The determinants of health are closely related to the needs and issues of a particular community. According to ODPHP (2020), the determinants of health are personal, economic, social, and environmental factors impacting health status. There are several determinant categories, including policies, social factors, health services, personal behavior, and biology. Community-wide determinants, such as poor housing, inadequate education, or poverty, lead to health inequities among different populations (Baciu et al., 2017). The most relevant determinant of health in Philadelphia is the lack of universal access to healthcare, which has significant effects on the health of the community, as uninsured individuals often avoid preventive care and delay treatment. Despite the efforts of the US government to provide universal insurance coverage via the Affordable Care Act (ACA), LGBTQ individuals in Philadelphia still experience problems with access to healthcare services. Poor access to healthcare presents challenges in my nursing practice, as vulnerable or insured patients develop complications. The case of the transgender patient with severe pyelonephritis demonstrated how the lack of healthcare undermined the patient’s well-being and complicated the nursing practice by requiring additional treatment efforts. Thus, the problem of healthcare inequality has a negative impact on patient outcomes and nursing practice.
Nurses can participate in interprofessional teams developing organizational policies and proposing the changes in local and federal policies dedicated to improving healthcare access and eliminating disparities. Evidence-based approach to interprofessional collaboration between nurses, leaders, physicians, and policymakers is important for efficient problem detection and decision-making processes. Moreover, nursing professionals might contribute to raising awareness of the issue of disparities via campaigns and letters to government officials and policymakers. The conclusions of the 2019 Health Equity Summit in Philadelphia reflect the need for public awareness of health disparities and establishing the collaboration between policymakers, healthcare professionals, and community members (Wardle, 2019). Local and federal policies have a considerable impact on the health of individuals and populations. For instance, the introduction of safety regulations requiring the use of seat belts resulted in the decreased rates of deaths in car accidents (ODPHP, 2020). Health equity is vital for the safety, quality, and affordability of care, so the nurses can use multiple opportunities to advocate for changes in current policies and improve the health of the community.
Firstly, in response to the problem of insufficient access to healthcare services by LGBTQ populations, nurses might develop a position paper listing the improvement suggestions to the ACA. The position paper will attract the attention of government officials to the problem of health disparities and promote the need for amendments in the relevant policies, such as the ACA. Secondly, nursing professionals may vote against the penalties for safety-net hospitals, which provide care and save the lives of vulnerable and uninsured individuals who cannot afford healthcare services in other medical facilities. Finally, nurses can collaborate with other healthcare specialists to organize awareness campaigns dedicated to health inequality, which might attract donations or funding from the government and investors. However, nurses might choose not to get professionally involved in the area of health inequality due to potential legal implications. Nurses, especially those working in the emergency department, have to manage their accountability regularly, so they will need to adapt their practice to the policy changes. The new policy might introduce legal obligations for nurses following the organizational changes. Therefore, some nurses might decide to avoid involvement in the area to protect themselves from disciplinary or legal action.
References
Basiu, A., Geller, A. B., Weinstein, J. N., & Negussie, Y. (Eds.) (2017). Communities in action: Pathways to health equity. National Academic Press.
ODPHP. (2020). Determinants of Health. Healthy People. Web.
Wardle, N. (2019). Department of Health highlights social determinants of health at 2019 Health Equity Summit. An Official Pennsylvania Government Website. Web.