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State & Federal Advocacy

What advocacy actions might you take to improve health care through legislation at the state or federal level?

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 

Discussion # 4

Disparities in health represent discrepancies in access to a variety of preventative, curative, or palliative health services, as well as variances in outcomes such as disability, morbidity, and mortality encompassing physical, mental, and social health. Inequalities in health have a dynamic nature and are influenced by a variety of factors. Health inequities, on the other hand, are health disparities that are deemed avoidable, unfair, and unjust. Systematic patterns or gradients in access or outcomes across groups with varying levels of underlying social advantage or disadvantage—that is, wealth, power, prestige, or other social stratification markers—are frequently revealed (“National Institute on minority health and health disparities (NIMHD), “2020). Housing, food security, and transportation are examples of social determinants of health (SDOH) that can have a significant impact on a patient’s physical and emotional health. Healthcare companies can support their patients in substantial ways beyond the typical provision of medical services by making direct investments in projects geared to address SDOHs and collaborating with community partners.

Numerous studies in low-, middle-, and high-income nations continue to show that health inequalities are linked not only to biological or genetic variables, but also to social determinants that are policy-relevant and potentially avoidable when comparing cross-group or cross-population comparisons. Although various methodologies exist, studies most typically demonstrate differential access to health treatments based on an individual’s socioeconomic status or place of residence, rather than on need. Individuals and groups’ position in the social hierarchy, together with the epidemiological environment, impacts their exposure and vulnerability to health-enhancing or health-damaging situations in daily life (e.g., where people are born, grow, live, work, and age). The underlying causes are numerous, and they frequently represent a combination of social, political, historical, economic, and environmental elements, as well as biological aspects. The term “social determinants” is a catch-all term for all of these factors, and it applies to both communicable and non-communicable diseases (Cooper et al., 2018).

According to a report from the National Academies of Sciences, Engineering, and Medicine, healthcare providers may address social determinants of health using five approaches: awareness, adjustment, assistance, alignment, and advocacy (Cooper et al., 2018). The committee recommends that public awareness efforts concentrate on recognizing the societal risks and assets of individual patients and patient groups. Patients visiting healthcare institutions are increasingly being requested to respond to social risk screening questionnaires as part of their care and care planning. Screening is rewarded in some regions by payers. Instead of directly addressing social needs, healthcare institutions might follow an adjustment strategy that focuses on clinical treatment adjustments to address social determinants of health. Healthcare providers might seek methods to connect socially disadvantaged patients with government and community resources. These activities range in intensity from light touch (one-time resource, information, or referrals) to lengthier and more extensive interventions that seek to assess and address patient-prioritized social needs more fully.

Healthcare providers can adopt an alignment strategy that evaluates community social care assets, organizes those assets to foster cross-organizational collaboration, and invests in assets to improve health outcomes. Healthcare practitioners and social service groups can develop partnerships to lobby for policies that encourage the creation and distribution of assets and resources to address social determinants of health. Healthcare organizations, for example, might advocate for policy reforms to improve a community’s transportation services (Cooper et al., 2018).

Healthcare organizations use their political, social, and economic capital within a community or local environment to encourage and enable healthcare and social care organizations to partner and pool resources, such as services and information, to achieve greater net benefit from the healthcare and social care services available in the community. The level of involvement from healthcare professionals in the community at both the personal and political level helps promote community health. 

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Influencing Health Policy

Health professionals play a vital role in the importance of educating both patients and their families about disease prevention as well as management. On both a community and population perspective, this is extremely important when needing to identify specific health disparities to any given location while educating the population regarding how to keep themselves healthy. ”Public health nursing (PHN) involves working with communities and populations as equal partners, and focusing on primary health prevention and health promotion” (Kulbok, 2016).

The health professional can look at the entire picture of the patient, and not what it just going on at that moment (Harkness & DeMarco, 2016). For example, the public health nurse is able to assess the patient’s living situation and other factors that can potentially jeopardize the patient’s health and long term success. Public health nurses can maintain and improve the health of populations by supporting health protection, health promotion, and disease prevention efforts, and by championing institutional changes to support these efforts.

