Black Nurses Matter March Highlights Need to Address Medical Racism

by Ashley Archibald

If you ask her family, Kaloni Bolton, 12, was a bubbly, peaceful person who kept everybody upbeat and uplifted. She was tough, always had an opinion and a personality that balanced the family out.

Bolton died on Jan. 1 after suffering an asthma attack on Dec. 29. Her family alleges that Bolton received substandard care from Valley Medical Center (VMC), a nonprofit health care provider that oversees two urgent care facilities in Renton that Bolton and her sister visited before Bolton was transferred to Seattle Children's Hospital.

"The entire system failed her, failed her family," Lylia Nichols told a crowd of protesters on Saturday, May 8, outside of the first urgent care facility that Bolton accessed. "We hold Kaloni up because the system failed our whole community."

Nichols is secretary of Black Nurses Matter, a national organization that works to improve the health and well-being of Black communities by eliminating structural racism in the health care system. The organization, started by Black nurses in Chicago after the murder of George Floyd, launched a series of marches on May 8, the beginning of Nurses Week. Nichols is also the CEO of Integrated Wellness CMS, a care coordinator organization based in Renton.

The Renton march was held in Bolton's honor.

In 2021, Black children should not be dying of asthma, said Ashley Paynter, a Ph.D. candidate in biological sciences at the University of Washington and leader of an organization called Decolonizing Science, who attended and spoke at the march and rally.

"I guarantee that if Kaloni was seen by entirely Black nurses, the outcome would have been different," Paynter said.

Bolton and her sister first went to the urgent care facility at The Landing, a shopping center in downtown Renton on Dec. 29. The family knew she needed to see a medical professional when Bolton needed to use her nebulizer — a machine used to treat asthma — too many times, said Bolton's mother, Kristina Williams.

Bolton was triaged to the North Benson facility, where she waited in the car, per clinic policy at the time due to COVID-19 restrictions. According to VMC, North Benson was one of two urgent cares that had upper respiratory treatment spaces. More than 30 minutes passed before Bolton was admitted, her family said. Her family says after she went into cardiac arrest, she was transported to Seattle Children's Hospital. She died on Jan. 1 after two days on life support, according to news reports of the situation.

VMC launched two investigations after Bolton's death and altered protocols so that patients with respiratory ailments no longer wait in their cars, the organization wrote in an online statement. The organization also established upper respiratory/COVID-19 evaluation spaces at all four of its urgent care clinics.

But Williams alleges that her daughter received substandard care. She says staff took too long to see her, and attempts to give Bolton oxygen failed due to the equipment. (VMC's statement disputes this claim.)

Williams questioned why medical staff wouldn't send her to a closer facility to stabilize Bolton's condition at this point. She says that her daughter was lifeless when she arrived at North Benson, and that she wasn't allowed in the ambulance.

"My daughter, she fought. She thought she could go there and get the help that we normally get. But we didn't get that," Williams said at the end of the march.

Bolton was transported to Seattle Children's because Children's has an "extremely specialized care environment that Valley is not equipped to provide," the VMC statement reads. A spokesperson responded to requests for further comment on Bolton's case by stating via email that: "Our staff is profoundly saddened by Kaloni's death and we're dedicated to providing the best possible care for our patients. Valley has a long and deep commitment to equitable access to care in our community and we have taken action to enhance workflows and processes to help ensure we live up to and, where possible, further strengthen that promise."

Organizers staged Saturday's march outside of the urgent care center at The Landing. Participants used chalk to write messages on the cement planters and the ground of the small plaza outside of the building. "Breathe for Kaloni." "Black Nurses Matter." "Health Equity Matters."

After a brief rally, dozens of protesters gathered on the corner of 10 Street North and Park Avenue North before taking over the southbound lane of Park Avenue North, protected by a phalanx of cars and bicycles that blocked oncoming traffic and driveways.

"Say her name," someone yelled into a bullhorn.

"Kaloni Bolton," the crowd responded.

The march proceeded through neighborhoods of single-family homes. Residents came out to witness and take photos. Cars honked in solidarity.

The destination was Liberty Park where music played and booths were set up with snacks and wares. Under an E-Z Up decorated with star-shaped balloons, speakers took turns calling for action. Their messages ranged: Protect Black girls; Engage with policymakers to demand change; Recognize the importance of Black health care professionals to the community.

"I would have seen that baby for who she was," Nichols said during her remarks.

Disparities in health care outcomes for marginalized communities are endemic in the U.S. health care system, and studies suggest that provider bias plays a role. A 2018 review of literature regarding bias and racism in medical settings published in the journal Social Science & Medicine found "evidence of pro-[w]hite or light-skin/anti-Black, Hispanic, American Indian or dark-skin bias among a variety of [health care providers] across multiple levels of training and disciplines" in 31 out of 37 studies included.

A 2019 release from the Centers for Disease Control and Prevention (CDC) found that Black mothers were two to three times more likely to die from pregnancy-related causes than their white counterparts. For women over the age of 30, that statistic leapt to four to five times as likely.

Environmental racism and other factors also contribute to lower life expectancy within the Black community. But there is evidence that Black medical professionals can help mitigate some portion of this through preventive care.

A 2018 working paper from the National Bureau of Economic Research,using a study from Oakland, California, found that Black men who saw Black doctors were far more likely to agree to preventive medical interventions, even ones considered invasive. The paper suggested that there could be as much as a 19% reduction in the Black-white male gap in cardiovascular mortality if Black men saw Black doctors.

But Black people are underrepresented in medicine. According to the same paper from Oakland, roughly 4% of doctors are Black even though 13% of the U.S. population is.

Black Nurses Matter aims to improve health care through activism but also through networking and mentoring for Black nurses in an attempt to support the Black community in an unequal health care system and hopefully boost the problem of underrepresentation.

"This system was not built for us, but I guarantee you we are going to infiltrate it," Nichols said.

Ashley Archibald is the editor of Real Change News and a freelance journalist with previous work in the Santa Monica Daily Press and the Union Democrat. Her work focuses on policy and economic development, and you can find it in the South Seattle Emerald, KNKX, and the Urbanist.

📸 Featured Image: Renton-area nurses march in solidarity on May 8, 2021. (Photo: Alex Garland)