Dean Azita Emami’s ‘insider–outsider’ perspective shapes her UW School of Nursing leadership

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Dean Azita Emami’s ‘insider–outsider’ perspective shapes her UW School of Nursing leadership

Azita Emami has been dean of the UW School of Nursing since 2013.

The UW School of Nursing announced in February it was launching the Center for Antiracism in Nursing. The first of its kind in the nation, the center will tackle racism in health care — from classroom to research to the doctor’s office.

“Racism is a complex problem that exists at many levels — personal, institutional and societal,” said UW School of Nursing Dean Azita Emami. “Nurses work at all those levels, and they have the potential to be a powerful force for transformation both inside and outside of the health care system.”

The COVID-19 pandemic has laid bare racial inequities in our society. The Black Lives Matter movement and related demonstrations have intensified calls for action. But Emami’s commitment to fighting for those underserved by the health care system predates the explosive events of 2020. It has deep roots in her identity.

Born in Iran, Emami has been shaped by the experience of being, what she calls, an “insider–outsider,” someone who is part of an institution but has a perspective different from others within it. She experienced this first in her native country, as the daughter of a Kurdish father in majority-Persian Iran, and then as an immigrant to Sweden, where she moved to at age 20 in the aftermath of the Iranian Revolution.

She minimized her Iranian identity to assimilate into Swedish culture. As an insider–outsider, she was able to recognize the underlying dynamics of interactions.

“You realize your place in society — where people see you and where you should place yourself in the caste system,” Emami said. “Whatever I do, whether professionally or personally in my life, it’s very deeply and strongly impacted by my identity as an immigrant.”

At the Karolinska Institutet, Sweden’s largest center of medical academic research, Emami studied phenomenology, a field that asks public health professionals to examine their assumptions and biases, put them aside and focus on patients’ lived experiences. The field incorporates insights from philosophy, psychology, social sciences and more.

She went on to earn her doctorate from the institute, and become a faculty member and head of nursing there, working with famed physician and epidemiologist Hans Rosling. He invited her to lead a joint doctoral program with the Ministry of Health and Education in Iran.

“Initially I was hesitant to partner with Iran and didn’t want to connect with a country I had migrated from decades ago,” Emami said. “But Hans convinced me that it would be very rewarding to be able to make a contribution to my country of origin, and that it would help me with my healing and reconciliation. I was very doubtful, but I followed Hans’s advice and I am very happy I did it.”

Her relationship with Rosling shaped how she viewed her work.

“I learned from him that it’s not only about global health. It’s about a lifestyle, how you view your life. If you really can manage to be aware of your blind spots, of your biases, it’s not only about your science or your professional contribution, it’s about who you become as a person.”

Emami moved to the United States in 2008 when she was hired as the dean of the College of Nursing at Seattle University. Five years later, she joined the UW in 2013 as the Robert G. and Jean A. Reid Dean of the School of Nursing.

At the UW, she’s applied her insider–outsider perspective, training and expertise.

Emami knows what it’s like coming into a new culture as an immigrant. She says the health care system for many is a new culture — with its own set of rules, customs and language. The system is challenging to navigate for patients, who are in vulnerable situations, and it’s easy for health care professionals to make assumptions or ignore the realities of their patients’ experiences.

The United States is a world leader in scientific research and spends more on health care per capita than any other country. Yet it ranks low in overall health outcomes, like life expectancy, compared to other developed nations. The COVID-19 pandemic has put that fact into stark relief, with the United States suffering more deaths from the virus than any other country as of early 2021.

“That disparity between science and outcome is explained by the gap in our understanding of human nature — equity, poverty, the caste system — as well as the injustice in our health care system and in our overall society,” she said. “And I don’t think that as a health care professional, particularly as a nurse, you can help people if your education isn’t expanded to include all these components.”

Emami’s interdisciplinary outlook aligns the School of Nursing with the UW’s Population Health Initiative. Launched in 2016, the initiative invites departments across campus to come together to improve health — looking beyond the absence of disease to issues ranging from equity to climate change to governance. The school’s role in the initiative also gives Emami another connection to her mentor Hans Rosling, the namesake of the UW’s new Center for Population Health.

As part of the initiative, the school has shifted its curricula to focus more on transforming health systems, engaging community and promoting health equity — not just managing a patient’s immediate health care needs.

With the Center for Antiracism, curricula will also be modified with an antiracist lens so that every nurse graduating from the UW will be empowered to become an advocate for antiracism.

Emami understands that health outcomes are best when people are seen as their full selves, with unique cultural and social identities. She has grown from the young woman who hid who she was to fit in with her new country.

“I refuse to be assimilated now. I refuse to deny important parts of my identity,” she said. “And I am committed to guarding people’s right to be who they really are.”


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