BS-M5-A1

PRESIDENT'S MESSAGE: Karethy (Kay) Edwards, DrPH, C-NP

Inequality in Healthcare

In 1999 the United States Congress asked the scientists atthe Institute of Medicine (IOM) to compare tbe qualityof healthcare that non-white racial populations receive with the healthcare that white populations in the United States (Smedley, Stith, & Nelson, 2003). After four years of extensive study the IOM reported ".. .that patients' race and ethnicity significantly predict the quality and intensity of care that they receive" (Smedley, Stith & Nelson, 2003, p. 79). Unequal care is pervasive in the healthcare system and reflects wide disparities between the quality of care delivered to non- white and white populations. These findings'substantiate the daily experiences of less than optimal healthcare tbat non- whites encounter in the healthcare system. The IOM report is significant because healthcare is a basic fundamental need and healthcare disparities lead to poor outcomes for non-whites. In particular, African Americans struggle more than they should from illnesses that have successful therapies and die sooner than they should.

In 2003 Congress commissioned the Agency for Healthcare Research and Quality (AHRQ) to monitor and report on the trends in the disparities in healthcare delivery among racial ethnic non-white populations and low-income populations (AHRQ, 2010). In the most recent AHRQ report, five core measures, effectiveness, patient safety, timeliness, patient centeredness and access to care were evaluated according to prevention, acute care, chronic care, and outcome. Overall, the findings indicated no improvement in decreasing health disparities according to race, ethnicity and socioeconomic status. Specifically, the findings revealed that African Americans and Native American Indians received worse care than their white counterparts on forty percent of the five core measures (AHRQ, 2010).

The persistence of these disparities is unacceptable and warrants immediate action. Professional nurses and nurse educators are uniquely qualified to address patient care effectiveness, patient safety, timeliness, patient centered care and access to care. In particular, access to care could be greatly improved by autonomous practice and recognition of Advanced Practice Nurses (APNs). Therefore, the Association of Black Nursing Faculty (ABNF) "... strongly advocates for the autonomous practice and recognition of Advanced Practice Nurses (APNs) as independent care providers by alb local, state, and f̂ ederal healthcare agencies and third party payers nationwide" (Association of Black Nursing Faculty, 2010, p. 1). If you are a nurse educator or nursing student, ABNF invites your participation in the movement to decrease healthcare disparities. Join our Public Policy Committee. For more information about ABNF's Policy Brief, contact us at httD://www.abnf.net/public.

REFERENCES Agency for Healthcare Research and Quality. (2010). National

healthcare disparities report Retrieved from http://www.ahrq. go v/qual/qrdr 10. htm

Association of Black Nursing Faculty. (2010). Endorsement of advanced practice nurses as independent practitioners. Retrieved from http://www.abnf.net/publicpolicy.html

Smedley, B.D., Stith, A. Y.,& Nelson, A. R. (Eds.). (2003). Unequal treatment: Confronting racial and ethnic disparities in healthcare. Washington, DC: The National Academies Press.

IN MEMORY OE...

Brigadier General Hazel Winifred Johnson-Brown,USA Retired, PhD, RN, FAAN, a dedicated andloyal ABNF member, died on August 5, 2011 in Wilmington, DE at the age of 83. Dr. Johnson-Brown was the first African American woman to be promoted to Army general in 1979, while at the same time the first to command the Army's over 7,000 nurses in the position of Chief of the US Army Nurse Corps.

Bom in West Chester, PA on October 10, 1927, as one of seven children. Dr. Johnson-Brown aspired to be a nurse from a young age. After graduating from Harlem Hospital School of Nursing in 1950, she enlisted in the Army in 1995 after President Harry S. Truman barred discrimination and segregation in the military services. She received her bachelor's degree in nursing from Villanova University in 1959, a master's degree from Columbia University and her doctorate from the Catholic University of America. During the 197O's, Dr. Johnson-Brown was director of the Walter Reed Institute of Nursing. Her military decorations included the Distinguished Service Medal, the Legion of Merit, the Meritorious Service medal, and the Army Commendation Medal. She was twice named Army Nurse of the year.

After retiring from the Army as chief nurse of the Nurse Corps, she became the assistant dean of the University of Maryland School of Nursing, the director of the George Mason University's Center for Health Policy and the director of the American Nurses Association's Government Relations Department.

ABNF is saddened by the loss of Dr. Johnson-Brown and will treasure memories of her active participation in our early growth.

The ABNF Journal Fall 2011

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