Diversity, Equity, & Inclusion in Nursing Practice
This guide is designed to provide resources and information to support nursing students and professionals in understanding and implementing DEI principles in their practice. Here, you will find scholarly articles, books, multimedia resources, and practical tools to enhance your knowledge and skills in creating inclusive and equitable healthcare environments.
What is DEI?
Importance of DEI in Nursing Practice
Diversity, Equity, and Inclusion (DEI) are crucial in nursing practice for several reasons, fundamentally impacting patient care, healthcare outcomes, and the work environment for healthcare professionals. Here are the key reasons why DEI is important in nursing practice:
DEI Frameworks and Models in Nursing Practice
Overview of Specific DEI Models in Nursing Practice
Cultural Competence
Cultural competence in nursing refers to the ability of healthcare providers to understand, respect, and effectively interact with patients from diverse cultural backgrounds. It encompasses a set of behaviors, attitudes, and policies that enable nurses to work proficiently in cross-cultural situations.
Importance in Nursing:
Understanding Health Disparities:
Health disparities refer to the differences in health and healthcare access, quality, and outcomes experienced by various population groups. These disparities are often seen along the lines of race, ethnicity, socioeconomic status, gender, age, disability, geographic location, and sexual orientation.
Key Areas of Health Disparities:
Access to Healthcare: Certain populations, such as low-income individuals and racial minorities, may face barriers to accessing healthcare services. These barriers can include lack of insurance, transportation issues, and shortages of healthcare providers in their area.
Quality of Care: Even when access to healthcare is available, the quality of care received can vary significantly. Studies have shown that minority groups often receive lower quality care compared to their white counterparts, even when insurance status and income are controlled.
Health Outcomes: Disparities in healthcare access and quality contribute to different health outcomes among population groups. For example, African Americans and Hispanics have higher rates of chronic conditions such as diabetes and hypertension, and they also experience higher mortality rates for diseases like cancer and heart disease.
Preventive Services: Disparities also exist in the utilization of preventive services, such as vaccinations, cancer screenings, and prenatal care. These services are critical for early detection and prevention of diseases but are less frequently accessed by disadvantaged populations.
Examples of Health Disparities:
Exploration of Social Determinants of Health (SDOH):
Social determinants of health are the non-medical factors that influence health outcomes. These include the conditions in which people are born, grow, live, work, and age, as well as the broader set of forces and systems shaping the conditions of daily life. Addressing these determinants is essential for improving health equity and reducing health disparities.
Key Social Determinants of Health:
Socioeconomic Status (SES): SES encompasses income, education, and occupation. Lower SES is associated with higher rates of chronic diseases, reduced access to healthcare, and poorer overall health outcomes.
Education: Education impacts health literacy, employment opportunities, and income levels. Higher educational attainment is linked to healthier lifestyles and better health outcomes.
Neighborhood and Physical Environment: The quality of housing, availability of healthy food, safety, and environmental conditions in a neighborhood significantly affect residents' health. Poor housing conditions and exposure to pollutants can lead to a range of health problems.
Employment: Employment provides income and often access to health insurance and other benefits. Unemployment and underemployment can lead to financial stress, limited access to healthcare, and adverse health outcomes.
Social Support Networks: Strong social support from family, friends, and the community is associated with better health outcomes. Social isolation and lack of support can increase stress and negatively impact mental and physical health.
Examples of Social Determinants Impacting Health:
National Center for Cultural Competence (NCCC): Offers a variety of training programs, resources, and tools to enhance cultural and linguistic competence in healthcare
Transcultural Nursing Society (TCNS): Provides certification programs, conferences, and continuing education opportunities focused on transcultural nursing
American Nurses Association (ANA): Offers resources and courses on cultural competence and diversity in nursing practice
Local Workshops and Seminars: Check with local healthcare organizations, hospitals, and your nursing programs for workshops and seminars on cultural competence. Many offer specialized training tailored to the needs of their community.
Ailing in Place: environmental inequities and health disparities in Appalachia by
In Ailing in Place, Michele Morrone explores the relationship between environmental conditions in Appalachia and health outcomes that are too often ascribed to individual choices only. She applies quantitative data to observations from environmental health professionals to frame the ways in which the environment, as a social determinant of health, leads to health disparities in Appalachian communities. These examples--these stories of place--trace the impacts of water quality, waste disposal, and natural resource extraction on the health and quality of life of Appalachian people. Public health is inextricably linked to place. Environmental conditions such as contaminated water, unsafe food, and polluted air are as important as culture, community, and landscape in characterizing a place and determining the health outcomes of the people who live there. In some places, the state of the environment is a consequence of historical activities related to natural resources and cultural practices. In others, political decisions to achieve short-term economic objectives are made with little consideration of long-term public health consequences.
