Introduction
Lisa Mckeithan and Sabra Hammond are two healthcare workers local to North Carolina who took drastically different paths to get to their profession. Through comparing their life stories and more specifically childhood experiences my goal is to deduce the social determinants of going into healthcare.
Background
Lisa Mckeithan was raised in Clarkton NC, a small rural town on the coast of North Carolina near Wilmington. She was a shy nerd that loved to read and go to Barnes and Noble. She went to the same high school and was taught by the same teachers that taught her parents. Faith served as a fundamental part of her childhood due to its importance in her small community. She lived in a stable home with her mother and father. Her mom was a Certified Nurse Assistant who did a lot of at-home care. She specifically remembers seeing the “joy my mom got from helping patients”(0:05:01.0 – 0:05:02.0), and thinking that this is something she wanted to do when she grew up. Her mom was insistent on the kids going to the doctors when they were sick. Lisa attributed this to her mother being from a large family that didn’t have access to a lot of traditional healthcare and “relied upon home remedies”(0:56:20.0 – 0:56:24.0). Lisa hated going to the doctor. She had tonsillitis and anemia, so going to the doctor was associated with being in pain. Lisa’s mother instilled values such as “communication”, “being a leader”, and the expectation that she would “go to college”(0:27:59.0 – 0:28:01.0). As a result, Lisa ended up going to UNC Chapel Hill where she spent a lot of time working in the prison system helping prisoners get acclimated to the world after being released. She eventually fell in love with work once started working in rural communities with patients with HIV/AID. She expressed how rewarding it is to help people that really needed it. To this day her mom is still her best friend. “She’s the wind beneath my wings”(0:27:55.0 – 0:27:58.0). Lisa’s mom used to always say that they had “servant’s hearts with the purpose to empower others”(0:35:08.0 – 0:35:14.0).
Sabra Hammond was from Long Island NY raised with Jewish heritage. She lived with her mother who worked in a medical office and her father who was a machinist. She was a nerd child that would go to her friend’s house and they would sit next to each other and read. Sabra was always interested in healthcare. She specifically said, “When I was 5 my future cousin-in-law at Passover Saber showed me that his hands were all red”(0:03:05.0 – 0:03:15.0) because alcohol dilates your blood vessels. She came up to him the next year at Passover and asked him to show her his hands. He said “You don’t know it yet, but you’re going to become a doctor”(0:03:05.2 – 0:03:09.0). She took that to heart and “thought that that was always true”(0:03:06.0 – 0:03:09.0). Growing up Lisa always had health insurance and went to the doctors. She was a sickly child and remembered having a good relationship with her pediatrician and internist. Medicine was considered important to her family. Her father had a brother that was a doctor, and her mom would “always go around diagnosing and discussing things, medical and whatever.”(0:16:11.3 – 0:16:20.0) Health was like “good food and culture. It was a thing that was known and talked about and considered to be a baseline part of who we were”(0:17:02.0 – 0:17:09.0). Lisa went to college, but at the time pre-med was very cutthroat. They would “destroy each other’s notebooks and homework”(0:04:02.0 – 0:04:04.0), and that’s when she decided “That’s not for me”(0:04:08.0 – 0:04:10.0). She became a freelance writer and had a very successful business. While in Costa Rico many years later she had a dream where she met a council of people and they told her she was going to medical school. They were insistent that she go to med school and from the moment “I woke up, it was like I’m in love. I had a secret and I was in love, and I am in love with medicine.”(0:06:06.0 – 0:06:12.0) She was a 40-year-old going through PA school, but she didn’t care. Being able to “care for people who are really in need is some of the most gratifying work”(0:02:25.0 – 0:02:29.0).
Analysis
Both Lisa and Sabra became health providers and the question I want to know is why? It has been proven that having a parent that is in healthcare makes you more likely to go into healthcare yourself. For example, one study found that children with parents in healthcare were 7% more likely to go into the industry themselves.(Norton et al., 2012) Another study found that having a parent who is a nurse is a significant predictor of pursuing a career in nursing. (Carter et al., 2017). These findings seem to be consistent with Lisa and Sabra’s story, but I want to know what part of having a parent in healthcare makes you more likely to follow in their footsteps.
