A recent report by the Annie E. Casey Foundation shed light on something nurses see every day – there’s a large gap in the well-being of minority children in the United States.
The report, Race for Results, highlights the struggles and challenges families face when they lack the support, funds, housing, and educational opportunities in their day-to-day lives. The report analyzed 12 points including things like percentage of babies born at a normal birth weight to poverty levels, high school graduation rates, and who the children live with.
Nurses, who treat these children across the country know how even prenatal malnutrition can set off a cascade of setbacks from infancy on. But nurses are also on the forefront, helping disadvantaged families find the resources they need, informing them about nutrition and education, and offering a a steady and caring hand.
The report compared experiences and opportunities of African American, American Indian, Asian and Pacific Islander, Latino, and White children to see where disparities occurred. The report also underscored a sense of urgency to challenge and change these disparities. In 2018, the report states, the majority of children in the country will be nonwhite and by 2050, no one racial or ethnic group will be a majority. If disparities and barriers in health, education, and opportunity aren’t addressed now, future generations of children will continue to lag behind.
“While it is widely understood that children’s life chances differ by race and ethnicity,” the report states, “we believe that more consistent and comprehensive data on these differences, coupled with the rationale and strategies for action by all sectors, will help lead to evidence-based solutions that can improve the odds of success for children of color.”
So what can nurses do? With nurses represented in all different sectors, they can advocate for change in their workplaces and neighborhoods. Programs to helps minority families, whether through food, jobs, childcare resources, neighborhood safety, education, or emotional support, will all help close the gap and bring more opportunities for children. Nurses can begin to address policy issues, calling attention to their communities that need help and offering suggestions to what kind of assistance is most pressing.
Advocating for equal early childhood access to good medical care, nutritious foods, high-quality childcare and preschool can set a solid foundation for families of all races and ethnicities across the country. By giving children the resources they need to be healthy and form strong family and community ties, they will be better poised to close the gaps that are detailed in the report.
Nurses can also push for change and alert local, state, and national government officials to the disparities they see in their own practices and suggest changes that can begin to fix those problems.
Taking the first step now can make a huge difference later for children.
Teen pregnancy, once a declining problem, is once again on the rise, particularly in minority communities. To combat the trend, one Massachusetts nurse started a program aimed at educating students and parents about teen pregnancy before it occurs. Anh Lewin, B.S.N., R.N., who works for Pediatrics West, started The Smart Sex Program for Teens in 2008 with a $5,000 grant from Fallon Community Health Plan, an insurance and health care provider. The program is held for two hours over a two-week period while a separate session for parents, called “Let’s Talk,” is a two and a half hour, one-time program.
Located in Groton and Westford, Massachusetts, Pediatrics West provides health care to some schools in those towns as well as in Chelmsford, Lawrence, Pepperell, and Tyngsborough. Lewin also has offered the program in nearby Lowell, which is the fourth-largest city in Massachusetts and has the highest percentage of native Cambodians of any place in the United States. Lawrence, meanwhile, is known as the “Immigrant City” and has always been a multi-ethnic and multicultural gateway with a high percentage of foreign-born residents, according to the city’s website.
The Smart Sex Program for Teens is free. It includes instruction on communication, the reproductive system, puberty, sexually transmitted diseases, protection, abstinence, and relationships.
For the parent workshop, there is a modest fee. “For the parents, we teach them all the facts. Now we want you to teach your kids how you feel about the situation,” Lewin says. “We ask, them, ‘What is your opinion?’ You have to give kids your values. We do not do that. We spend four to five hours with them. You have your entire life with your child. It is not one talk; it is multiple talks. It is talks that should start when they are really young, so you are always comfortable talking about it.”
To learn more, visit the Pediatrics West educational programs website (www.pediatricswest.com/education.htm).
During the 2011 National Nurses Week, a week the American Nurses Association honors every year from National Nurses Day, May 6, to Florence Nightingale’s birthday, May 11, four nursing students were given the opportunity to travel to Sierra Leone to work on a field mission for Mercy Ships.
Since 1978, Mercy Ships has delivered free health care and services to more than 70 countries in the developing world—taking their facilities and staff with them across the oceans on ships. The field mission welcomed four nursing students from Northwest University to prepare in Sierra Leone for the arrival of the largest non-government hospital ship in the world, with a crew of 450, the Africa Mercy.
From their campus near Seattle, Washington, the four students and their professor joined a team of 350 nurses from more than 40 countries who volunteer with Mercy Ships every year. Because Mercy Ships requires volunteer nurses to be registered nurses with at least two years of professional experience, the nursing students prepared on land for the ship’s arrival by gathering medical records for patients and testing day-workers from the local community, who volunteer on the ship, for tuberculosis. One future nurse says she left with an appreciation for the availability of health care in the United States; many of the people they helped in Sierra Leone do not have any hospitals nearby.
Mercy Ships has over 1,200 volunteers every year from a variety of professions, such as surgeons, dentists, cooks, and teachers. While surgical nurses volunteer for two weeks, patient care nurses can volunteer for eight weeks or longer. Students gained perspectives not normally absorbed from classroom lectures or even technical training.
