For years, many in healthcare have been focused on improving health equity and reducing disparities. However, despite these efforts, a new report finds little has changed in the last two decades. Now more than ever, we need new models of care, new policies and new ways of thinking about the healthcare workforce to end health and healthcare inequities.
The facts are striking: In 2003, the Institute of Medicine – now the National Academies of Sciences, Engineering and Medicine – published Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, a landmark report that documented inequities in the quality of healthcare received by racial and ethnic minoritized populations. More than 20 years later, the National Academies of Sciences, Engineering, and Medicine convened a committee to revisit and update the report, finding, unfortunately, minimal progress and in some instances, worsening inequity since 2003.
One of the report’s contributors is Vincent Guilamo-Ramos, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, FAAN, tenured distinguished professor and executive director of the Institute for Policy Solutions at the Johns Hopkins School of Nursing. Guilamo-Ramos joined the SEE YOU NOW podcast to discuss the need for policy solutions that address long-standing inequities in health and healthcare, and the value of nurse-led solutions in policy development and health care services that eliminate inequities.
As the new report – Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All– makes clear, new approaches are needed in healthcare policy to drive more progress, and there’s a well-positioned group with the experience and skills to shape better, more equitable healthcare – nurses.
Below, find some key takeaways from the episode, and tune in to the episode to learn more.
Nurses see the impact of policy up close — and how to improve it
Nurses’ frontline perspective is invaluable in policy development. As the clinician who often spends the most time and engages most deeply with patients and their families, nurses see more of the structural and systemic barriers that contribute to health inequities than many other healthcare professionals.
However, it is more than just their clinical expertise and skill that makes nurses a good fit for policy creation. Policy efforts must take into consideration social and clinical issues across age, race, gender, health condition, and geography. Nurses derive innovative power and problem-solving skills from their direct and sustained relationships with patients across diverse communities that can inform policies that ensure “whole person” care.
Guilamo-Ramos is very familiar with the social determinants of health that impede many communities from receiving the care they need. His career began in social work, which exposed the cracks through which many people in society fall, urging him to think about how the health care system can better engage communities and provide direct, compassionate, and relevant care to them, no matter their race, ethnicity, neighborhood or economic circumstance.
“I was committed to health promotion,” said Guilamo-Ramos. “When people do get sick, I wanted to help them get better, and that led to nursing.”
Nurses are leading a solution revolution — here’s how
The Institute for Policy Solutions is working to redesign the healthcare system with the goal of shifting policy and practice to more proactive, value-based and whole person care. To Guilamo-Ramos, it represents an opportunity to shape policy that improves health for all people by integrating principles of both public health and social justice. And nurses are key to accomplishing these goals.
Diving into nursing publications, he found recurring themes across the evidence-based, effective solutions built by nurses: they all tend to leverage whole-person care, are highly flexible, culturally appropriate and community-centered, and are diverse in setting. Nurse-led solutions were not only committed to solving the problem but aligning with communities to meet their specific needs.
“They tended to focus on communities and families,” he said. “It really pulled in the resources that wrap around our lives,” he said.
A brighter future lies ahead through person-focused health policy
Guilamo-Ramos is optimistic about a world where nurse-led interventions can prevent health inequities before they even occur, preventing chronic diseases and improving population health outcomes.
Interested in learning more about nurses’ role in healthcare policy and civic health? Click below and tune into another SEE YOU NOW episode.
