DiversityNursing Blog

Underserved communities often face significant barriers to accessing equitable healthcare. To make meaningful progress, these communities need to see themselves reflected in the systems designed to improve their health. This requires a commitment to Diversity and Inclusion across all aspects of healthcare.

The Role of Representation in Healthcare

Healthcare systems must prioritize the lived experiences, preferences, and concerns of individuals, considering factors such as gender, geography, and cultural background. Evidence shows diverse voices lead to more effective solutions and better health outcomes. By including a broader range of perspectives, we can identify blind spots and address unmet needs with sensitivity and precision.

This change must extend across industries, from pharmaceutical companies creating life-saving medicines to hospitals staffed by Doctors and Nurses who understand the unique challenges of the populations they serve. Universities shaping the next generation of medical professionals must also prioritize diversity to ensure future providers are equipped to connect with and care for diverse communities.

However, it’s not just about inclusion, it’s also about rebuilding trust. Many underserved communities have experienced a long history of neglect or bias in healthcare, leading to deep-rooted mistrust. Improving representation and fostering inclusivity is key to restoring confidence and ensuring better health outcomes for all.

Persistent Health Inequities

Despite advancements in healthcare, inequities persist:

• Women are more likely to die after a heart attack than men.
• Black women have a higher likelihood of dying from breast cancer compared to white women.
• Rural communities consistently experience poorer health outcomes than urban areas.

Health disparities are directly related to the unequal distribution of social, political, economic, and environmental resources, which manifests in various ways across different communities.

Socially, marginalized groups often lack access to quality education and employment opportunities, which can lead to lower income levels and limited access to healthcare services.

Politically, these communities may have less representation and influence in decision-making processes, resulting in policies that do not adequately address their specific health needs.

Economically, the gap in wealth distribution can mean underserved populations struggle to afford necessary medical care, nutritious food, and safe housing.

Environmentally, these communities might reside in areas with higher pollution levels or limited access to clean water and green spaces, further exacerbating health issues.

Addressing these disparities requires a comprehensive approach that considers all these interconnected factors to create a more equitable healthcare system for all.

Workforce Inclusivity: A Path to Health Equity

Creating an inclusive healthcare workforce is critical for driving innovation and addressing inequities. Diverse teams foster creativity, uncover blind spots, and develop transformative solutions that meet the needs of underserved populations. This approach encourages the development of medicines and treatments that reflect the lived experiences of diverse communities.

Inclusion also strengthens relationships between healthcare providers and patients. When patients feel heard and represented, trust improves, leading to better communication, more accurate diagnoses, and more personalized treatments.

Programs Driving Change

Globally, organizations are taking steps to improve diversity and representation in healthcare. For example:

• The World Health Organization’s Global Knowledge Network for Health Equity (GKNHE) aims to address social determinants of health.
• The American Medical Women's Association's Gender Equity Task Force aims to achieve gender equity in society, starting with the healthcare industry, through education, action, and collaborations.
• The Novartis US Foundation’s Beacon of Hope initiative works with historically Black colleges and universities (HBCUs) to tackle health disparities. This program aims to increase clinical trial participation, support research into health inequities, and develop future healthcare leaders.
  
  

A Call to Action

The journey to health equity requires collective effort and sustained focus. Prioritizing Diversity and Inclusion is not just the right thing to do, it’s essential for improving outcomes and rebuilding trust with underserved communities. As we face the health challenges of the future, let’s ensure inclusivity remains at the forefront of healthcare innovation, education, and delivery.

By working together, we can create a healthcare system that truly serves everyone.

It is essential for healthcare to be fair and accessible to all individuals, yet LGBTQ+ individuals often face significant health disparities. These disparities arise from various factors, including societal stigma, discrimination, and a lack of culturally competent care.

As Nurses, we hold a unique position to recognize and address these health inequities, guaranteeing LGBTQ+ patients receive high-quality care they rightfully deserve. In this discussion, we delve into the specific health challenges encountered by LGBTQ+ communities and explore strategies for Nurses to alleviate these disparities.

