The Future of Nursing 2020-2030 Charting a Path to Achieve Health Equity (2021) / Chapter Skim
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5 The Role of Nurses in Improving Health Equity
5 The Role of Nurses in Improving Health Equity
Pages 127-146
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From page 127... ...
When this study was envisioned in 2019, it was clear that the future of nursing would look different by 2030; however, no one could predict how rapidly and dramatically circumstances would shift before the end of 2020. Over the coming decade, the nursing profession will continue to be shaped by the pressing health, social, and ethical challenges facing the nation today.
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From page 128... ...
NURSES' ROLE IN ADDRESSING HEALTH EQUITY As described in Chapter 1, the history of nursing is grounded in social justice and community health advocacy (Donley and Flaherty, 2002; Pittman, 2019; Rafferty, 2015; Tyson et al., 2018) , and as noted in Chapter 2, the Code of Ethics for Nurses with Interpretive Statements, reiterated by American Nurses Association (ANA)
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From page 129... ...
Advocacy Activities in which health care organizations Work to promote policies that work with partner social care organizations fundamentally change the transportation to promote policies that facilitate the infrastructure within the community. creation and redeployment of assets or resources to address health and social needs.
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And these activities can continue to the high level of system change through advocacy for health policies aimed at altering community infrastructure to help prevent falls. In short, improving population health entails challenging and changing the factors and institutions that give rise to health inequity through interventions and reforms that influence the institutions, social systems, and public policies that drive health (Lantz, 2019)
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From page 131... ...
. Nurses may conduct screenings; review their results; create care plans based on social needs as indicated by those results; refer patients to appropriate professionals and social services; and coordinate care by interfacing with social workers, community health workers, and social services providers.
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From page 132... ...
At the population health level, public health nurses work to achieve health equity within communities through both health promotion and disease prevention and control. They often work in municipal and state health departments and apply
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. In their role as trusted professionals, and given their widespread presence in communities, incorporating public health nurses into community, state, and federal government strategies for health education and dissemination of information can help extend the reach and impact of messaging during infectious disease outbreaks and other public health emergencies.
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From page 134... ...
Because multiple factors influence individual and population health, a multidisciplinary, multisectoral approach is necessary to improve health and reduce health inequity. While an approach focusing on only one SDOH may improve one dimension of health, such as food insecurity, intersectional approaches that simultaneously address complex, holistic needs of individuals, families, and communities are often required.
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From page 135... ...
Two illustrative programs are described below: the Camden Core Model and Edge Runner. Camden Core Model The Camden Coalition, based in Camden, New Jersey, is a multidisciplinary, nonprofit organization that works across sectors to address health and social needs.
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From page 136... ...
. Other RCTs, conducted in Philadelphia and Chicago, showed that similar social care programs using case management and community health workers can reduce hospital admissions and save money in addition to improving health and quality of health care.
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From page 137... ...
Many Edge Runner programs are built around the needs of underserved communities and seek to improve health through holistic care that addresses social needs and SDOH, including a range of upstream, midstream, and downstream determinants. Mason and colleagues (2015)
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From page 138... ...
The Edge Runner programs emphasize how, in the pursuit of improving care, lowering costs, and increasing satisfaction for people and families, nurses are actively working to achieve person-centered care that addresses social needs and SDOH and focusing on the needs of underserved populations to promote health equity (Martsolf et al., 2016, 2017; Mason et al., 2015)
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From page 139... ...
. Important to underscore in the context of this report is that multisector engagement, as well as health care teams that may involve social workers, community health workers, physicians, and others engaging alongside nurses, all are oriented to a shared agenda focused on improving health and advancing health equity.
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From page 140... ...
Bethany Hall-Long, was trained as a community health nurse and currently serves as the lieutenant governor of Delaware.* The Delaware Cancer Consortium supported a program that provided free col orectal cancer screening (colonoscopy)
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From page 141... ...
Nonetheless, broader engagement as a core activity of every nurse will help advance health equity nationwide. To achieve this aim will require • support for and the willingness of the nursing workforce to take on new roles in new settings in the community; • consistency in nurses' preparation for engaging in downstream, mid stream, and upstream strategies aimed at improving health equity by addressing issues that compromise health, such as geographic dispari ties, poverty, racism, homelessness, trauma, drug abuse, and behavioral health conditions; • more experiential learning and opportunities to work in community settings throughout nursing education to ensure that nurses have skills and competencies to address individuals' complex needs and promote efforts to improve the well-being of communities; • nursing education that goes beyond teaching the principles of diver sity, equity, and inclusion to provide sustained student engagement in hands-on community and clinical experiences with these issues; • funding to support new models of care and functions that address SDOH, health equity, and population health; and • evaluation of models to build the evidence needed to scale programs and the policies and resources necessary to sustain them.
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From page 142... ...
2019. Designing and assessing multilevel interventions to improve minority health and reduce health disparities.
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From page 143... ...
2019. Meeting individual social needs falls short of addressing social determinants of health.
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From page 144... ...
2020. Evidence-based community health worker program addresses unmet social needs and generates positive return on investment.
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From page 145... ...
2019. Integrating social care into the delivery of health care: Moving upstream to improve the nation's health.
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