NURS 6050 Discussion 1: Evidence Base in Design
The selected is the Health Equity and Accountability Act (HEAA) of 2020. A brief background about this act is (congress.gov, 2020) “this bill directs the Department of health, and human services (DHHS) and others to undertake efforts to reduce disparities”. These are disparities that exist particularly in health care.
It has been reported since 2007, HEAA has been introduced by Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC).
The development of HEAA builds on the gains made under the Affordable Care Act (ACA) and lays out a vision of additional investments Congress should make to respond to the policy threats against the health and well-being of the underserved communities, address health disparities and ensure access to quality, affordable health care for all.
In (The health equity and accountability act, n.d.) “Over 300 racial, and health equity organizations, researchers, provider groups, and community-based organizations have contributed to the development of HEAA since its inception”.
I believe there is evidence to support the proposed policy because being a woman of color working in the behavioral health emergency department within a large metropolitan health system, and as a board certified psychiatric, and mental health registered nurse, I have experienced the disparities when providing care to people of color, health care professionals are often dismissive, and or mental health patients are provided less resources than white people. Therefore, the proposed HEAA is needed to overturn systemic disparities in mental health care.
Supporters of HEAA point to statistics that demonstrate the current lack of health equity. HEAA specifically addresses multiple issues such as (Walden University, 2021) “culturally, and linguistically appropriate care, health workforce diversity, and mental health” to mention a few.
For instance, expanding mental, and behavioral services targeting low-income, communities of color because “mental health research has found that while mental health illness is more or less equally prevalent in all groups, members of minority groups enter treatment later and have worse outcomes” (Walden University, 2021). This policy affects me personally and professionally and as a result I am a strong supporter of the health equity and accountability act.
References
The Health Equity and accountability act – unidosus.org. (n.d.). Retrieved January 9, 2022, from https://www.unidosus.org/wp-content/uploads/2021/07/unidosus_heaafactsheet_10819.pdf
H.R.6637 – 116th Congress (2019-2020): Health Equity and … (n.d.). Retrieved January 9, 2022, from
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett Learning.
Walden University. (2021, November 4). The-facts-behind-the-health-equity-and-accountability-act-HEAA. Walden University. Retrieved January 9, 2022, from https://www.waldenu.edu/online-doctoral-programs/phd-in-public-health/resource/the-facts-behind-the-health-equity-and-accountability-act-heaa
RE: Discussion – Week 7
After reviewing the congress website provided in the resources, I chose to discuss Bill S.347 named “Data to Save Moms.” The Democrat Party sponsors this Bill. It was introduced in February of 2021 and has been referred to a committee. This Bill intends to require the CDC to include a program that studies indicators of severe maternal mortality, reviews deaths by suicide, overdose, or other mental health issues in the intra or postpartum periods, and consults representatives from minority areas to determine nonclinical contributing factors (Congress.gov, n.d).
In 2017, The World Health Organization proclaimed that the United States was one of only two countries whose maternal mortality rate was rising, US and the Dominican Republic. Not only is the death rate rising, but the maternal death rate of African American mothers is double that of White mothers and triple that of Hispanic mothers (Declercc and Zephyrin, 2020). Studies include mortality related to pregnancy up to one year after delivery and while pregnant. This Bill ties in both of my specialties as an RN. I work at a mental health facility and an inner-city hospital treating high-risk pregnancies, including substance abuse. This Bill has enough data to support the need for improved medical and mental health care. Postpartum depression affects more than 3 million moms a year, according to Mayo Clinic. Postpartum depression can lead to severe mood disorders or psychoses. Depression or “baby blues” is vaguely covered during RN discharge from the hospital after delivery. There is a gap in treating postpartum mood disorders. OBGYNs typically do not have the qualifications to treat severe mood disorders, leading to new moms trying to find a psych provider while in crisis or caring for an infant. In conclusion, recognition, education, and research is needed to lower American moms’ mortality rate, and this bill would be beneficial.
References
Congress.gov (n.d) retrieved July 9th 2021. Data to Saves Mom Act.
Declercc and Zephyrin (December 2020) Maternal Mortality in the United States: A Primer.
https://www.commonwealthfund.org/publications/issue-brief-report/2020/dec/maternal-mortality-united-states-primer
Mayo Clinic. (n.d) Retrieved July 9th 2021. Postpartum depression.
https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
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Robin Squellati Walden Instructor Manager
RE: Discussion – Week 7
Hi Courtney,
Good post. I would like to see bills focus on combatting the population health cause of maternal morbidity, such as controlling obesity (Nelson et al., 2018). About 80 percent of African American women are overweight or obese (HHS, 2020). America has not been able to make any significant changes toward decreasing obesity, which leads to hypertension and other health conditions. Were there any proposals to tackle any of the underlying causes of maternal morbidity?
