week 4 DQ response

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”


  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Response posts: Minimum 300 words excluding references.

Peer DQ1

Civil Rights and Health Care

Public health is the promotion of health to a group, large or small, and for disease prevention (Mason, Gardner, Outlaw & O’Grady, 2015) utilizing multiple organizations and agencies that are integral in the process of the health care system. It is no secret that access to health care in the United States is not equal and varies by race, gender, nativity, income and other factors such as social power, resource and status (Mason, Gardner, Outlaw & O’Grady, 2015). Unfortunately, these increased barriers in health care lead to unhealthier populations. This paper will review health care policies and related factors to health care, the Affordable Care Act (ACA) and health care reform. Since health care is limited to certain populations, we as nurses are responsible and competent to ensure patients’ civil rights and access to health care

Multiple factors affect quality of health care and any difference in health care is considered a disparity. (Almgren, 2018). Even though the ACA, Medicaid and Medicare insure many, there are still risks and benefits that are dependent on the sociology of the professional medical encounter. Biases, such as the stigma of being on Medicare, or “assistance”, can adversely affect the care sought and access, resulting is lesser health of a population or community.

Affordable Care Act provided health care access to many who would not have received health care. The health care crisis has been described by conservative politicians as federal health care spending at an unsustainable level leading to disastrous results in our national economy. While liberal politicians blame documented health care system failures resulting in unavailability of health care to Americans. The growth of health care has resulted in increased use of federal funds due to Medicare and Medicaid programs.

Health care reform is the federal government’s action to change financing, structure and health care delivery services. Consumers who may feel well-served are supportive of current health system and may include industrial employees, citizens who are middle income, and federal government employees. Those who are not well served may find the system unfavorable, such as employees in the service industries, workers who are undocumented or geographically isolated, and the working and nonworking poor. (Almgren, 2018). Basically, if we benefit from the current system we will view it favorably and oppose change, but those who aren’t benefitting, favor public assistance or universal coverage for health care.

According to HealthyPeople2020 (2104), the biggest barrier to health care access is limited insurance coverage, which causes poor health outcomes leading to disparities in health. Underinsured on those with higher out of pocket costs are less likely to access preventative health care, even for chronic health conditions, immunizations and well visits. Also, poorer populations may have less access to transportation to get to medical visits. ACA’s goal was to provide nearly universal health care coverage through insurance mandates, expansion of program for public entitlement and regulatory insurance market forums.

Initially, to increase civil right awareness in health care, nurses must recognize the population that is at risk and what risk factors exist. Medical professionals are regarded as stakeholder in relation to health care reform issues. Evidence shows there are issues that need to be addressed to understand the nurse’s potential contribution to patient care and civil rights. Accordingly, nursing involvement is required to be at the leadership level by practice, policy, scientific and professional through social and economic avenues (Shamian & Ellen, 2016). Within health reform, nurses play a major role in patient-centered health care, not only by health care reform but realizing social impacts in their community or society. Evidence based findings support the economic impact that healthier populations and adequate nursing staffing to care for them lead to lower hospital costs, less admissions or readmissions saving costs within the health system, and the sooner patient return to work force, resulting in improved outcome economically.

In closing, nurses need to be aware of own knowledge and skills and put time and effort into evidence-based communication, advocacy, decision and policymaking and continually strive to meet the needs of populations and healthcare. Increased socialization, training and education in the social and economic areas lead to engagement in policy and politics (Shamian & Ellen, 2016). According to Doshi, Hendrick, Graff & Stuart (2016) evaluation of data and policies are necessary to remove barriers so resources can be utilized, and revisions made to current policies. Notably, instead of focus on own affiliations and interests, the investigator and stakeholder should focus on quality of research and the intent, decreasing bias to achieve optimal evidence-based policies and standards.


Almgren, G. (2018). A social justice analysis. Health Care Politics, Policy, and Services (3rd

ed.). New York, NY: Springer.

Doshi, J. A., Hendrick, F. B., Graff, J. S., & Stuart, B. C. (2016). Data, data everywhere, but

access remains a big issue for researchers: A review of access policies for publicly

funded patient-level health care data in the United States. The Journal for

Electronic Health Data and Methods, 4(2), 1–20. Retrieved from


HealthyPeople.gov. 2014. Access to health services. Office of Disease Prevention and Health

Promotion. Retrieved from https://www.healthypeople.gov/2020/topics-


Mason, D.J., Gardner, D.B., Outlaw, F.H., & O’Grady, E.T. (2015). Policy & Politics

in Nursing and Health Care. (7th ed.). St Louis, MO: Elsevier

Shamian, J. & Ellen, M.E. (2016). The role of nurses and nurse leaders in realizing the clinical,

social, and economic return on investment of nursing care. Healthcare Management

Forum, 29(3), 99-103. Retrieved from




Peer DQ 2

The U.S. has long been of country of stigmas placed on those of lower socioeconomic and minority statuses. This is no different when assessing access to health care and disparities in health care related to those of lower socioeconomic and minority statuses. While many strides have been made to alleviate those stigmas, thus increasing access to care, the fact remains that disparities still exist. This posting will discussion the implications of health care policy of issues related to access, equity, quality, and cost, while also examining impact of limited access to care by the uninsured, underinsured, and vulnerable populations.

Repressed citizens within the U.S. struggle to provided daily necessities, including food, clothing, and housing, for themselves and their families. Health care access has often been viewed in this country as a priviledge for those that can afford it as opposed to a right in which every citizen should be granted. This can also be referred to as health inequality, whereas health equality would present with all citizens an equal opportunity to utilize proper health care access (Mason, Gardner, Hopkins Outlaw & O’Grady, 2015).

Health inequalities often lead to higher health care costs due to those with disparities often not seeking care until costly and invasive interventions are required (de Boer, Buskens, Koning, & Mierau, 2019). Furthermore Mason et al., (2015) correlates health inequalities to poor access to care which can be attributes poor access to care to lack of preventative care including cancer screenings, infant mortality, routine wellness exams.

Lower socioeconomic status is often attributed to increased health disparities due uninsured, underinsured, or of vulnerable population. Lack of ability to pay for costly care can be a deterrent for those people to seek care early on instead of requiring care when one’s health status is declining due to lack of care. Changes in policy has long been a focus of government for decades. The enactment of the Affordable Care Act (ACA) in 2010 became the first in many years to address disparities and alleviate the need for costly, invasive health care by promoting routine, preventative care (Mason et al., 2015). Mason et al. (2015) further explains that state funded health care coverage expansion achieves the disparities for uninsured. Though this has been one of the first policies to address disparities in many years, the ACA has been contested for years with the future of the policy has a whole uncertain (Mason et al., 2015).

In conclusion, health disparities for those of lower socioeconomic status and of minority backgrounds exist which can drive health care expenses up, the need for change is apparent. Though there has been much contention against newer policies to aid in decreasing health disparities across the country, they need for improvements in the U.S. health is apparent.


de Boer, W., Buskens, E., Koning, R., and MIerau, J. (2019). Neighborhood socioeconomic stats and health care costs: A population-wid study in the Netherlands. American Journal of Public Health, 109(6), 927-933. doi: 10.2105/AHPJ/2019.305035

Mason, D., Gardner, D., Hopkins Outlaw, F., & O’Grady, E. (2015). Policy and politics in nursing and health care. (7th ed.). St. Louis, MO: Elsevier.

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