equity and social justice is not a small undertaking, but if we get paralyzed and don’t do anything, it will not get better,” she said. “People will not have an opportunity to be as healthy as they can be, and that is unacceptable. However, if we each chip away at something, taking our own small piece, we will make progress.”