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Chapter 1: Health Equity

INTRODUCTION

In This Chapter

  • This Is a Journey: Dismantling Structural Racism

  • Building Social Capital in Nursing: Doing With Intention

  • Health Equity and Black Maternal Mortality

  • Redistribute Power Over Data, Definitions, and Decision-Making

  • Nurses as Champions for Bridging the Health Equity Gap

  • Our Hope for the Future

This chapter focuses on the nurse’s role in promoting health equity on the front lines and beyond, providing equitable care, addressing social determinants of health (see Figure 1.1), and dismantling structural racism. Social determinants of health lead to disparate health outcomes, but as nurses, it is imperative that we move beyond this acknowledgment and take action to promote equitable healthcare services so that everyone receives care that optimizes their health. When we recognize that a person’s cultural and social backgrounds affect where, when, how, and if they receive healthcare services, it is no longer acceptable to uphold a system that provides the same care for every patient (equality). Instead, a system that takes an individual’s needs into account to create a personalized plan of care (equity) should be endorsed. A shift toward health equity is a shift toward improved healthcare outcomes for all.

Figure 1.1

Social determinants of health.

(US Department of Health and Human Services & Office of Disease Prevention and Health Promotion, n.d.)

A schematic shows the social determinants of health. The illustration begins with a man icon at the center surrounded by 5 different icons. From the top right corner, a plus sign shows health care access and quality, and a building and an individual residence icon show a neighborhood and built environment. The icon of three people holding and raising hands shows social and community context. A dollar sign shows economic stability. A graduate hat icon shows education access and quality.
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Consider the following questions as you read the essays about health equity:

  • Why should nurses care about health equity?

  • What are some examples of how biases and stereotypes held by nurses negatively affect health equity and health outcomes?

  • What roles can nurses play in bridging the health equity gap across healthcare and in the community?

  • What actions can nurses take to dismantle structural racism and improve health equity?

  • What are some local, state, and national resources and organizations available to support the nurses’ journey toward health equity?

THIS IS A JOURNEY: DISMANTLING STRUCTURAL RACISM

Ernest J. Grant, PhD, DSc(h), RN, FAAN

ANA President

Nursing today has been forced to recognize that racism does exist within the profession, with the patients we care for and in the world around us. Surveys conducted by the National Commission to Address Racism in Nursing only confirm what we already knew (Singer, 2022). In addition, the pandemic has also exacerbated and shone a light on healthcare disparities and racism. This is something that members of the BIPOC (Black and Indigenous people of color) community knew existed all along. But how do we tear down those walls so that everyone can be seen for who they are and the contribution that they make to society versus the opposite? What can I, as a nurse, and my fellow nurse colleagues do to ensure racism is no longer tolerated in nursing, in healthcare, and in society? The answer is very ...

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