Seeing the Greater Purpose; A Profile on Dr. Underwood

By: Catie Middleton

“We’re just a heartbeat away from being on the other side of the stethoscope. And I think all too often we forget that,” said Dr. Sandra Millon-Underwood.

Underwood, a Professor at the University of Wisconsin-Milwaukee’s College of Nursing, has dedicated much of her life to ensuring that those on the other side of the stethoscope receive the care they need.  She works specifically with populations that are disparate; populations that are at an increased risk, but also that are under-served. Underwood understands that these populations are under-served because of lack of resources and education, but also that often they are not sought out to be served. “Often times they are missed. Often times they are dismissed. Dismissed by systems, dismissed by providers, dismissed by family, but in spite of that, these are individuals that have the same needs as you and I.”

A population that Underwood has focused specifically on is women who are working in low-income jobs, like nursing assistants, dietary aids, or custodial staff.  Several years ago, Underwood chose to do a ventures program at UWM, designed to address those populations within communities that are often invisible. “My vision was that we need to be able to envision who they are but also identify who they are within our own sphere,” said Underwood.

Underwood remembers sitting in her office thinking about this vision, of finding a population within her own sphere who she could serve, when two people walked past. “It’s like the lights started flashing in the back of my mind. I got it in a way that I hadn’t received it before,” said Underwood. The two people who walked past her office were two of the building’s custodians. Underwood planned and executed a breast health program for them, for the custodial staff at UWM in the College of Nursing. “It was remarkable, it was wonderful,” said Underwood. This ventures program allowed Underwood to fulfill a piece of her vision, a vision that is and was based solely on reaching those who aren’t served, especially within one’s own sphere of influence.

This vision contributed to Underwood founding the UWM House of Peace Community Nursing Center. The UWM House of Peace Community Nursing Center is located in Milwaukee’s Walnut Way neighborhood and focuses on developing strong and lasting relationships with clients and advocate for their health and well-being. Here, Underwood involves students with clinical experiences, and also the opportunity to serve outside of the classroom. “To get our students involved, they get excited. They see the need, and they see their role and that they can make a difference,” said Underwood.

Underwood loves to see her students involved in all areas of the nursing science and encourages them to do so. She involves them in reviewing the science, assisting, analyzing, tabulating and summarizing data, as well as co-collaborators in projects.

Underwood, originally from Maywood, Ill., is no stranger to encouragement, and knows how crucial it can be for one’s success. Underwood always wanted to be a nurse, and her path, which led from her Undergraduate and Master’s at Loyola University Chicago to Northwestern University for her Doctorate, never changed. “When I was selecting programs to study during high school, it was always nursing,” said Underwood. “When I began my education at Loyola, my perspective never wavered. And even now, having completed both my Master’s and Baccalaureate program in nursing and Doctorate in education and social policy, as I reflect back on what I have achieved, and what I have experienced, I’m just so thankful that I did what I did because it seems to be the perfect fit.”

Underwood remembers two women in particular who encouraged her to continue to progress in nursing, one of whom was a mentor and collaborating faculty member of hers, Dr. Lucille Davis. Underwood was in awe of Dr. Davis because she was much like herself. “Dr. Davis was an African American doctorally-prepared scholar. When we first met, I was in awe. I remember I just didn’t have the words. But I took note” said Underwood. Davis encouraged Underwood to go on for advanced education and instilled in her the idea that there was more she could achieve. “She taught me what was possible. And that it was important to envision those possibilities and the importance of pursuing the ‘possibilities’ based on one’s skill set,” said Underwood.

Through this encouragement, Underwood pursued higher education and was rewarded with careers at Rush Presbyterian-St. Luke’s in Chicago, Edward Hines Jr. Veterans Administration Hospital, Chicago State University, and finally, UWM. At UWM, Underwood found immense support for her research, work, and practice. “I remember one of the Deans went to great lengths to convince me just how much I was valued, and I hope that was true. I’d like to believe that it was. But at the end of our conversation she asked if there was anything I needed? It wasn’t a matter of the substance, it was the support she and my colleagues provided me at UWM that demonstrated the value of myself, and other aspiring faculty like myself,” said Underwood.

Underwood’s projects and research focus on various cancers, including breast, cervical, prostate, colon, rectal, and lung. “These are cancers that we know many of the key risk factors,” said Underwood.  “These are cancers in which we do have tools to reduce the risk, but also to screen early, diagnose early, and have sound treatment to avert mortality.”

She has served on a myriad of state and national organizations that include, the National Institute of Health, the National Cancer Advisory Board, the National Cancer Policy Board, the National Institute of Nursing Research, the National Black Leadership Initiative, the Department of Defense’s Prostate Cancer Integration Panel, The American Cancer Society Board of Directors, the State of Wisconsin Minority Health Council, and the Susan G. Komen Foundation African American Breast Cancer Collaborative.

For Underwood, holding these positions was an honor and an opportunity. “To be able to provide a perspective from the lived experiences of people who are affected or afflicted by health conditions but also impacted by the systems that exist and that are impacted by systems that don’t exist. To be able to share that voice and that insight, and to be able to see how that voice is being heard, and how that insight is being integrated into practice and policy. It’s tremendous. It’s beyond anything I ever would’ve anticipated,” said Underwood of serving in those organizations.

Underwood, in addition to holding positions in those organizations also receives funding for her research and projects from institutions and organizations like the National Cancer Institute, the American Cancer Society, Sigma Theta Tau International, Susan G. Komen Foundation and the Wisconsin Department of Health Center for Disease Control Well Women Program. Underwood feels humbled by their support, but also feels challenged. “It’s also challenging in that I recognize that with this type of support there is a real need for accountability. To be responsive to what they are funding,” said Underwood.

Underwood and her colleagues have gleaned a fair amount of insights from their research, including the importance of early detection for breast cancer in under-served populations. Many health systems have adopted the principles that Underwood and her colleagues have suggested are important to healthcare systems.  Underwood hopes to see her work progress and continue. “I would like to see a greater understanding of the importance of bridging the divides that separate us, whatever they are.” To her, all of her work is being done for the greater good because everyone can be impacted by health issues.

“I think the reality is, something that my father said years ago, he said ‘If you don’t think these issues will ever impact you, keep living. Because if you keep living, it’s just a matter of time,’” said Underwood. But for now, Underwood will continue her work and live by another lesson her father taught her; Whether the goal for the targeted population is research, advocacy, education or service, “never forget the importance of stopping by when you don’t need or want something”.