Advocacy Area
In the first two Discussions, you identified a vulnerable or marginalized population for whom you can determine an issue that could be addressed through engaging in policy advocacy. Now it is time to present this advocacy area with evidence to support and defend your selection.
For this Assignment, you will explain and defend your selected advocacy issue. Using evidence and experience, you will determine the advocacy issue most important to your practice and organization. Why are you selecting this issue? Why is this an area of high need? How might this area be improved with policy? What can you do to advocate for this area of need?
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare
- Review resources associated with vulnerable or marginalized populations to determine an advocacy issue.
- Consider which advocacy issue you find most important, and why.
- Consider how policy might help to mitigate this need.
The Assignment: (1 page)
Select an issue you find most important, and then defend your position in a persuasive paper.
Submit a 1-page persuasive argument defending why you selected the advocacy issue to move forward with as your priority in this course.
Supportwith evidencewhy this advocacy issue is most important, and how it might be mitigated or eliminated through policy. Consider how this issue might set your policy agenda.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Walden Writing Center Sample Paper provides an example of those required elements (available at
). All papers submitted must use this formatting.
–
–
–
- Dawes, Daniel E. (2020). The political determinants of health . Johns Hopkins University Press.
- Chapter 3, The Political Determinants of Health Model (pp. 41-77)
=
=
=
my post
Allegory of the Orchard
Dawes (2020) shows that health inequities are not accidental but from political choices that affect the environments in which individuals reside. Trees planted on fertile soil grow well, and trees planted in rocky soil or soils that contain few nutrients do not grow well. The soil symbolizes political determinants of health and is the laws, policies, and institutional practices that disproportionately allocate resources and opportunities. As a psychiatric mental health nurse practitioner in New Jersey, I observe the adverse effects of these determinants on patients with severe mental illness (SMI), especially the uninsured, the underinsured, and those in the criminal justice system.
Structural aspects, including poor Medicaid reimbursement, restrictive scope-of-practice legislation, housing instability, and disjointed funding of behavioral health, directly affect the outcomes of many of my patients. Dawes (2020) contends that social determinants of health are shaped by political factors that influence access to quality education, employment, transport, and healthcare. Inadequate funding in the community context usually contributes to revolving-door hospitalization in psychiatric practice. Policies and whatnot that do not emphasize parity in mental health care are among the reasons leading to low outpatient follow-ups, nonadherence to medication because of its cost, and long emergency department boarding (Brooks et al., 2024). Such political choices result in “poor soil,” in which patients with SMI are more likely to be in homeless conditions, have substance use disorder, and commit suicide than the general population.
As stated by Porche (2023), nurses need to be aware of the role of healthcare systems and policies on care delivery and patient access. In Chapter 6, the author points out that the payment system and regulatory environment can define which services are reimbursable and sustainable. Patients are victims when policies are biased toward acute care rather than prevention and community-based health services. The work of advocates should be equity rather than equality. Equality would allocate equal resources to the whole population; equity would recognize the fact that disadvantaged communities would require additional resources to access information and to get rid of historical and structural injustices (Chidambaram et al., 2024). This, in the orchard allegory, would translate to knowingly fertilizing the soil of struggling trees without necessarily thinking that the required watering amount is adequate.
As a nurse practitioner, I am in a unique position to actively participate in the politics of addressing these determinants. Nurses have consistently been rated among the most trusted professionals, and, as we are in close contact with patients, we get firsthand experience of policy failures. We get to see how prior approval slows down the prescribing of psychiatric drugs, how insurance gaps lead to a break in care, and how housing policies influence a relapse. Porche (2023) reminds us that the concept of policy engagement is not an option but a professional necessity.
My advocacy can be conducted at many levels: I can become a member of state-level professional associations, support bills strengthening mental health parity, and work with policymakers on reimbursement reform. Additionally, by sharing data and patient stories without blowing the whistle, it can shed light on the practical implications of political inaction worldwide. Health outcomes can be improved by intervening in the upstream political determinants.
Ultimately, this asks medical professionals to consider systemic forces and look at an individual’s behavior differently. As a psychiatric mental health nurse practitioner, I have an ethical and professional duty to create a healthier “soil” by engaging in policy making so that the vulnerable patients can have equal access to quality mental healthcare services.
References
Brooks, E., Godziewski, C., & Deruelle, T. (2024). The political determinants of health and the European Union. Journal of Health Politics, Policy and Law, 49(5), 673-689.
Chidambaram, S., Jain, B., Jain, U., Mwavu, R., Baru, R., Thomas, B., … & Darzi, A. (2024). An introduction to digital determinants of health. PLOS digital health, 3(1), e0000346.
Dawes, D. E. (2020). The political determinants of health. Johns Hopkins University Press.
Porche, D. J. (2021). Health Policy: Applications for Nurses and Other Healthcare Professionals:. Jones & Bartlett Learning.