My initial hypotheses for this trend were inherited values, socioeconomic status, and ease of access to experience/advice. It was a common experience in both stories that there was some sort of inherited love for medicine. Lisa had a very direct example of seeing her mother as a CNA and falling in love through seeing her help patients, while Sabra had her Pre-med cousin who exposed her to the intricacies of medicine. Furthermore, going to the doctor when you were sick was an expectation in both families, which I think displays how medicine was respected and valued. What I found interesting is that enjoying going to the doctor during childhood does not seem to be indicative of becoming a healthcare worker, as seen by the opposing views on going to the doctor by Lisa and Sabra.
Connected to another hypothesis of mine, having a parent in healthcare provides children with the financial ability to go to the doctor when they are sick. The average healthcare worker in North Carolina is paid $56,271(ZipRecruiter, 2023), while North Carolina’s average income is $30,768(Salary.com, 2022). This hints at the idea that the healthcare field is being gatekept by the financial barrier of education needed to enter. Furthermore, It has been shown that having parents that work for low-income increases your chance of working for low income yourself, again supporting the idea that socioeconomic status plays a large role in the accessibility to the healthcare field. (Duncan, 1997) We know that Sabra had the wealth to go into medicine, as she stated she was a part of “a very successful business”(0:05:02.0 – 0:05:04.0) and her family had health insurance. We know less about Lisa’s financial situation, but we can assume that since her mother was a CNA and she was able to go to college that she was somewhat financially stable.
My final determinant is the ease of access to experience/advice. My thinking goes if someone has a parent that has made it into the healthcare field then they will have better advice to give their child in terms of how to get in as well. Furthermore, on the parent’s path to medicine, they will have made connections with people that can help their child gain experience in the field or provide expertise. Shown in Lisa’s close connection to her mother who she called “the wind beneath her wings”(0:27:55.0 – 0:27:58.0), and Sabra’s interactions with her cousin.
Conclusion
The truth is that it’s impossible to answer the question of what makes us who we are. There are simply too many factors as to the reason why we see the trend in kids of healthcare workers becoming healthcare workers themselves. It is almost certainly a combination of all the previously mentioned reasons and thousands more. Still, the goal of this paper was to figure out some key childhood determinants and explain why I think they would increase the likelihood. Using oral histories as a connection from the theoretical rationale to how the determinants play out in real life. In concussion, I believe that inherited values, socioeconomic status, and ease of access to experience/advice are some of the main reasons why children of health workers are more likely to become one themselves as exemplified by Lisa and Sabra’s stories.
References
Duncan, G. J., & Brooks-Gunn, J. (1997). Consequences of Growing Up Poor. New York, NY: Russell Sage Foundation.
Norton, E. C., Wang, H., & Ai, C. (2012). Genetic Information, Obesity, and Labor Market Outcomes. Journal of Health Economics, 31(1), 1–16. doi: 10.1016/j.jhealeco.2011.11.004
Carter, A. G., Schwartz, R., & Jones, D. (2017). The Influence of Parental Nursing on the Decision to Pursue Nursing as a Career. Journal of Nursing Education, 56(4), 231–235. doi: 10.3928/01484834-20170322-10
Kameny, Maddy. Interview with Lisa Mckeithan. 29 June 2018 (Y-0038). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill
Kameny, Maddy. Interview with Jane “Sabra” Hammond, P.A. 27 June 2018 (Y-0028). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill
Salary.com. (2022). Health Care Worker Salary in North Carolina. Retrieved April 23, 2023, from https://www.salary.com/research/salary/posting/health-care-worker-salary/nc#:~:text=The%20average%20Health%20Care%20Worker,falls%20between%20%2441%2C564%20and%20%2462%2C438.
ZipRecruiter. (2023). Hourly Wage for Healthcare Workers in North Carolina. Retrieved April 23, 2023, from https://www.ziprecruiter.com/Salaries/Hourly-Salary–in-North-Carolina