MEET THE SCHOLARS: LEAH ESTRADA
Leah Estrada is a PhD student at the Columbia University School of Nursing. She is a member of Health Policy Research Scholars Cohort 2020.
Tell us a little bit about yourself and what your research interests are.
I’m a registered nurse and I was raised in Long Island, New York, to immigrant parents from El Salvador and Guatemala. My family background taught me values of humility and service and a deep respect for education, particularly because many in my family were unable to receive formal education. My research interests are centered on advancing health equity in palliative and end-of-life care for older adults. Ultimately, I hope to improve palliative care for all historically marginalized older adults with serious illness, not only the ones I had the privilege of serving personally at the bedside.
What’s the story behind why you’re doing what you’re doing?
I believe my life in general has led up to what I’m doing now. I became a caregiver at the age of 10 when my grandmother moved in with family. She had Parkinson’s disease, developed dementia toward the end of her life, did not speak English, and did not receive formal education. This childhood experience provided me with the opportunity to learn about compassion, comfort, and dignity throughout the lifespan, but particularly at the end of life.
Prior to becoming a nurse, I worked with immigrant communities, both abroad and in the United States, which led me to a deeper understanding of their unique challenges across the lifespan. As a registered nurse in the intensive care unit, I came across many patients with serious illness, often approaching the end of life and an underutilization of the palliative care team. It was a privilege for me to serve my patients and families, oftentimes in their most vulnerable moments, but I wanted to do more. There is a universality with the end of life, and not that palliative care necessarily makes death easier, but it provides space to honor the dignity of the individual as they approach the end of their life and to support them and their loved ones.
Tell us about a project you are currently working on that you are excited about.
I am currently working on my dissertation, which is exploring racial differences in nursing home palliative care and potentially avoidable hospitalizations at the end of life. Health disparities are pervasive in nursing homes, and especially those serving predominantly Black or Hispanic residents had increased cases of COVID-19 incidence and mortality. I have hope that my research can help improve care for these residents and I do believe that palliative care is one way to achieve this.
For people unfamiliar with your research area, what is one piece of information you think is important for them to know?
Palliative care is not synonymous with hospice and end of life (even though my current research is at end of life). Palliative care is essential for delivering high-quality care, but it is not limited to the end of life. Rather than provide aggressive treatments, palliative care is intended to alleviate symptoms, improve quality of life, and provide support to all individuals and families with a diagnosis of severe illness, regardless of prognosis.
Who is a researcher you admire and why?
I admire my advisor/home institution mentor, Dr. Patricia Stone. She is someone who advocates for her mentees, is generous with her time and resources, and is truly dedicated to mentoring the next generation of nurse scientists, including myself. She has fostered natural networks between her current and former mentees through her example of generosity and collaboration, which I have benefited from and work to pass on. Dr. Stone has made a monumental impact on my predoctoral journey through her mentorship and providing the necessary guidance while fostering independence.
How do you think HPRS will complement your doctoral training?
HPRS has complemented my doctoral training in many ways, and I am humbled and honored to be a scholar. The financial support has been tremendous, not only the stipend, but I was also able to use a travel award recently for an in-person conference. HPRS has also given me confidence and courage to do the work that needs to get done. It is an empowering program where I have felt validated in my research and experiences, and have been equipped with the tools for “good trouble!”
What part(s) of HPRS excite you the most?
I love the access to a network of like-minded, passionate scholars who encourage me to continue down this path! Unfortunately, we have not been able to meet in person due to the pandemic, but we have found ways to support each other. I, and other scholars, were awarded the COVID and/or Racism grant, which provided me the opportunity to do interdisciplinary work within the program, learn how to understand these complex issues from different disciplines, and work together to find solutions. I am also part of a Writing Accountability Group that has provided space to support each other in our predoctoral studies and get to know each other a bit better. So many things excite me, including the classes and workshops, but most of all it’s the network of scholars and the HPRS NPC—an amazing and beautiful group of individuals.
In the RWJF HPRS program we will work with you to help you think further about using your research to develop policy. If you could use your research to change any policy, what policy would it be?
I am currently working on my policy memo for the year 2 course, which is based off of my research. The Centers for Medicare and Medicaid have an Innovation Center, which develops new payment and service delivery models to improve quality of care. Currently, there is an initiative focused on Medicare-Medicaid enrollees to reduce potentially avoidable hospitalizations (which I will explore in my dissertation), so I hope that my research can expand coverage of quality nursing home palliative care as a means to improve quality of care and reduce these potentially avoidable hospitalizations.
If you could visit anyplace in the world, where would you choose to go and why?
Glacier National Park! This desire was sparked about 10 years ago when it was randomly advertised for a short time in the NYC subways. It just looks absolutely breathtaking and peaceful, a nice break from NYC and predoctoral work! I need to hurry up because the glaciers are unfortunately melting, but I don’t have strong outdoorsy skills (nor does anyone I would travel with, yikes!).