A conversation with Vincent Guilamo-Ramos

In July, the Duke University School of Nursing officially welcomed its 12th dean, Vincent Guilamo-Ramos, PhD, MPH, LCSW, PMHNP-BC, ANP-BC, AAHIVS, FAAN. Ramos brings with him a staunch commitment to social justice and equity, particularly as seen through the lens of social determinants of health.

The child of immigrants, Ramos grew up in the Bronx and didn’t really understand the concept of disparity until he left his borough on a field trip to lower Manhattan.

“I could see from the window of that school bus that things looked different in other parts of New York City than where I lived,” he said.

That started Ramos thinking and questioning, which led to a career of seeking answers through education in public health, social work and nursing, a natural combination, said Ramos, who in addition to most recently having served as professor and associate vice provost for Mentoring and Outreach Programs at New York University (NYU), founded and currently directs the Center for Latino Adolescent and Family Health (CLAFH), which is relocating from NYU to the Duke School of Nursing. CLAFH has an extensive history of addressing the health and overall wellbeing of Latino youth and their families across the United States, and in Latin America and in the Spanish-speaking Caribbean. Ramos is nationally recognized as an expert on the development, evaluation and dissemination of family-based interventions designed to support adolescent health. He has held academic appointments in the NYU schools of nursing, social work and public health. Prior to NYU, Ramos was a tenured faculty member at Columbia University.

“Social work has a heavy emphasis on social justice, on really thinking about the root causes of why people find themselves in the circumstances that they do,” he said. “It led me to want to understand population health. I think public health was a natural partner, particularly epidemiology and the science of distribution of diseases and outcomes. Ultimately nursing was really about wanting to respond clinically.”

Ramos’s interdisciplinary approach to problem solving will inform his leadership at Duke University School of Nursing, guiding his development of a nursing program that continues to focus not just on critical partnerships but on leadership and meaningful impact, something Ramos said nurses are particularly suited for.

“I think nursing is really positioned to be at the forefront of what we need to do in our country to resolve health inequities,” he said, noting that nurses are the largest segment of the health care workforce and the most trusted.

Health inequities are impacted by forces outside the immediate control of most health systems: social processes, economics, policies and even geography.

“We need a health workforce, in large part shaped by nurses, to think outside of traditional health-delivery system frameworks,” Ramos said. “That means attention to meaningful community engagement and population health, the development and evaluation of nurse-led models of care, and nurses demonstrating large scale impact on health inequities. It means nurses taking leadership roles in policy-making, gaining skills in empirical perspectives, and learning to develop evidence through discovery and nursing science. It also means being able to communicate effectively and learning to advocate for patients and policies that affect patient care.”

Nurses work in teams, which demands listening and understanding differing perspectives, including from other disciplines. Interpersonal skills and empathy, coupled with understanding health holistically and not just physically, position nurses as natural leaders in patient care and prevention, Ramos said. Nurse leaders can extend those skills and knowledge to impact patient populations as a whole.

“It’s not just being cured,” Ramos said. “It’s also about how well you are living with whatever you’re grappling with.”

Ramos is driven to reduce health inequities in the world by working to find solutions to determinants of health: housing, education, income inequities and social marginalization.

“Those are things that weigh on me personally and professionally,” he said. “My commitment is trying to contribute to making a more just society for everyone.”

Professionally, Ramos has worked for decades with adolescents and families concerning sexual and reproductive health, including prevention of unwanted pregnancies and sexually transmitted diseases, particularly HIV. Ramos’ work focuses on family and community factors that lead to particular outcomes, including resource allocation and environment. Personal decision-making is part of one’s trajectory, but Ramos said focusing solely on individual behavior can miss the mark, as the resources and responses to that individual’s decision-making and behavior can actually have more influence on a particular outcome.

“Historically nurses have been trained to address the specific health issue,” he said, citing unplanned pregnancies or sexually transmitted infections as examples.

Increasingly, Ramos said, the goal is that nurses provide care all along the trajectory of one’s life through education, advocacy, policy-making and community partnership. Improving health outcomes can actually start proactively with nurse leaders and community partners in all populations, addressing outside forces that may negatively impact a person’s ability to thrive not just physically but holistically in life.

Coming to Duke

Only the School’s second alumnus to hold the position of dean, Ramos said one thing that attracted him to Duke was Durham’s historical relationship with the Black and African-American communities.

Ramos also welcomes the opportunity to work with the growing Latino communities. In a 10-year period, the Latino population in North Carolina has grown from 90,000 to almost one million, mostly by immigrants settling and starting families in the area in pursuit of a better quality of life.

“I knew that I could have an impact here,” said Ramos, noting that he has worked with many diverse populations during his time at NYU. Ramos said the pull to Duke was also influenced by Chancellor Eugene Washington’s concept of the “third curve,” the goal of advancing population health improvement via academic health care systems, something that Ramos wholeheartedly supports.

“Coming to Duke is a huge opportunity to be someplace where your values and commitments align with what the actual job is,” Ramos said. “That’s an honor.”

Taking the helm at the beginning of post-pandemic recovery, Ramos said he’s excited to engage with faculty, staff and students and hopes that he can give back to the School’s community what he has received throughout his lengthy career — windows of opportunity via mentors and colleagues who have helped him grow and learn and find his passions. As the first male and first Latino dean, Ramos also wants to be a reflection of possibility.

“I think people need mirrors to see themselves and to imagine themselves doing that role and beyond,” he said. “That’s something that matters to me. I’m looking forward to being immersed in a school of nursing and learning more about what some of the challenges are that nurses in 2021 and beyond are facing.”