dean sitting on couch

A Citizen of the World

Columbia Nursing’s dean, Lorraine Frazier, is driven to address health inequities both close to home and around the globe.

By Andrea Kott, MPH
This article originally appeared in the Spring 2019 issue of Columbia Nursing Magazine.

When Lorraine Frazier, PhD, arrived at Columbia Nursing, she felt she’d come home. That may sound odd, since Frazier was born in Northern Ireland and has spent much of her life in Houston, Texas. But feeling at home for the school’s dean is less about how long she’s lived someplace and more about belonging to a community that shares her passion for social justice and health equity. “Coming here has really been coming home to a place that values what I value,” she says.

Her arrival at Columbia last fall capped a decades-long journey to live a purposeful life as a clinician, educator, researcher, and nursing leader. “I have always been driven by a sense of purpose,” she says. That purpose has been to help others.

Frazier’s journey began in Northern Ireland, where she lived until age eight, amidst growing political and social upheaval. “My father was from a Catholic family and my mother was from a Protestant family, and they struggled to settle in the divided country,” she says. Her parents instilled in her the importance of inclusion and of respect for all people—a focus that laid the foundation for her professional passions today. They also instilled in her the importance of living a life of purpose and of achieving the education to accomplish it. Money was tight for her workingclass parents—too tight to send Frazier to university, her dream since childhood. “I was always academic, always thinking of the future,” she says.

Her parents, also thinking of the future, relocated the family to the United States, settling in Houston when Frazier was eight. “They wanted us to have more opportunity and to live in a country where religion wouldn’t be a problem for us,” she says. It was a difficult move for the family in many ways, and Frazier’s parents urged her and her siblings to make every opportunity count, she notes. “My parents would say, ‘You have to make your life purposeful.’ That has driven me a lot.”

Frazier lived in Houston long enough to lose any obvious hint of an Irish accent. “If you were from Northern Ireland, you’d hear it,” she says with a smile. But the family didn’t stay there long. Her father’s work—and, later, treatments he needed for a kidney disease he contracted—necessitated moves back and forth between the U.S. and Northern Ireland. His work also took them to Malaysia through Frazier’s graduation from high school. “I was always changing schools, which was challenging for me when school meant so much to me,” she recalls. Fortunately, school grounded her, no matter where she lived. “I was always hungry for information, and school was always my home.”

Instead of feeling displaced or insecure as a result of constantly moving, Frazier grew resilient. “None of us is ever certain or secure about anything,” she says, matter-of-factly. “I feel the world is beautifully complex, life’s journey is always a bit of good and a bit of a challenge. I’m happy to have a challenge.” Later, as a Robert Wood Johnson Nurse Executive Fellow, she learned that if you are not uncomfortable, you are not where you need to be. “Life prepared me to be comfortable with the in-between-ness of fitting and not fitting in,” she says, adding that the famous 19th-century philosopher William James also believed that it is in life’s between-nesses, its transitions, that life happens.

In the process, she discovered where she fit in best: first, as a child of 11, by her father’s hospital bed, marveling at the caliber of doctors and nurses who cared for him and for her family, and, later, in nursing herself. “I remember as a child thinking, ‘These people have all these answers and the information we need.’ I wanted to be one of those people because I knew what people needed and, more importantly, how they needed to be approached. I understood at a young age the devastation of illness and the financial stress on families. I wanted to do the kind of work where I could be part of the solution.”

Hungry to learn, eager for a challenge, resilient and empathic, Frazier believed she had the makings of someone who could have an impact on the care of patients and their families. “I knew what it was like to be in the patient’s room, I understood their fears,” she says. She had found her life’s purpose early.

After earning her associate’s degree in nursing from Southwest Texas State University (now Texas State University), she quickly advanced in her nursing career. “My interest was in the complexities of individuals living with chronic illness and disability and the challenge of including their voice in the type of care delivered,” she explains. She was particularly interested in the relationship between social class, health equity, and health outcomes. She went on to earn her bachelor’s in nursing from the University of Oklahoma; a few years later, she added a master’s in nursing from the Cizik School of Nursing at the University of Texas Health Science Center at Houston (UTHealth) and completed her doctorate there in 2000. Her interests grew to encompass understanding risk and why some individuals are more susceptible than others to stressors that result in disease. This work led her to pursue her interest in genetics, and, with National Institutes of Health (NIH) funding, she did postdoctoral research just as the Human Genome Project was getting underway. She concentrated on the link between genetics and heart disease and conducted numerous original investigations, including an NIH-funded study of the interactions between behavior and genetics in patients with acute coronary syndrome.

