Question

Think back to when you were becoming an RN and how many times you were told to be an advocate for your patient. discuss how you as a nurse can advocate for ethical policies that promote access, equity, quality, and cost.

Answer 1

Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts.Many barriers hamper advocacy for health equity, including the contemporary economic zeitgeist, the biomedical health perspective, and difficulties cooperating across policy sectors on the issue.Effective advocacy should include persistent efforts to raise awareness and understanding of the social determinants of health. Education on the social determinants as part of medical training should be encouraged, including professional training within disadvantaged communities.Advocacy organizations have a central role in advocating for health equity given the challenges bridging theworlds of civil society, research, and policy.Health inequalities are systematic differences in health between social groups. Although socially excluded and minority groups are particularly vulnerable to ill health, differences in rates of illness affect everyone: health status diminishes continually along what is called the “social gradient in health.”These differences relate to the social determinants of health (SDH), the conditions of daily life, which in turn are shaped by the unequal distributions of power, money, and resources within and between countries.Health equity” refers to a state characterized by the absence of systematic inequalities in health. While this state is usually referred to in aspirational terms, because inequalities are pervasive and arguably will never be eliminated, the policy goal of moving toward health equity implies attempts to reduce health inequalities to a minimal level. It is therefore “an ethical concept, grounded in the principle of distributive justice”and connected to a field of research that is “unavoidably politicized.”Advocacy is recognized as a means of promoting policies that help improve health equity. These policies take action on the SDH, either through universal provision of services, as part of strategies to improve the health of disadvantaged groups, or by “leveling up” the health of less advantaged groups to that enjoyed by more advantaged groups in society.The aim of this review is to synthesize evidence in the academic and gray literature regarding advocacy for health equity and to provide a body of knowledge to inform practice. It was written by a team of research and project managers at EuroHealthNet, a nonprofit network of agencies responsible for public health across the European Union. EuroHealthNet's aim is to improve health equity by coordinating research projects, highlighting good practices, and increasing capacities to tackle the SDH. Accordingly, this article is written from an EU-level, rather than a national or subnational perspective. We do not focus solely on European evidence here, however, because issues concerning advocacy for health equity may be common across countries, regardless of their level of economic development,so limiting evidence to Europe could result in our overlooking useful practices. Indeed, much may be learned through what has been termed “reverse innovation,” in which practices applied in developing contexts are taken up in the “industrialized” world and advocacy for health equity should be no exception.The article is structured as follows: First, we introduce health inequalities in the European political and economic context. Second, we introduce our concept of advocacy for health equity. Third, we outline the methods used. The fourth section represents a synthesis of the reviewed literature. The fifth section comprises a critical discussion of themethodology, the literature reviewed, and barriers and enablers of effectiveadvocacy for health equity.