American Health Crisis by
A history of U.S. public health emergencies and how we can turn the tide. Despite enormous advances in medical science and public health education over the last century, access to health care remains a dominant issue in American life. U.S. health care is often hailed as the best in the world, yet the public health emergencies of today often echo the public health emergencies of yesterday: consider the Great Influenza Pandemic of 1918-19 and COVID-19, the displacement of the Dust Bowl and the havoc of Hurricane Maria, the Reagan administration's antipathy toward the AIDS epidemic and the lack of accountability during the water crisis in Flint, Michigan. Spanning the period from the presidency of Woodrow Wilson to that of Donald Trump, American Health Crisis illuminates how--despite the elevation of health care as a human right throughout the world--vulnerable communities in the United States continue to be victimized by structural inequalities across disparate geographies, income levels, and ethnic groups. Martin Halliwell views contemporary public health crises through the lens of historical and cultural revisionings, suturing individual events together into a narrative of calamity that has brought us to our current crisis in health politics. American Health Crisis considers the future of public health in the United States and, presenting a reinvigorated concept of health citizenship, argues that now is the moment to act for lasting change.
Health Equity, Diversity, and Inclusion by
The second edition of this forward-thinking text goes beyond the discussion of health disparities to highlight the importance of health equity. Health Equity, Diversity and Inclusion: Context, Controversies, and Solutions helps the reader understand key social justice issues relevant to health disparities with an eye to creating greater health equity - taking the reader from the classroom to the real world to implement new solutions.Key Features:- Two new chapters: one on the impact of urban education on urban health (Ch 4) and another covering the elderly and health equity (Ch 10)- Updated and enhanced coverage on men's health, demographic data, the importance of cultural proficiency, maternal mortality and Black women, and much more.- Current trends and movements, including the role of social media in the provision of health care information for improved health literacy; mass incarceration and criminal justice reform; and new efforts toward resolving health disparities.- Case studies and problems that engage students in thinking about health disparities/equity and diversity issues and prompt them to consider possible solutions.
Interrogating Gendered Pathologies by
Interrogating Gendered Pathologies points out and critiques unjust patterns of pathology. Erin A. Frost and Michelle F. Eble assemble a transdisciplinary approach from/to technologies, rhetorics, philosophies, epistemologies, and biomedical data to consider the effects of biomedicine's gendered norms on people's lives. Using a range of complementary and intersectional theoretical approaches, contributors ask questions about rhetoric's role in healthcare and how it differs depending on patient embodiment and the ways nonnormative bodies are pathologized. These chapters engage common narratives about the ways in which gender in healthcare is secondary and highlights the stories of people who have battled to prioritize their own bodies through extraordinary difficulties. Employing a multiplicity of voices, the book represents a number of different perspectives on what it might look like to return health and medical data to embodied experience, to consider the effects of gendered and intersectional biomedical norms on lived realities, and to subvert the power of institutions in ways that move us toward biomedical justice. This collection contributes to the burgeoning field of health and medical rhetorics by rhetorically and theoretically intervening in what are often seen as objective and neutral decisions related to the body and to scientific and medical data about bodies. Interrogating Gendered Pathologies will be of interest to feminist scholars in the field of rhetoric and writing studies, specifically those in the rhetorics of health and medicine, as well as scholars of technical communication, feminist studies, gender studies, technoscience studies, and bioethics. Contributors: Leslie Anglesey, Mary Assad, Beth Boser, Lillian Campbell, Marleah Dean, Lori Beth De Hertogh, Leandra Hernandez, Elizabeth Horn-Walker, Caitlin Leach, Jordan Liz, Miriam Mara, Cathryn Molloy, Kerri Morris, Maria Novotny, Sage Perdue, Colleen Reilly
Sickening : anti-black racism and health disparities in the United States by
An event-by-event look at how institutionalized racism harms the health of African Americans in the twenty-first century A crucial component of anti-Black racism is the unconscionable disparity in health outcomes between Black and white Americans. Sickening examines this institutionalized inequality through dramatic, concrete events from the past two decades, revealing how unequal living conditions and inadequate medical care have become routine. From the spike in chronic disease after Hurricane Katrina to the lack of protection for Black residents during the Flint water crisis--and even the life-threatening childbirth experience for tennis star Serena Williams--author Anne Pollock takes readers on a journey through the diversity of anti-Black racism operating in healthcare. She goes beneath the surface to deconstruct the structures that make these events possible, including mass incarceration, police brutality, and the hypervisibility of Black athletes' bodies. Ultimately, Sickening shows what these shocking events reveal about the everyday racialization of health in the United States. Concluding with a vital examination of racialized healthcare during the COVID pandemic and the Black Lives Matter rebellions of 2020, Sickening cuts through the mind-numbing statistics to vividly portray healthcare inequalities. In a gripping and passionate style, Pollock shows the devastating reality and consequences of systemic racism on the lives and health of Black Americans.
