AAN News & Opinion
Achieving advance care planning in diverse, underserved populationsThere remains a gap in meeting the palliative and end-of-life (EOL) care needs, including advance care planning (ACP) needs of ethnic minority, under-resourced, veterans, and lesbian, gay, bisexual, transgender, and queer (LGBTQ) Americans, as well as persons with disabilities and residing in geographically isolated regions. Intersecting socially constructed characteristics influence the lived experience of marginalized communities, including their health-care experiences. These persistent gaps pose a serious barrier to achieving high-quality care, including palliative and EOL care, across the life span of members of these growing populations.
African-American mothers' persistent excessive maternal death rates“Maternal health has significantly improved in the 21st century, but too many women continue to die or suffer severe pregnancy complications every year” (Centers for Disease Control and Prevention, 2016). African-American mothers in the United States die more often than their counterparts during childbirth and delivery. Research findings highlight disparity among African-American mothers as it relates to childbearing (Research overview of maternal mortality and morbidity in the United States). A focus on disparities during childbearing has been a national priority with federal support programs directed toward improving the health disparities of Maternal and Infant Health (MIH) among disadvantaged populations ( https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm ).
An effective human papillomavirus vaccination policy will reduce infection- and malignancy-related morbidity and mortalityTwelve human papillomaviruses (HPVs) are classified as strong human carcinogens, commonly referred to as high-risk HPVs (hrHPVs), and are responsible for nearly all cervical malignancies and 40% to 50% of all vaginal and vulvar cancers in women (Bouvard et al., 2009; International Agency for Research on Cancer, 2006; International Agency for Research on Cancer (IARC) Working Group on Evaluation of Carcinogenic Risks to Humans, 2007). Together these hrHPVs are the cause of ≥75% of anal and perianal cancers in male and female adults (Bosch & de Sanjose, 2003; Clifford, Smith, Plummer, Munoz, & Franceschi, 2003; Munoz, 2000; Walboomers et al., 1999).
Nurses play essential roles in reducing health problems due to climate changeClimate change is endangering the stability of the planet's ecological systems and poses untoward risks to the continued survival of humans (Kurth, 2017; Landrigan et al., 2017; Melillo, Richmond, & Yohe, 2014; Watts et al., 2017). In our communities, climate change is experienced as increased frequency and intensity of wildfires, heat waves, winter storms, hurricanes, and floods, as well as changes in vector distribution. Climate- and weather-related conditions affect health conditions as diverse as asthma, sudden cardiac death, premature birth, gastrointestinal illness, depression, malnutrition, and vector-borne illness (Schifino, Lallo, De Sario, Davoli, & Michelozzi, 2013; Sheffield & Landrigan, 2011).
Critical conversation: Toxic stress in children living in povertyOn October 27, 2017, the American Academy of Nursing President and Executive Vice President/Chief Operating Officer Children's Mercy Kansas City Karen Cox, PhD, RN, FAAN, convened a critical conversation on Toxic Stress in Children Living in Poverty. An invitation-only event, the critical conversation was launched in response to the Robert Wood Johnson Foundation's Culture of Health working group that met in 2016 on eliminating childhood poverty. Among the approximately 100 participants who assembled at the National Press Club, Washington, DC, were representatives of 33 organizations and 15 universities including First Focus, the Child Welfare League of America, Zero to Three, the Association for the Education of Young Children, the Campaign for Grade-Level Reading, National Association of Social Workers, and the Coalition to Stop Gun Violence.