Understanding Health Disparities in LGBTQ+ Populations

Mental Health: LGBTQ+ individuals are at a higher risk for mental health issues such as depression, anxiety, and suicidal ideation. Factors contributing to these issues include societal stigma, discrimination, and lack of social support.

Substance Use: Higher rates of substance use and abuse are observed among LGBTQ+ populations. An estimated 20 to 30% of the LGBTQ+ community abuses substances, compared to about 9% of the general population. This is often a coping mechanism for dealing with discrimination, trauma, and social rejection.

Sexual and Reproductive Health: LGBTQ+ individuals may face challenges in accessing appropriate sexual and reproductive health services. This includes higher rates of sexually transmitted infections (STIs), including HIV, particularly among gay and bisexual men and transgender women.

Chronic Diseases: There is a higher prevalence of certain chronic diseases in LGBTQ+ populations, such as cardiovascular disease, obesity, and certain cancers. These are often linked to stress, smoking, and other lifestyle factors influenced by minority stress.

Access to Healthcare: LGBTQ+ individuals often experience barriers to healthcare access, including lack of insurance, discrimination by healthcare providers, and fear of disclosing their sexual orientation or gender identity.

Strategies for Nurses to Address and Reduce Health Disparities

Provide Culturally Competent Care

Education and Training: Participate in ongoing education and training focused on LGBTQ+ health disparities and cultural competence. This involves gaining insight into the specific healthcare requirements of LGBTQ+ individuals and honing effective and respectful communication skills.

Inclusive Environment: Establish a warm and inviting atmosphere within your healthcare facility. Showcase symbols of inclusivity, incorporate inclusive language in documentation, and guarantee all team members are well-versed in LGBTQ+ cultural competence.

Enhance Mental Health Support

Screening and Referral: Conduct regular screenings for mental health concerns such as depression, anxiety, and thoughts of self-harm. Connect LGBTQ+ individuals to mental health providers and support services that affirm their identities and experiences.

Peer Support: Foster peer support groups within your healthcare facility or local community. These groups offer a safe and understanding environment for LGBTQ+ individuals to exchange experiences and effective coping mechanisms.

Address Substance Use

Non-Judgmental Approach: Approach discussions surrounding substance use with empathy and understanding. Take into account the underlying factors contributing to substance use and offer compassionate support and access to appropriate treatment resources.

Tailored Interventions: Create and execute substance use interventions that cater to the unique requirements of LGBTQ+ individuals. This entails offering culturally sensitive counseling and support programs tailored to their specific needs.

Improve Sexual and Reproductive Health Services

Comprehensive Care: Provide comprehensive and accessible sexual and reproductive health services to meet the needs of LGBTQ+ individuals. This encompasses offering STI screening, HIV prevention and treatment, as well as inclusive family planning services.

Education and Outreach: Offer education on safe sex practices and sexual health catered to the unique needs of LGBTQ+ patients. Engage in outreach efforts to link individuals with pertinent services and resources, promoting a holistic approach to sexual and reproductive health care.

Promote Chronic Disease Prevention and Management

Regular Screening: Conduct regular screenings for chronic illnesses among LGBTQ+ individuals, focusing on conditions that are commonly seen within this community.

Lifestyle Support: Provide assistance for promoting healthy lifestyle choices, including programs to quit smoking, guidance on nutrition, and techniques for managing stress.

Advocate for Policy Changes

Inclusive Policies: Advocate for the establishment of inclusive policies in healthcare environments, ensuring these policies explicitly encompass and protect individuals based on their sexual orientation and gender identity.

Access to Care: Push for enhanced healthcare access for LGBTQ+ individuals by advocating for inclusive insurance coverage, expanding healthcare services, and dismantling barriers to care. 