Strategies for Deconstructing Racism in the Health and Human Services by
Building on the successful outcomes of a five-year initiative undertaken in New York City, Alma Carten, Alan Siskind, and Mary Pender Greene bring together a national roster of leading practitioners, scholars, and advocates who draw upon extensive practice experiences and original research. Together, they offer a range of strategies with a high potential for creating the critical mass for change that is essential to transforming the nation's health and human services systems. Strategies for Deconstructing Racism in the Health and Human Services closes the gap in the literature examining the role of interpersonal bias, structural racism, and institutional racism that diminish service access and serve as the root cause for the persistence of disparate racial and ethnic outcomes observed in the nation's health and human services systems. The one-of-a-kind text is especially relevant today as population trends are dramatically changing the nation's demographic and cultural landscape, while funds for the health and human services diminish and demands for culturally relevant evidence-based interventions increase. The book is an invaluable resource for service providers and educational institutions that play a central role in the education and preparation of the health and human service workforce.
Tackling Causes and Consequences of Health Inequalities by
Addressing health inequalities is a key focus for health and social care organizations. This book explores how best frontline health workers in areas of deprivation can address these problems. Aimed at doctors and their wider multidisciplinary teams, this book provides key knowledge and practical advice on how to address the causes and consequences of health inequalities to achieve better outcomes for patients. Considering the psychological, financial and social aspects of well-being as well as health concerns, this book offers a concise but comprehensive overview of the key issues in health inequalities and, most importantly, how practically to address them. Key Features Comprehensively covers the breadth of subjects identified by RCGP's work to formulate a curriculum for health inequalities The first book to address the urgent area of causes and consequences of health inequalities in clinical practice. Chapters are authored by expert practitioners with proven experience in each aspect of health care. Applied, practical focus, demonstrating approaches that will work and can be applied in 'every' situation of inequality. Provides evidence of how community based primary care can make a change.
Transgender and Gender Diverse Health Care: the Fenway Guide by
The first case-based comprehensive textbook to address the unique health care needs of transgender and gender diverse adults A Doody's Core Title for 2023! Demand for state-of-the-art health care services for transgender and gender diverse communities is rapidly increasing. Transgender and Gender Diverse Health Care: The Fenway Guide offers a roadmap for clinicians to provide culturally responsive care that meets the primary, preventive, and specialty health needs of transgender and gender diverse adult patients. With the most up-to-date scientific and clinical information, this practical guide reviews new data on terminology, demographics, and epidemiology; highlights key aspects of gender identity emergence across the lifespan; and provides guidance on both hormonal and surgical gender affirmation. Applying a health-equity model of care, this invaluable resource offers a foundation for clinicians when addressing health needs of transgender and gender diverse communities. Transgender and Gender Diverse Health Care: The Fenway Guide features essential information that includes the following topics and more: The history and epidemiology of transgender and gender diverse health care Primary, preventive, and specialty care considerations for transgender and gender diverse patients Hormonal, surgical and non-medical gender affirmation Trauma-informed and gender-affirming care Behavior health, eating disorders and body positivity Reproductive health, obstetrical care, and family building Treatment of HIV and sexually transmitted infections Community building, advocacy and partnership
Treating Contemporary Families by
Linking research with clinical practice, this text shows therapists how to do evidence-based practice when treating contemporary families. Today's families are diverse and complex, and their problems do not always improve when treatment focuses on addressing a diagnosis. To achieve successful, lasting change, therapists must help families change their patterns of interaction. This book examines several common interactional challenges that contemporary families face, such as co-parenting, divorce, intimate partner violence, blending families, and loss and bereavement. Contributors examine research on each challenge alongside research on various diverse family types and offer targeted interventions for each family type. With its strong emphasis on inclusion, social justice, and evidence-based practice, this book will help clinicians work with today's diverse families in effective, empathic, and culturally responsive ways.