The healthcare sector is crucial to the country’s development and growth. A healthy nation means that the population can work and grow its economy. Consequently, the government should ensure everyone is protected and living in a safe environment. In particular, health equity is a policy issue caused by inadequate insurance coverage and structural racism, and I think that the problem affects many people from minority groups, while nurses can participate in solving it (Wakefield et al., 2021). Health equity is a significant issue in the United States. With many vulnerable communities and underserved individuals, enhancing health equity can significantly improve their lives and health outcomes in general (Wakefield et al., 2021). The role of healthcare systems is to offer efficient, quality and cost-effective care to all populations. Many individuals who need care can receive adequate, timely care through health equity. This paper will thus evaluate health equity policy with proper descriptions of the different faucets of the policy in health care systems.
Relevance and Significance of the Health Equity Policy Issue to Nursing/Healthcare
Health equity is a current policy issue that affects access to quality medical care in the United States (US). For instance, structural racism shows that private industries and government influence inequalities through the segregation of Blacks from Whites in housing, which occurs due to zoning laws (Wakefield et al., 2021, p. 172). The segregation of Blacks from Whites in housing translates to inequalities in healthcare facilities. Whites do not want to associate with minority groups. Moreover, socioeconomic status causes disparities in healthcare because people from minority groups are low-income earners. Yearby et al. (2022) claim that “racial identity is independently associated with lack of health insurance but also that “low-income [minority people] with bad health had 68% fewer odds of being insured than high-income [White people] with good health” (pp. 187-188). Many individuals in minority groups earn little and cannot afford to pay for expensive healthcare services and insurance coverage. Therefore, health equity is an issue that needs to be addressed to ensure inclusion of all American citizens.
The lack of adequate insurance coverage has limited access to quality healthcare. When the Patient Protection and Affordable Care Act (ACA) expanded insurance coverage to about 20 million people, not all who obtained the coverage had adequate access to the healthcare system (Wakefield et al., 2021, p. 80). The act may have improved access to affordable healthcare but failed to promote equality. Health Resources and Services Administration (HRSA) asserted that health professional shortage areas (HPSAs) nationwide increased to 7,059 in March 2020, affecting 80.6 million individuals (Wakefield et al., 2021, p. 80). The shortage of healthcare providers means that people are paying for insurance coverage but not accessing the services they deserve. Thus, inadequate healthcare workers have caused health equity policy issues.
Prevailing Positions Regarding the Health Equity Policy Issue and Key Stakeholders
Structural racism in healthcare policy has a long history since the Jim Crow era. For example, the Hospital Survey and Construction Act allowed racially unequal and separate healthcare facilities where medical programs were underfunded (Yearby et al., 2022, p. 188). The facilities intentionally provided poor healthcare for minority groups because they were perceived as unworthy people compared to Whites. As a result, health inequalities are a policy issue that has existed for decades, requiring urgent interventions.
Inequalities in health care have been a source of suffering for minority groups in the United States, and the breakout of the Coronavirus has made the situation much more dire. As a result of COVID-19 in 2021, the rates of mortality and hospitalization were significantly higher among people of African descent, American Indians, Latinos, and Alaska natives (Yearby et al., 2022, p. 187). Because of the existing health disparities that are maintained by structural racism in healthcare policy, minority groups were more likely to be afflicted by the Coronavirus. According to Yearby et al. (2022), structural racism is a kind of racism that is carried out via the implementation of policies and regulations that distribute resources in a way that devalues and disempowers racial and ethnic minority groups. The laws and practices of the United States do not adequately safeguard minority groups and do not provide them with fair access to decent medical care.
Furthermore, racism has caused people from minority groups to be harassed because of medical problems that they do not understand. Asian nurses reported physical and verbal attacks, and some patients did not want contact with them because the COVID-19 virus was first discovered in China (Wakefield et al., 2021, p. 315). Asian nurses were being blamed for the outbreak of COVID-19, a situation that they did not control. In turn, the behaviour shows how racism affects minority groups working in the health sector.
The key stakeholders in the medical sector are patients, healthcare providers, and policymakers. Healthcare stakeholders are responsible for ensuring that health equity is enhanced in hospitals. Nurses can promote equality by respecting all patients (Wakefield et al., 2021). Other stakeholders are vulnerable and underserved communities because the policy focuses on enhancing their access to health care, thus directly impacting them. The other key stakeholders are legislators or lawmakers responsible for funding, supporting, and passing the bill at the Congress and Senate (Wakefield et al., 2021). This set of stakeholders is vital to the implementation of the policy. Policymakers can also boost equity by implementing policies that discourage racism and unequal distribution of resources. Therefore, the collaboration of the key stakeholders can eliminate health inequalities and policy issues. Nurses will ensure that all stakeholders play their critical parts in the implementation process of the policy.