Addressing health disparities in LGBTQ+ populations requires a multifaceted approach that includes education, compassionate care, and advocacy. By understanding the unique challenges faced by LGBTQ+ individuals and implementing targeted strategies, Nurses can play a crucial role in reducing these disparities and improving health outcomes. Our commitment to equity and inclusivity in healthcare can make a profound difference in the lives of LGBTQ+ patients, fostering a system where everyone receives the care and respect they deserve.

As Nurses, we have the responsibility and the opportunity to lead the way in creating a more equitable healthcare system. By embracing these strategies, we can ensure our care is inclusive, compassionate, and effective for all patients, regardless of their sexual orientation or gender identity.

Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age, and the broader array of influences and structures impacting everyday living. These determinants are the key drivers of health disparities, leading to unjust and preventable health outcomes.

SDOH include factors such as:

Economic Stability 

This includes factors like employment, income, debt, and socioeconomic status. People with lower income levels often face greater challenges accessing healthcare and maintaining healthy lifestyles. The ability to secure stable employment, earn a livable wage, manage financial obligations, and attain a certain socioeconomic status directly impacts one's access to healthcare services, ability to afford healthy lifestyle choices, and overall quality of life.

Individuals facing financial hardships may struggle to prioritize their health due to limited resources, leading to disparities in healthcare access and health outcomes. It is essential to address economic inequalities and provide support systems to ensure all individuals have equal opportunities to lead healthy and fulfilling lives.

Education 

Individuals with a higher education level tend to exhibit better health behaviors, such as regular exercise, balanced nutrition, and avoidance of harmful substances like tobacco and excessive alcohol consumption. This is because education not only provides individuals with the knowledge and understanding of healthy lifestyle choices but also empowers them to make informed decisions about their health.

Higher levels of education are closely linked to greater access to healthcare services. Educated individuals are more likely to have health insurance coverage, seek preventive care, and adhere to medical treatments, leading to better overall health outcomes. Education can also enhance health literacy, enabling individuals to better understand health information, navigate the healthcare system, and communicate effectively with healthcare providers.

Social Connectedness 

Social support networks play a crucial role in individuals' overall health and well-being. Having strong social connections and a supportive community can act as a buffer against stress, loneliness, and mental health issues. When people feel connected and supported by those around them, they are more likely to engage in healthy behaviors, seek out healthcare when needed, and have a sense of belonging and purpose.

On the other hand, discrimination and social isolation can have detrimental effects on both mental and physical health. Experiencing discrimination based on factors like race, gender, or socioeconomic status can lead to chronic stress, anxiety, and depression, all of which can impact one's overall health. Similarly, feeling socially isolated or disconnected from others can increase the risk of developing mental health disorders and exacerbate existing health conditions.

In contrast, communities that foster social cohesion and inclusivity create environments where individuals feel valued, supported, and encouraged to prioritize their health and well-being. By promoting social support networks, community engagement, and addressing issues of discrimination and social isolation, we can create healthier and more resilient communities where everyone has the opportunity to thrive.

Neighborhood and Physical Environment

The physical environment in which people live, work, and play can significantly impact health. Factors such as access to safe housing, clean air and water, transportation options, and green spaces all influence health outcomes.

Access to safe and secure housing is fundamental to maintaining a healthy lifestyle, as it provides a foundation for stability and a sense of security. Clean air and water are essential elements directly impacting respiratory health and overall physical well-being. Inadequate access to clean air and water can lead to respiratory illnesses and other health complications.

Transportation and infrastructure also play a significant role in health outcomes. Easy access to public transportation, walkable neighborhoods, and bike-friendly paths can promote active lifestyles and reduce reliance on cars, thereby contributing to improved physical health. The availability of green spaces and parks in communities provides opportunities for outdoor recreational activities, which are vital for mental well-being and stress reduction.

Access to Healthcare

Healthcare access includes factors such as health insurance coverage, proximity to healthcare facilities, availability of primary care providers, and affordability of healthcare services. Limited access to healthcare can lead to delayed or inadequate treatment, exacerbating health disparities.

