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Issues of social justice are as prevalent as ever, with mostly every media story revolving around one issue or another. Some of these issues include healthcare, the income gap, and equality, which also can be cyclical and interconnected to each other. The Coronavirus pandemic has brought many of these issues into the forefront due to the rapid changes in the economy and unemployment rates. The current state of the world has pushed healthcare providers into leadership roles and has furthered the importance of tying the improvement of social issues into nursing practice.
Healthcare has been a highly debated topic for many years and has regularly been a platform for political pundits to discuss. There is a slew of issues that fall under the healthcare umbrella including insurance coverage, access to care, supply shortages, etc. One major change in healthcare took place with the passing of the Patient Protection and Affordable Care Act in 2010 which gave more US citizens access to healthcare, with the most recent statistics showing 4.1 million Americans signing up in 2019 (BBC, 2019). However, there have been many attempts to disband the ACA by the Trump Administration for reasons of believing it is unconstitutional to tax a citizen for not applying for healthcare. Overall, this controversial topic has proven to heighten the disparities in access to care since, even with improved coverage, some Americans are still having issues with receiving quality care. A recent study found that young adults who benefited from remaining on their parent’s coverage until 26 years old truly benefitted those young adults who already had access to resources and healthcare, with additional issues for those covered with covering out-of-pocket costs therefore proving insurance coverage does not directly translate into increased access (Alvarez, Keegan, Johnston, Haile, et al., 2018). Therefore, healthcare access will continue to be a social justice issue since it is influenced by other socioeconomic factors.
The income gap has been driving the higher-income and lower-income classes further apart for many years. This wide gap between the rich and poor has left people with minimal access to essential needs and has become cyclical in nature with those at the lower-income end of the spectrum little to no chance of moving upward. A recent study shows that lower-income households have little to no exposure to business ventures, therefore leaving them in the lower-income bracket which provides more choices for higher-income households who will, in turn, move upward into higher wealth (Meszaros, 2020). Therefore, the inability for low-income families to further their wealth continues to decrease their access to healthcare, education systems, food and nutrition services, etc.
Lastly, equality has been a large social justice issue for decades, with an emphasis recently on the Black Lives Matter movement for racial inequality. Equality has been a discussion for years with discrepancies seen between gender, the LGBTQ+ community, race, socioeconomic class, and the list continues. Racial inequality has been prevalent in this country since its foundation, and has perpetuated societal, governmental, and economic systems that were installed to keep these injustices in place. This continued problem has contributed to inconsistencies across the board for non-white citizens, with science and healthcare at their center. In this current pandemic, people of color were found to be more susceptible to contracting COVID-19, with the black community 3.5 times more likely to die than white people, and the Latinx people 2 times more likely to die (Sandoiu, 2020). Therefore, racism is a public health issue and emergency that needs to be addressed worldwide. It is the root cause of continued disparities in death and disease between Black and white people in the USA. Black people aged 18–34 years have higher mortality rates than white people for eight of the ten leading causes of death (The Lancet, 2020). We must aid in this fight as healthcare providers since it is part of our ethical, moral, and practical duty.
Individual nurses at all levels can help in the social injustice fight through their individual practice. It is the shared responsibility of professional nursing organizations to speak for nurses collectively in shaping healthcare and to promulgate change for the improvement of health and healthcare locally, nationally, and internationally (ANA, 2015). Nurses should continue to practice with ethical values of justice, beneficence, nonmaleficence, and autonomy. Nursing has incorporated cultural sensitivity training into its curricula to enhance each nurse’s worldview and gain perspective on cultural differences. This creates an atmosphere of tolerance and empathy for others with different backgrounds from their own, which furthers the notion of caring for someone holistically. By understanding where a person comes from, both geographically, economically, socially, etc., a nurse is upholding their responsibility to care for each person to the best of their ability and without bias. Another important way nurses can utilize these ethical values and perpetuate the cause for justice is through their role of advocacy. Advocating for a patient’s rights, and the rights of everyone, is something nurses must continue to do every day in their workplace. Grace (2018) describes how advocacy should be viewed as a broader responsibility to further professional goals at both the individual and societal levels, and since the goal of almost all healthcare professionals has to do with improving the health of individuals, then this often requires addressing injustice that is deep rooted in a society (Grace, 2020, p. 145). By writing opinion pieces, joining committees, and educating others are only a few ways that nurses can raise these standards. Nurses of all levels are in a unique position at this moment in time to use their voice to bring these social injustices to light since the global pandemic has given them this platform.
Alvarez, E., Keegan, T., Johnston, E., Haile, R., Sanders, L., Wise, P., . . . Chamberlain, L. (2018). The Patient Protection and Affordable Care Act dependent coverage expansion: Disparities in impact among young adult oncology patients. Cancer, 124(1), 110-117.
American Nurses Association. (2015). Code of Ethics for Nurses With Interpretive Statements. Silver Spring, MD: ANA Publication.
Grace, P.J. (2018). Nursing ethics and professional responsibility in advanced practice, 3rd edition. Jones & Bartlett: Burlington, MA. ISBN-10: 1284107337; ISBN-13: 978-1284107333
The Lancet. (2020). Medicine and medical science: Black lives must matter more. The Lancet (British Edition), 395(10240), 1813.
Meszaros, J. (2020). Long-Term Rates, Capital Shares, and Income Inequality. Open Economies Review, 31(3), 619-635.
Obamacare: Has Trump managed to kill off Affordable Care Act? (2019, March 29). Retrieved July 15, 2020, from https://www.bbc.com/news/world-us-canada-24370967
Sandoiu, A. (2020). ‘A no-win situation’ – Expert weighs in on COVID-19 racial disparities. Retrieved July 15, 2020, from https://www.medicalnewstoday.com/articles/a-no-win-situation-expert-weighs-in-on-covid-19-racial-disparities
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