A clinician, educator, scientist, and leader, Frazier also attended the executive education program at the University of Pennsylvania’s Wharton School and has won numerous honors, including fellowships from the Robert Wood Johnson Foundation’s Executive Nurse Fellows program and the American Heart Association. In addition to her renown for pioneering state-of-the-art translational research programs, Frazier is a national expert in biobanking and has served as director of the UTHealth Biobank and as project director for TexGen, a biobank consortium of academic institutions across Texas. She has also held appointments as a professor and dean at the University of Arkansas for Medical Sciences College of Nursing and as a distinguished professor and dean at her alma mater, UTHealth’s Cizik School of Nursing.

The opportunity to combine her wealth of clinical, academic, and leadership experience is what drew Frazier to Columbia Nursing. “I love the nursing profession. I’m interested in research and education within the framework of social justice and health equity for all people. That quest to have an impact on health and health policy makes Columbia a great fit,” she says.

Columbia saw Frazier as a great fit from its perspective, too. She “stood out because of her combination of academic accomplishments and very strong leadership experience,” observes Lee Goldman, MD, dean of the Faculties of Health Sciences and Medicine. “The search committee was especially impressed with her leadership in the field of biobanking, because it cuts across so many disciplines—nursing, medicine, basic science, and data science. Being able to lead across organizational boundaries is essential to advancing health care, and she has a talent for doing that.”

Frazier’s vision for the school—which, she says, will build on the tremendous achievements of previous administrations—includes increasing student scholarship funding. “How do we make it possible for more students to come to Columbia?” she muses. “Our students dedicate so much time and money to their education. We’d love to see the day when we can support them 100 percent.”

Increasing the school’s sizable global outreach efforts is another goal. Currently, some 40 percent of the students in the Masters Direct Entry program gain international educational and clinical experience through the school’s Office of Global Initiatives (OGI). With support from the Global Fellows Fund, OGI gives students an opportunity to apply their classroom learning to different countries’ health care settings. It also allows them to learn about different cultures, health care systems, and practices by interacting with local nurses and patients and their families at 11 clinical sites around the world. “At Columbia, we are having impact nationally and globally,” Frazier says. “I think this is undeniably one of the most important experiences we can give our students if we are to help them understand what health equity means and the vital role nursing plays in promoting it.”

In addition to expanding the school’s global focus, Frazier hopes to enlarge its already substantial community health footprint. One of her key initiatives in this area will be to sharpen the curricular focus on delivering primary and palliative care to hard-to-reach populations—particularly patients who are homebound, elderly, recovering from strokes, or living with Alzheimer’s disease. “Palliative care focuses on the relief of symptoms from a serious illness. Nevertheless, some families and some cultures don’t like the term ‘palliative care’ because they feel you’ve given up on them,” she says. “So how do you take palliative care into patients’ homes in a way that they and their families want it?”

Another important goal for Frazier is sensitizing students to inequities in health and health care, while preparing them to think about ways of increasing health care access. “I want our students to look critically at health disparities, to look not just at the patients in their clinics but also at the neighborhoods and environments surrounding those clinics,” she says. “I want there to be aspects of health equity and social justice in every case study and every simulation and for our nursing graduates to be leaders in health and policy.”

Frazier underscores the importance of increasing health care access for patients as well as for family members who are caring for loved ones. “We need to create options that are centered on families. We need to incorporate families into patient care with innovations such as telehealth systems,” she says.

Being part of a loved one’s care is an issue close to Frazier’s heart. Although she could only observe her father’s care, she and her husband of 39 years, David, play an integral role in the care of their developmentally disabled daughter, Molly, now an adult. “Molly has given me a new understanding of the health care challenges that families with a disabled family member face,” she says, noting that many disabled or otherwise vulnerable individuals do not have family to help them navigate the health care system. “She has been the greatest influence in helping me to understand that disabled adults need a voice. She’s part of what drives me to make sure that people have health care access.”

All the issues that Frazier champions happen to be among those that have long driven Columbia Nursing’s curriculum, research, and practice. This synchrony is what makes Columbia feel like home. As for New York City, it, too, feels like home already. “New Yorkers, like the Irish, are easy to talk to, and I enjoy that,” Frazier says. A voracious reader, she’s also happy to spend time alone with a book, or with a sketchpad. But she has yet to try her much-loved bicycle on the city’s roads or to locate a spot to pursue her favorite pastime, fly-fishing.

“My life is my work,” she says, beaming. “What I love about leadership is being part of a great team that is making a difference. It’s what I love about Columbia.

“I think for institutions, transitions are also where life happens,” she adds. “I am excited to see how we as a school will grow with this transition.”