Health Behaviors

Individual behaviors such as diet, exercise, smoking, alcohol and drug use, and sexual activity all play a critical role in determining an individual's overall health and well-being. These behaviors are not only influenced by personal choices but also by a complex interplay of social, economic, and environmental factors.

By addressing the social determinants of health that shape these behaviors, such as promoting affordable and nutritious food options, creating safe and accessible environments for physical activity, and implementing education and prevention programs, we can empower individuals to make healthier choices and ultimately improve population health outcomes.

Addressing social determinants of health requires comprehensive, multi-sectoral approaches that go beyond traditional healthcare interventions. This involves collaboration between various sectors such as education, housing, transportation, and social services to create a holistic approach to improving health outcomes.

By working together to address the underlying factors that contribute to health disparities, we can create a more equitable and inclusive society where everyone has the opportunity to lead a healthy and fulfilling life. This approach not only benefits individuals but also strengthens communities and promotes overall well-being for all. 

Versailles, Ky. – On June 8-9, 2023, Frontier Nursing University (FNU) will hold its annual Diversity Impact Conference. The Diversity Impact Conference brings together renowned thought leaders and speakers to increase awareness of the importance of diversity, equity, and inclusion (DEI) in the healthcare workforce, particularly for those working in underserved and rural communities. This year, for the first time, the conference will be available for attendees outside of FNU.

“We are extremely excited about the 2023 Diversity Impact Conference,” said FNU Chief Diversity and Inclusion Officer Dr. Paula Alexander-Delpech, Ph.D., PMHNP-BC, APRN. “The Conference gets better each and every year, and we are putting the finishing touches on the plan for this year’s sessions. We are most excited, however, about being able to include more attendees this year. As we grow this important event, we want to invite leaders and students from some of our area universities to join us. This event is all about collaboration, learning, and growing. I’m confident that it will benefit any university, department, or individual.”

The 2023 Diversity Impact Conference will be conducted via Zoom. The theme of this year’s conference is “Better Together: Advancing a Culture of Identity and Belonging in Healthcare.” The two-day event will feature keynote presentations on both days from nationally recognized leaders in diversity, equity, and inclusion. Additional sessions will include panel discussions, breakout sessions, and time for reflection.

The opening keynote address will be given by Dr. Tia Brown McNair, Vice President of the Office of Diversity, Equity, and Student Success and Executive Director for the Truth, Racial Healing, and Transformation (TRHT) Campus Centers at the American Association of Colleges and Universities (AAC&U) in Washington, D.C. On the second day of the conference, the keynote speaker will be Rebekka Eshler, National President of the Transgender American Veterans Association in Washington, D.C.  All speaker bios and the full conference schedule can be found at https://frontier.edu/diversity-impact/

The learning outcomes attendees can expect to take away from the Diversity Impact Conference include:

• Identify specific strategies to create a culture of belonging amongst peers and the larger community
• Discuss the causes behind healthcare disparities and their effect on creating a culture of belonging
• Reflect on ways to effectively engage in spaces to promote diversity in identity
• Practice ways to build collaborative communities

Students attending any institution can register for the conference for free. All others can register at the registration price of $99 until the day before the event. For more information about the 2023 Diversity Impact Conference and to register, please visit https://frontier.edu/diversity-impact/.

#####

About Frontier Nursing University:

The mission of Frontier Nursing University is to provide accessible nurse-midwifery and nurse practitioner education that integrates the principles of diversity, equity, and inclusion. We transform healthcare by preparing innovative, ethical, compassionate, and entrepreneurial leaders to work with all people with an emphasis on rural and underserved communities. FNU offers graduate Nurse-Midwifery and Nurse-Practitioner distance education programs that can be pursued full- or part-time with the student’s home community serving as the classroom. Degrees and options offered include Doctor of Nursing Practice (DNP), Master of Science in Nursing (MSN), or Post-Graduate Certificates. In 2021 and 2022, Frontier was named a “Great College to Work For” by the Great Colleges to Work For® program. To learn more about FNU and the programs and degrees offered, please visit Frontier.edu.

