Marina Del Rios, MD, MS, associate professor of emergency medicine, is the recipient of this years individual Culturally Responsive Health Care Award.

Through her patient care and research, Del Rios is a champion of equity, voice, and empowerment for Black and Hispanic populations, writes Karen Cyndari, MD, PhD, a research fellow in the emergency medicine department who nominated Del Rios for the award.

In this Q&A, Del Rios shares her passion for connecting with her patients and community beyond the emergency department (ED) doors.

Marina Del Rios, MD, MS, receives the 2023 Culturally Responsive Health Care Award for an individual.

Ive always been interested in racial, ethnic, and socioeconomic disparities in health care. Coming from a Latino household that was low income, I definitely have firsthand experience in the challenges of navigating the health care system.

At UIC (University of Illinois Chicago), I took an interest in cardiac arrest, which has now been in the news due to NFL football player Damar Hamlins event and shows that with prompt action lay people can save lives. Much of my work over the last ten years has been focused on disparities in cardiac arrest care and trying to activate communities so that we can increase awareness of cardiac arrest and respond when it occurs.

Now in Iowa, Im partnering with Johnson County Ambulance Services and the Rotary Kerber HeartSafe Community Campaign to train communities on bystander CPR. My current research is looking at what puts a community at riskso we can both prevent the cardiac arrest from happening by looking at different community-level social determinants of health and comorbidities that might put a community more at riskand then using that to create simulation models where we can test out interventions before implementing them in a real population. Were using data to help communities build a more effective response system for cardiac arrest that would limit the inequities that exist in incidence and survival.

There are some recipes that we know increase the chance of somebody surviving cardiac arrest. A very obvious example is bystander CPR. Those first few minutes after a cardiac arrest are critical. An average emergency medical response time is about 7 minutes and thats in a good situationin an urban place like Iowa City. If you live out in a rural county then it might be more like 15 or 20 minutes, so having lay people who are ready and willing to act is crucial to increasing that survival rate.

But at the same time, its not a one-size-fits-all recipe.

There are health systems that have implemented an ECMO (extracorporeal membrane oxygenation) program, or advanced critical care. That works in a place like Johnson County because our survival rates are high to start with. That means a lot of people make it to the hospital and can benefit from that intervention, but other health systems might be better off investing in more basic services to save more lives in their communities. The simulation program were developing considers local contextswhat the comorbidity in that area is, what the resources arebecause if you dont live in a community that has a university hospital then maybe youre better off investing in dispatch-assisted CPR, for example.

Marina Del Rios, MD, MS, in the Emergency Department at UI Hospitals & Clinics.

In my 15 or so years of academic career in different hospitals, Ive always made it a point to try to connect with the neighborhoods I serve. It seems counterintuitive because the emergency physician is usually more worried about the acute care issue that is in front of them but what Ive recognized is that it doesnt matter what I do in the ED; the interventions I put in place are affected by the reality of people before they even walk in through our doors.

Understanding their reality: are they going to be able to afford their medication, are they living in a reality where its going to be difficult for them to see a primary care provider, and how can I facilitate appropriate continuity of care? I think that we often just go for the disease thats in front of us, but medicine is also about the social sciences and understanding peoples social vulnerabilities.

Everyones journey is very personal. The way that I did it in Chicago was through cultural organizations that were part of my own heritage, like getting involved with the Puerto Rican Cultural Center. Here, Ive been getting to know people through some of the churches and schools. It can start with your own church or a hobbysomething that fulfills you in a different way and gives you an opportunity to connect with the community. Now that tends to keep us in our own circles, but a lot of these organizations have partnerships elsewhere, so its in those partnerships that you can branch out and get to know other people.

I always say start small. Our community is very grateful when they see academic physicians step in because theres a sense that you care for them. Giving back also helps with burnout and with your mental health.

Im surprised at how much diversity of languages there is in our city and county. Having been on the patient side with my mother-in-law who does not speak much English and finding a provider who can speak in Spanish has been very challenging. Shes very privileged that she has me and my husband who can go to appointments with her, but at times its been uncomfortable because some of the questions can be very personal. We have great translation services, but we could always use more. With the growing immigrant population in the county thats one aspect that leads to delays and barriers to care and certainly something we can work on.

The other thing that Ive really stressed with the residents is to not depend so much on family members because they very rarely translate word for word what patients are saying. They have their own interpretations, and although theyre important to have in the room for discussion, there are also some delicate questions that family members dont know about and why its so important to really involve the interpreters.

Another thing weve been trying to push in the department is giving the interpreter some context of whats happening with the patient because sometimes that also helps with how they frame questions and how they relay information. Interpreters are part of the care team too and they need to be prepared emotionally about how they engage with the patients.

See the rest here:

Del Rios: A 'boots on the ground' emergency medicine physician ... - University of Iowa Health Care