In health promotion, health professionals are tasked with the responsibility of facilitating the espousal of health beliefs, behaviors, and attitudes that contribute to the well-being of their entire population (American Nurses Association, 2013). I can achieve this through advocacy, public policy, public engagement, community-based action and action on the determinants and inequities of health. In my community of South Florida, I have been involved in efforts to increase insurance coverage among patients. I have also partnered with the major healthy systems in the area to implement community outreach projects aimed at expanding access to care among the uninsured and homeless individuals in the region. I also promote health by assisting individuals, families, and communities to take charge of creating, sustaining and improving their health by growing their knowledge and control over the determinants of health.

2 post answer short paragrah

Influencing Health Policy

Health professionals can, regardless of their practice area and site, promote population and community health by engaging in disease and injury prevention. Health professionals, such as nurses, work to minimize the risk of infectious disease epidemics through investigations, early identification, contact tracing, preventive interventions and efforts to facilitate safe behaviors (Winland-Brown, Lachman, & Swanson, 2015). Health professionals are also tasked with the application of effective strategies to decrease the risk factors associated with the onset of chronic disease and disability. Health professionals can also assist individuals and families in implementing health behaviors that minimize the probability of injury, disease and development of chronic illnesses (Nies & McEwen, 2014). For example, in the recent Covid-19 threat, community and public health nurses were at the forefront in educating the public about the virus and disseminating knowledge about safe behavior associated with the disease.

Community and public health nursing are crucial components in healthcare. These nurses are tasked with the responsibility of extending care services beyond the primary care scope to influence macro factors that impact health outcomes among populations. Community and public health nurses participate in advocacy efforts and policy formulation processes to promote the health of communities. They also disseminate knowledge to assist individuals in the espousal of safe behaviors to reduce the risk of injury and disease occurrence.

As defined by Butts (2016, p. 54) advocacy means “identify unmet patient needs and the follow up to address these appropriately.” Being a patient advocate is the foundation of our nursing practice, because it is our responsibility to help our community and society meet the needs of those who are vulnerable. As nurses, we are the last line of defense against patient harm, thus, it is our professional duty to ensure that the care that a certain patient is receiving meets the standards of care and practice (Butts, 2016). Also, nurses need to aid patients in expressing their concerns, issues or changes that are needed throughout the provision of care, and we can do that at the state and federal level. Nurses can become the voice for their patients when necessary. An example of when advocacy can be of great assistance for a patient at the local level is to assist a patient who needs further information regarding a future procedure by contacting the physician, to clarify his doubts, and to provide the patient with any additional information necessary to make an informed decision. However, to perform this function effectively, the nurse needs to be knowledgeable about patient’s rights, and involved in all aspects of the patient’s care (Winland-Brown, Lachman, & Swanson, 2015).

I believe that the concept of patient advocacy is well intended at its basic cores which are, preserving human dignity, patient equality and freedom of suffering which are emphasized during nursing school. As we learn about patient’s rights, we realize how important it is to ensure that these rights are respected, and that patients have the opportunity to express their needs. Also, we learned that nursing is “the protection, promotion and optimization of health abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities and populations” (Winland-Brown, Lachman, & Swanson, 2015, p. 269). We also learned some of the barriers to advocacy which are lack of support, lack of power and fear of retaliation conflict of interest between our responsibility to the patient, and to our duty to the work institution (Winland-Brown, Lachman, & Swanson, 2015).

References

Butts, J. B. (2016). Nursing ethics (4th ed.). Community/public health nursing: Promoting the health of

populations. New York, NY: Elsevier Health Sciences

Winland-Brown, J., Lachman, V. D., & Swanson, E. (2015). The new code of ethics for nurses with interpretive statements: Practical clinical application. MEDSURG Nursing, 24(4), 268-271.ReplyReply to Comment