President Obama signed the historic Patient Protection and Affordable Care Act into law on March 23, 2010, and its first changes went into effect on July 1 of the same year. But signing that bill was just the beginning of a passionate national health care debate. Even one year later, the dust is far from settling.
One of the most politically divisive issues in the United States’ history, the Patient Protection and Affordable Care Act has been at the forefront of public and Congressional discourse practically from the moment it was written. Reforming the health care laws of the early 20th century has been a topic of discussion since the 1970s.
Yet, revisiting the Patient Protection and Affordable Care Act today is really just rehashing what was signed into law a year ago. Not much has actually changed, though those opposing the Act in the deeply divided Congress say it will change, and soon.
“Reforms under the Affordable Care Act have brought an end to some of the worst abuses of the insurance industry,” says the White House on its health care reform website, www.healthcare.gov.
Some of the more prominent facets of the reform include ending lifetime and some annual limits on care, allowing adults under age 26 to stay on their parents’ insurance plans, and forbidding insurance agents from denying care to children with preexisting conditions.
Regarding Medicare, almost 48 million of those receiving aid are eligible for free preventive care, including mammograms and colonoscopies, among other Medicare-specific reforms like prescription drug discounts.
The Act also takes into special consideration the disparities surrounding health care and minority populations. Minority Nursefrequently covers the lack of access to care and disproportionate incidences of disease, and the Patient Protection and Affordable Care Act outlines several initiatives to combat those inequalities.
Especially pertinent to low-income patients, the Act calls for subsidized preventive health care services like annual exams, immunizations, and cancer screenings for those falling into certain eligibility groups. It also invests in cultural competency and language training, chronic condition management teams, and community clinics, with a goal of doubling the number of patients those clinics can serve. The Act also provides funds for home care visits for pregnant women and new mothers, in an effort to stem the low birth weight and infant mortality epidemic affecting minorities.
Finally, by 2014, the Act will establish State-based Health Insurance Exchanges that will create a competitive health insurance marketplace and “guarantee that all people have a choice for quality, affordable health insurance even if a job loss, job switch, move, or illness occurs,” according to the U.S. Department of Health & Human Services.
Multiple parties have already questioned the Patient Protection and Affordable Care Act’s constitutionality, saying Congress does not have the power to require individuals to buy health insurance. The Obama administration has countered these claims, pointing to Congress’s Constitutional right to regulate interstate economic activity. The crux of the Act is fostering those State-based Health Insurance Exchanges, giving states flexibility in their implementation and giving individuals a choice that spans state borders. Surveys conducted by third parties, such as the Harvard School of Public Health, showed many Americans support the Act and many of its provisions, and that there is no swell of people hoping to have it repealed. Obama’s Congressional Budget Office also estimates the Act will eventually save money, reducing the deficit by $138 billion.
The White House, for its part, has tried to tout those functions of the Act that are already helping people, like the Medicare discounts and continued insurance coverage for young adults. However, though millions have already benefited from the law, most of the country has yet to feel its effects, making the continuation of these costly and sweeping changes seem pointless. The Act calls for more drastic health care overhauls through 2014, including many of the provisions directed toward reducing health disparities, but for the uninsured and underinsured, that can be a long wait.
Of course, speeding up the implementation of the Act isn’t an option, but voting during the 2012 election is. Nurses can support these changes (or refute them) with their vote. In the meantime, nurses can educate themselves, as the repercussions of the Act—whether it endures or is repealed—will be felt in communities and clinics, in juggernaut HMOs and small businesses, for years to come.
As a partnership between the Healthy Schools Campaign, Chicago Public Schools, the Office of Minority Health, and the U.S. Department of Health and Human Services, the Heroes for Healthy Schools week-long campaign launched in May in Chicago public schools to revolutionize the way schools and children think about health and exercise in the classroom.
The week’s events were held in Chicago to recognize the city’s public schools’ efforts to change the thinking in low-income minority students about nutrition and fitness. The Heroes for Healthy Schools campaign is a part of First Lady Michelle Obama’s Let’s Move program and HealthierUS School Challenge. Chicago adopted the USDA’s food program in its schools in 2010, and was the first major public school system to do so. Chicago public schools have a goal to get at least 100 schools to meet the USDA’s HealthierUS School Challenge.
Heroes for Healthy Schools week included visits from Chicago chefs; classroom breakfast initiatives; school-wide fitness challenges; conferences and professional development classes for teachers, administrators, and school nurses; local farm support with “buy local” webinars for low-income families; and meetings for parents to learn about the national initiatives to transform health education in public schools.
Thirty public health educators came to Chicago to run events and programs during the campaign, including Cornell McClellan, the Obama family’s personal trainer, and Tonya Lewis Lee, the official spokesperson for the Office of Minority Health.
The Office of Minority Health also hosted a screening of Lewis Lee’s documentary Crisis in the Crib: Saving Our Nation’s Babies and a citywide forum on private-public school partnerships to target nutrition and fitness education in children from minority and low-income families.
For more information on Heroes for Healthy Schools week and how you can get involved in your school system’s efforts, visit www.healthyschoolscampaign.org.
