​​​​​​​​​​​Q and A with Dr. S​hannon N. Zenk, Director of the National Institute of Nursing Research

How did you begin your research career?

I really became interested in communities—and how resources and risks are distributed across communities and the implications for people’s health—while practicing as a nurse. One of my first jobs was as a home health care nurse case manager. I helped patients with pain management, taught them to manage chronic conditions and provided wound care. As I spent time in different communities, I was struck by the tremendous differences in the environments of my patients, both in terms of privilege and poverty. I found it difficult to talk to some about healthy eating when what they really needed was stable housing, a safe environment and access to healthy, affordable foods nearby. In response, I went back to school to learn more.

How did you progress on the research track?

I started my research in Detroit, then moved to Chicago, then nationwide. In our first study, we found that low-income and Black communities have less access to healthy foods. For example, we showed that supermarkets with the broadest selection of healthy foods in the Detroit area were located over a mile further away from Black high poverty communities than White high poverty communities. This was one of the earliest studies on food deserts in the United States.

We also evaluated the impact of community investments and policy changes on the environment and health behaviors. An example of this was research into the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package revision. This update dramatically expanded the inclusion of healthy foods such as fruits and vegetables in the package. This cost-neutral policy change benefited maternal and child health and was associated with improvements in the community food environment. Studies like these can help us accumulate evidence for more promising approaches to improve health outcomes in communities of color.

How have you been involved globally?

I personally have had a long-standing interest in global health. My first experience was in an undergraduate program where I spent a month in northern Nigeria learning about economic development. Along with several nurses and other nursing students on the trip, I visited hospitals and clinics to understand more about health and health care in the country. I also had the privilege of spending several weeks working with the nursing faculty at the University of Rwanda, helping their team develop research ideas. In addition, I had the pleasure of participating in Rwanda's first international conference in nursing and midwifery.

What is the role of nursing science?

Nurses know people and nursing science is centered on people. Of all health professionals, nurses spend the most time with people in a wide variety of clinical and community settings. Because of nurses’ holistic perspective, we see firsthand—and COVID-19 has demonstrated how—advancing health and health equity will require developing prevention and treatment strategies that are responsive to the realities of people's lives and living conditions. I believe this holistic perspective is nursing science’s most important contribution to research and health and, because of this, nurses have an important role to play in advancing health equity, too. At NINR, we want to maximize the impact of nursing science by tackling the world's most pressing health challenges and discovering solutions in the clinical and community settings where nurses practice. We want our research to reach populations that experience an undue burden of disease and illness and have been historically underrepresented, and we want to advance health equity. Global health and health equity are issues that have always been near to my heart since my early career as a home health nurse. I’m looking forward to collaborating with Fogarty and its funded scientists to support research and training that will help eliminate the pressing health problems around the world.