 

Healthcare should be accessible to everyone regardless of socioeconomic status, age, gender, race, or ethnicity. Unfortunately, many people across the nation struggle to access affordable and reliable healthcare. Health equity can only be achieved when every person, regardless of the situation, has a fair and equal opportunity to be as healthy as possible.

Many factors can influence health equity, including health disparities, social determinants of health, and cultural competence. Therefore, Nurses must understand these concepts strongly to identify health inequalities and implement changes so our patients can achieve optimal health.

Health Disparities

Unfortunately, health disparities in the United States are more common than you may realize. Health disparities are any barriers that limit a person's access to quality medical care. Population groups most affected by health disparities include ethnic minorities, immigrants, and low-income families. Common barriers that people may experience include socioeconomic status, geological location, sexual identity or orientation, ethnicity, race, age, or disability.

Health disparities can look different for everyone. For example, some people may live in rural areas where they cannot easily access routine health exams. Others may need help understanding health recommendations due to language barriers. Whatever the disadvantage, health disparities can lead to poor health outcomes that negatively contribute to health equity.  

Nurses have a unique advantage in identifying health disparities and implementing changes so that more people can access care. There are many ways Nurses can implement change, including:

• Supporting telehealth and mobile health units so people in rural areas can access medical services
• Ensuring patients have access to interpreter services so they fully understand medical recommendations
• Creating community health projects so those in under-educated populations can better access health education.

Social Determinants of Health (SDOH)

Social determinants of health can often be confused with health disparities. Although similar, SDOH refers to an individual's personal circumstances apart from medical care and genetics that can affect health outcomes.

Social determinants of health fall into 5 groups that define how people are born, grow, work, live, and age. These groups are interwoven, causing them all to overlap and relate to each other. The five groups include healthcare, economic stability, education, social life, and neighborhood.

• Healthcare encompasses a person's access and quality of medical care, including access to primary care services, health insurance coverage, and understanding of health literacy.
• Economic stability is the connection between finances and access to healthcare. Employment, poverty, food, and housing security can all affect economic stability and access to healthcare.
• Education focuses on the link between access to quality education and how it relates to health. People who do not have access to secondary or higher education may not have the necessary language and literacy to understand medical needs and care.
• Social life has contributed to learned behaviors around healthcare access. How people live, work, play, and learn within their communities can change how people feel about medical care.
• The neighborhood considers how a person's quality of housing, transportation, access to healthy foods and clean water, as well as exposure to crime and violence play a role in a person's health.

Nurses play a significant role in addressing social determinants of health. You can promote health equity by getting involved in public policies and decision making. Advocating for better care can help prevent illness in underserved populations and improve health equity for all.

Cultural Competence

A strong understanding of cultural competency is essential to achieve health equity. Cultural competency is when healthcare providers provide effective healthcare, even if there may be cultural differences between the provider and the patient.

Nurses can become more culturally competent by learning to engage with a wide range of patients with different cultural, religious, and societal backgrounds. Nurses can show cultural competency by speaking to patients in language and terms they understand or by respecting a patient's cultural or religious values or beliefs.

As a Nurse, providing culturally competent Nursing care can break down communication barriers and improve the health outcomes of our patients.

To better serve our communities, Nurses must be able to identify inequalities in healthcare and implement the necessary changes to improve patient experiences and outcomes. Nurses have a unique position on the frontlines of healthcare to positively improve health equity by helping to provide effective and accessible medical care to all.

The Foundation of the National Student Nurses’ Association is delighted to announce a new diversity scholarship award sponsored by Johnson & Johnson. Funding may be used for tuition, fees, and books. Use the same application to apply for all FNSNA scholarships. 

Students must complete the race/ethnicity question to qualify. There is $225,000 available. Awards up to $7,500.

Click here for more information: https://www.forevernursing.org/2021-online-scholarship-applicationinstructional-sheet.html

Click here for the application: https://app.mykaleidoscope.com/scholarship/fnsna2021

Deadline is February 15, 2021