One of the most important social justice topics that relates not only to nursing in particular but to healthcare in general, is affordable healthcare. Around half of the US adults report problems paying for dental care and out-of-pocket costs for medical care not covered by insurance (Kearney et al., 2021). Even among the insured, 27% say that they find their monthly premium difficult to afford (Kearney et al., 2021). This leads to people using medical services less, avoiding seeking medical help even when they need it, which deteriorates the nation’s health. This is one of the hundreds of issues that are to be addressed in order to achieve better social justice, and nurses have their significant part to play.
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Social Justice and Nursing
Nursing as a profession is based on various values and activities, which include social justice, making it fundamental for nursing. This is demonstrated by the history of the profession and the consensus of specialists and academia. “It is plausible to state that the nursing profession is rooted in social justice responsibilities, as exemplified by the pioneering activities of Mary Seacole, Florence Nightingale, Lillian Wald, among others” (Abu, 2020). For instance, Florence Nightingale, who is considered to be the founder of modern nursing, was widely known for the social reforms she promoted. These reforms were necessary to improve healthcare across the socio-economic classes in Britain; moreover, she stood for better hunger relief and extensive sanitation improvement in India. These nurses and activists left a rich and important heritage for the future generations of professionals to come and forged unbreakable ties between nursing and social justice.
Moreover, social justice is identified and recognized as one of the basic nursing values these days. “Within nursing literature, social justice is presented frequently as a core or shared value at the very foundation of nursing as a prerequisite of health for both society and the individual” (Matwick and Woodgate, 2016). The American Association of Colleges of Nursing (AACN) lists human dignity, integrity, autonomy, altruism, and social justice as the profession’s core values (as cited in Habibzadeh et al., 2021). The same can be said about the International Council of Nurses (ICN), Canadian Nurses Association (CNA), and American Nurses Association (ANA).
Social Justice and Diversity
According to Oxford Reference (n.d.), social justice implies “creating a fair and equal society in which each individual matters, their rights are recognized and protected, decisions are made in ways that are fair and honest.” Diversity is defined as “the inclusion of people of different races, cultures, etc. in a group or organization” (Merriam-Webster, n.d.). Social justice and diversity are directly linked by their definitions – social justice in the society implies diversity because an equal and fair society implies inclusion. Diversity promotion should be seen as one of the fundamental steps towards achieving social justice.
The same can be applied to patient- and family-centered care (PFCC). IPFCC (n.d.) states that “PFCC redefines the relationships in health care by placing an emphasis on collaborating with people of all ages, at all levels of care, and in all health care settings.” Based on that perception, PFCC can be incorporated into the social justice concept as well, as its realization creates a more fair and equal society and increases opportunities for people of different backgrounds. In my own experience, I was told numerous times about the importance of mentioned concepts, and so far, my working experience demonstrated the conformity of the system with the mentioned concepts.
Barriers to Providing Social Justice Care
There are numerous barriers on different levels to providing social justice care by nurses for a diverse population. According to the study by Hosseinzadegan et al. (2021), those include insufficient attention to social justice within the educational system, the inadequate professional authority of nurses, clinical concerns, and reflection of personality traits. Regarding the professional authority, nurses indicated problems with the performance of nursing managers, nursing institutions, existing laws and regulations, and the presence of nurses in policy-making and management. In the educational domain, nurses pointed to the imbalance in the curriculum between social determinants of health and biological health factors; furthermore, in many cases, the poor performance of university professors was mentioned. Clinical concerns include high workload paired with the lack of resources and facilities. Finally, the lack of professional self-esteem that impacts the confidence and independence of nurses also serves as an obstacle.
Recommendations for Providing Health Promotion Activities
Health promotion activities imply addressing social determinants of health and modifiable risk behaviors of the population that include eating habits, physical activity, substance abuse. These activities should be wide-ranging and effective, targeting those groups that require it the most. Looking through the prism of social justice and diversity issues, health promotion activities need to address all of the parts of the population equally effectively, regardless of age, race, gender, and culture. For instance, for the US, this implies performing activities and information campaigns not only in English but in Spanish as well, as 13 percent of the country’s population speaks Spanish at home (Thompson, 2021). This number will increase in the future, and by 2050 one third of the US citizens will speak Spanish.
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Social justice directly interacts with nursing in many different areas and aspects. It is necessary to emphasize the fundamental role of social justice in nursing as a profession and remember that in many cases, nursing is inseparable from activism. This is especially important in a diverse population, and promoting diversity is crucial to achieving social justice. It is vital to focus on overcoming the existing barriers to providing social justice care and look at healthcare through the prism of inclusivity and diversity. Social justice activism, forever fused into nursing, may be one of the answers.
Abu, V.K. (2020). Let us be unequivocal about social justice in nursing. Nurse Education in Practice, 47. Web.
Habibzadeh, H., Jasemi, M., & Hosseinzadegan, F. (2021). Social justice in health system; a neglected component of academic nursing education: A qualitative study. BMC Nursing, 20(16). Web.
Hosseinzadegan, F., Jasemi, M., & Habibzadeh, H. (2021). Factors affecting nurses’ impact on social justice in the health system. Nursing Ethics, 28(1), 118-130. Web.
Kearney, A., Hamel, L., Stokes, M., & Brodie, M. (2021). Americans’ challenges with health care costs. KFF. Web.
Matwick, A.L., & Woodgate, R.L. (2016). Social justice: A concept analysis. Public Health Nursing, 34(2), 176-184. Web.
Merriam-Webster. (n.d.). Diversity. Web.
Oxford Reference. (n.d.). Social justice. Web.
Thompson, S. (2021). The U.S. has the second-largest population of Spanish speakers—how to equip your brand to serve them. Forbes. Web.