Dr. Robin
Nelson, D. B., Moniz, M. H., Davis, M. M. (2018, August 13). Population-level factors associated with maternal mortality in the United States, 1997–2012. BMC Public Health, 18(1007). doi: 10.1186/s12889-018-5935-2
U.S. Department of Health and Human Services, Office of Minority Health. (2020, March 26). Obesity and African Americans.
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CHIBUIKE ENYINNIA
RE: Discussion – Week 7
Dear Courtney,
You did a good job by writing on this bill as it has not gotten the attention it deserves.
Despite the United Nations Millennium Development Goal for a 75% reduction in maternal mortality by 2015, the estimated maternal mortality rate for 48 states and Washington D.C. increased from 2000–2014, while the international trend was in the opposite direction. There is a need to redouble efforts to prevent maternal deaths and improve maternity care for the 4 million U.S. women giving birth each year
It’s unfortunate to read that this bill does not at the moment have bipartisan support.
This bill expands data collection and research on maternal morbidity and mortality among minority populations. Specifically, the bill adds requirements to a program within the Centers for Disease Control and Prevention (CDC) that supports maternal mortality review committees (Congress.gov, n.d).
According to MacDorman, M. et.al 2016” maternal mortality rate that more than doubled from 9.8 maternal deaths per 100,000 live births in 2000 to 21.5 in 2014
References;
MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Recent Increases in the U.S. Maternal Mortality Rate: Disentangling Trends From Measurement Issues. Obstetrics and gynecology, 128(3), 447–455.
Congress.gov (n.d) retrieved July 13th 2021. Data to Saves Mom Act.
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Augaesha Taylor
Augaesha Taylor Reply RE: Discussion – Week 7
Hi Courtney, I enjoyed reading your post. You mentioned about the maternal death rate of African Americans being much higher than those of other ethnicities, why do you think that is so? It is reported that black women in the U.S have a “maternal mortality rate of 44 deaths per 100,000 live births, while the rate for white women is 13 deaths per 100,000 live births” (The U.S Centers for Disease Control and Prevention, n.d.). I am an African American woman of child bearing age and this information is terrifying. I was curious as to why the statistics are as high as they are. I was hoping it wasn’t related to race but from my research that seems to be the number one cause. Black women who are of a lower social class are undervalued. They tend to have a lack of resources which result in poor quality of care during pregnancy. Often times after birth, African American mothers are not monitored carefully and dismissed by their providers when they complain of symptoms (American Heart Association News, 2019, para. 6,7); because of this, preventable issues occur which often times lead to complications or even worse death. This is why it is important for nurses to advocate for their patients regardless of their ethnicity or socioeconomic levels. In my opinion, the passing of Bill S. 347 will save a lot of lives.
Debbie,
Great post. Mental health is an area that needs a lot of improvement. Statistics show that depression, in particular, has a lower
occurrence among African Americans and Hispanics. However, depression in African Americans and Hispanics has a greater chance
of being persistent. (psychiatry.org, n.d.) In 2015, White Americans received 17% more mental health treatment than African
Americans and Hispanics. (psychiatry.org) There are many factors that contribute to this. Discriminating providers and lack of
insurance have been a cause of lack of treatment for the minority population. I too, am all for this policy. We as Americans have to
do better.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett Learning.
Psychiatry.org. (n.d.). Mental Health Disparities: Diverse Populations. American Psychiatric Association. Retrieved January 14, 2022,
from file:///C:/Users/ISD16465/Downloads/Mental-Health-Facts-for-Diverse-Populations.pdf
Thank you for the great post. The COVID-19 Health Disparities Action Act of 2021 was created in reaction to the growing health differences between various populations during the COVID-19 pandemic. The COVID-19 pandemic has underlined the numerous health differences in the United States. These disparities exist between different racial and ethnic groups and socioeconomic groups (Valencia et al., 2022). The act also shows a mission to study and create guidance on addressing health differences associated with COVID-19.
One of the social determinants that most impact this policy is income. Income imbalance is a significant element in health differences, as low-income people and families usually have less access to quality healthcare. The COVID-19 pandemic has worsened these differences, as low-income people are more likely to contract the virus and understand more severe symptoms. The COVID-19 Health Disparities Action Act of 2021 aims to manage these differences by delivering research funding, data collection, and agendas to enhance access to healthcare for vulnerable people.
Another social determinant that impacts this policy is a different race. Discrimination is a significant aspect of health differences, as minority groups are often underserved by the healthcare system (Arredondo, 2021). The COVID-19 pandemic has heightened these differences, as minority groups have more potential to contract the virus and experience more intense symptoms.
References
Arredondo, A. (2021). Health disparities and covid-19. Health Affairs, 40(9), 1514–1514. https://doi.org/10.1377/hlthaff.2021.00887
Valencia, C. I., Gachupin, F. C., Molina, Y., & Batai, K. (2022). Interrogating patterns of cancer disparities by expanding the social determinants of health framework to include biological pathways of social experiences. International Journal of Environmental Research and Public Health, 19(4), 2455. https://doi.org/10.3390/ijerph19042455
