Dr. Manka Nkimbeng of Columbia Heights has received a Bush Fellowship to develop a coalition of healthcare organizations devoted to the health of Black immigrants. (Caroline Yang)
Closing equity gaps in health care and strengthening wellness literacy for African immigrants and adults with dementia are initiatives that Manka Nkimbeng’s 2024 Bush Fellowship will help her expand in her community.
“The fellowship is a really great opportunity to take the time to think about who I am as a leader,” said Nkimbeng, a researcher and assistant professor at the University of Minnesota School of Public Health.
The Columbia Heights resident experienced gaps in medical care and health education while growing up in Cameroon, and has vivid memories of going to the tiny health center with her grandparents for care, but at times without any doctor on-site.
“There’s not enough providers [in Africa] to meet the needs of the community,” Nkimbeng said. “There’s a similar thing in the U.S. where we need more doctors often too, but compared to a lot of African countries, there’s not that many providers.”
While annual visits to a practitioner for preventative care is common in America, it isn’t a regular practice in Cameroon or for many African immigrants and minority groups, where visits to a provider are only for active medical problems.
“When you need something, you go urgently,” Nkimbeng said. “So when I grew up, I wanted to provide and take care of people in the community.”
Nkimbeng attended high school in the United States and completed her Bachelor of Science in nursing from University of Massachusetts Amherst. Working as a primary care nurse at a federally-qualified community health center in Lowell, Mass., she saw how disparities affected patients.
“I was working with the most minoritized people in the city at the time — people who have the simplest insurance programs, because the more affluent hospitals and systems do not accept those kinds of insurance,” Nkimbeng said. “I saw that there’s a bunch of patients that struggled with choosing how to take care of themselves … having to choose between buying food or taking care of their medications.”
Nkimbeng then pursued her Masters in Public Health at Boston University and eventually obtained her PhD in nursing at John Hopkins University in Baltimore, Md. She supported older adults as a community health nurse and wanted to enact health interventions for immigrants with similar needs, but she said there was no current measured data about the health of African immigrants.
“It’s almost like, you really cannot intervene when you don’t have a full grasp of what is happening,” Nkimbeng says.
“Policies can be changed when there’s new evidence. That’s research, because you need research to bring about new evidence, to understand and study, and see what is effective versus not.”
Nkimbeng worked on the Community Aging in Place: Advancing Better Living for Elders study in Baltimore, an intervention that addressed health determinants in older adult populations, and has now completed 51 peer-reviewed research studies. Much of her work focuses on understanding African and Black immigrant health by studying their collective physical, social, mental, and cognitive health, needs, strengths and trends.
Nkimbeng also addresses how culture impacts the health of immigrants, at the intersections of cultural behaviors in Africa and the social environment in America.
“Exercise is built in a lot of things that we did back home. We would walk to church, we would walk to visit friends and family – just accessing the community most of the time [in a] walkable distance,” said Nkimbeng. “But here you rarely walk anywhere, because everybody’s living so far apart that you drive to everything, so that built-in exercise and activity is not there. You have to actually be intentional about exercising.”
Nkimbeng’s research also identified dementia education as one of the biggest needs. She developed a dementia and a public health education program at the U of M for African and Black immigrants, and recently launched a comprehensive dementia care resource booklet with Immigrant Memory Collaborative and African Career, Education, and Resources, Inc.
“Recognizing that for a condition like dementia, if people do not know a lot about it, you really are in the dark,” Nkimbeng said. “I think that’s the piece that was critical for me to be involved in dementia health and literacy. Most of the time when I’m doing dementia education, I’m doing general health literacy, too.”
Advanced care, specific health directives, achieving access to health insurance and interpreters all are part of Nkimbeng’s dimension of health literacy. But the largest dimension of health and wellness for her overall will always be community.
To have a strong presence of organizations in the Twin Cities, such as Restoration for All, AfroCare, and Progressive Individual Resources Inc., and have them work together and include organizations outside of the metro area, is Nkimbeng’s ideal goal.
“That’s one of the things I want to learn the skills to do during the Bush Fellowship,” Nakimbeng said. “How do we actually develop a coalition of all of these organizations so we’re literally in the same room talking about health for this community, because everybody’s doing an aspect of it.”