My Position
Health equity is a significant policy issue that should be addressed because it is causing more harm than good. The inequalities in the health sector make people from minority groups feel devalued, yet they contribute to the economy by paying taxes (Wakefield et al., 2021). The government should make an effort to bridge the gap created by structural racism. Besides, the US population is expected to be more ethically and racially diverse. According to the US Census Bureau report, the current population of Whites will grow by 4%, Blacks by 10%, Asians by 22%, and Hispanics by 20% (Wakefield et al., 2021, p. 84). The population will be more diverse and will require equitable distribution of resources. The advanced practice registered nurse (APRN) workforce must reflect on racial equity that has been lacking for decades. Nurse Practitioners are required to provide culturally competent health/medical care. Thus, no racial group should experience cultural discrimination or racial inequity.
Furthermore, the government should provide equal insurance coverage to promote health equity. Health insurance inequalities are one of the main barriers to accessible healthcare services for all people because of unequal distribution of coverage (Yearby et al., 2022, p. 187). Unequal distribution of coverage disfavors minority racial groups and limits their access to quality healthcare. Incorporation of health equity, anti-racism policies, and understanding of health disparities can improve healthcare quality for all people. Nurse Practitioners can help to cultivate healthcare equity through their ability to offer their ideas and solutions to existing issues (ASTHO, 2022, para. 9). The government should solve the issues of structural racism and discrimination to ensure everyone has a right to quality healthcare. Hence, I think healthcare inequalities are unfair to minority groups.
Implications for Advanced Nursing Practice
Nurses contribute a lot to ensuring people access quality healthcare services. In this case, healthcare providers can help to reduce healthcare disparities through improved communication, team-based care, and the use of proven strategic patient services without discrimination. Person-centred care focuses on the community’s needs by paying attention to age, religion, and socioeconomic status (Wakefield et al., 2021, p. 114). Healthcare providers should respect people’s religious beliefs and values. Thus, APRNs/NPs can aid in reducing the adverse effects of health equity.
On the other hand, discrimination based on sexual orientation and gender identity has a dominant position inside the healthcare system. Nursing staff members who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) have reported experiencing harassment and discrimination based on their sexual orientation, gender identity, and gender expression. For instance, LGBTQ healthcare workers face stress linked to their jobs as well as animosity from their coworkers and patients in the form of unfavourable remarks, gossip, and a lack of advancement (Wakefield et al., 2021, p. 315). In healthcare facilities, individuals who identify as LGBTQ often face discrimination based on their sexual orientation. Respecting their freedom to express themselves is essential since they have that right. When nurses perceive that their identity is being questioned, they may be unable to provide high-quality medical treatment to their patients. For this reason, every nurse needs to be valued and encouraged to advance the delivery of their services to patients.
In conclusion, healthcare equity is a serious policy issue, making minority groups lack access to quality medical care in America. The government should revise policies to ensure everyone has access to affordable healthcare. Additionally, nurse practitioners should be empowered to allow them to offer medical services in rural and urban areas when there is limited access to hospitals (Nardi et al., 2020, p. 670) because racism and discrimination are the leading cause of health equity policy issues. Health equity involves offering care to every individual regardless of race, ethnicity, socioeconomic status and background. Healthy inequities are, however, widely present in the healthcare sector (Wakefield et al., 2021). Private health facilities have prioritized profits over enhancing access to health care. Now, individuals from high socioeconomic status can access better medications, diagnostics, treatment, and follow-up protocols, unlike their low socioeconomic status counterparts. Eliminating issues like structural racism and system bias can help enhance health equity. A health equity policy will thus improve community health outcomes by enhancing access to timely, high-quality health care.
References
ASTHO. (2022, December 14). ASTHO unveils top 10 public health policy issues to watch in 2023. Association of State and Territorial Health Officials https://www.astho.org/communications/newsroom/2022/astho-unveils-top-10-public-health-policy-issues-to-watch-in-2023/#
Nardi, D., Waite, R., Nowak, M., Hatcher, B., Hines‐Martin, V., & Stacciarini, J. M. R. (2020). Achieving health equity through eradicating structural racism in the United States: A call to action for nursing leadership. Journal of Nursing Scholarship, 52(6), 696-704. https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/jnu.12602
Wakefield, M. K., Williams, D. R., Le Menestrel, S., & Flaubert, J. L. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity (2021). The National Academies Press. https://doi.org/10.17226/25982
Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Academy of Sciences. http://sadil.ws/bitstream/handle/123456789/781/The%20future%20of%20Nursing%202030.pdf?sequence=1&isAllowed=y
Yearby, R., Clark, B., & Figueroa, J. F. (2022). Structural racism in historical and modern US health care policy. Health Affairs, 41(2), 187-194. https://doi.org/10.1377/hithaff.2021.01466
write