NUR 514 CLC – When Patient Advocacy Meets Policy: Lobbying for Health Care Change Presentation

NUR 514 CLC – When Patient Advocacy Meets Policy: Lobbying for Health Care Change Presentation

NUR 514 CLC – When Patient Advocacy Meets Policy: Lobbying for Health Care Change Presentation

Healthcare Issue

Diabetes is a critical public health issue affecting American public health system. It is a disorder that is caused by the lack of or poor utilization of the insulin in the body. Diabetes can be classified into two types. They include diabetes type 1 and diabetes mellitus type 2. Diabetes mellitus type 1 arises from the production of antibodies that attack insulin producing cells in the pancreas. Diabetes mellitus type 2 accounts for a majority of people with diabetes mellitus disease. It is mainly caused by a combination of factors that include insulin resistance and deficiency in the secretion of insulin in the pancreatic beta cells. The risk factors for this type of diabetes include overweight, tobacco use, hypertension, ethnicity, advancing age, and family history of diabetes. Diabetes mellitus can be managed using a number of interventions that include physical exercises, dietary modifications, and use of medications (Roglic, 2016).

The rate of diabetes in America is significantly high. It is estimated that it affects about 9.4% of the American population, which translates into 30 million people. There is a high rate of inequalities in the populations affected by diabetes in America. Accordingly, the ethnic minorities have been shown to be affected disproportionately by it when compared to native American whites. For example, the Center for Disease Control estimated that about 15.1% of the patients affected by diabetes in America comprised of the American Indians or Alaska Natives. This was followed by Asians (8%), Hispanics (12.1%), Blacks (12.7), and white non-Hispanic (7.4%). Diabetes is ranked among the leading causes of mortalities in the US. Its overall contribution to mortality rates is at 3%. This rate is comparable to that caused by cancers, cardiovascular diseases, injuries, respiratory diseases, and communicable, perinatal, nutritional, and maternal conditions (WHO, 2016).

Diabetes is also a serious public health issue of concern in Arizona. According to the Arizona Department of Health Services, it contributes to not only early disability but also significant mortalities in the population. The mortalities arise from poor management of the disease, which leads to complications such as kidney disease, stroke, heart disease, blindness, lower leg amputation, and nerve damage. It is currently estimated that about 600, 000 people in Arizona are diabetic. This statistics is attributed to the majority of the population that is yet to be tested for the disease. There is a great similarity in the populations at risk between the general statistics of the US and those of Arizona. Accordingly, race as well as ethnicity play a critical role in the development of diabetes in Arizona. Pacific Islanders, Hispanics, African Americans, American Indians, and Asian Americans are highly at a risk of developing the disease (ADHS, 2019).

Relevance to my Role

The selected health issue is relevant to my role as an advanced practice nurse in a number of ways. Advanced

NUR 514 CLC - When Patient Advocacy Meets Policy Lobbying for Health Care Change Presentation
NUR 514 CLC – When Patient Advocacy Meets Policy Lobbying for Health Care Change Presentation

practice nurses are tasked with the responsibility of implementing interventions that will promote the health and wellbeing of the diverse populations. They ensure that safe environments are provided to the populations to minimize their risk of developing health problems and diseases. They also provide services such as screening and health education to promote the health and wellbeing of the public. There exist significant disparities in access to and utilization of the available healthcare services by the American populations. The minorities are largely affected by the inequalities in health alongside their predisposition to health problems, including diabetes. As a result, advanced practice nurses have the responsibility of ensuring that strategic interventions that promote equity in healthcare are embraced. Lastly, the health issue is relevant to my role since it increases the need for the adoption of interventions that strengthen policy actions in healthcare. It raises the relevance of the roles played by advanced practice nurses in championing the adoption of policies that enhance equity in healthcare.

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Relevance to my Scope

The roles of advanced practice nurses are varied. The health issue of concern in this presentation supports some of these roles. One of them is increasing the relevance of community health focus in advanced practice nurses’ role. The high prevalence of diabetes in Arizona implies that APNs have to engage in activities that aim at addressing the health issue at the community level. This includes engaging actively in community-based interventions that raise awareness and promote lifestyle and behavioral change. The health issue also raises the need for APNs engaging in activities that promote preventive health in the populations at risk. This includes the provision of health education and screening services to identify those affected and at risk for immediate management. The population is also educated on the need for lifestyle and behavioral modifications for their optimum health. The health issue is also relevant to APNs role because it increases the need for patient-centeredness in care and utilization of evidence-based data in meeting their needs. Accordingly, APNs must explore the available evidence that can be utilized to meet the individual needs of the target population. Through it, they will maintain their obligation to meeting the health needs of their societies.

Relevance to My Population

My state is Arizona. The population of Arizona is highly at a risk of being affected by diabetes. As shown in the above statistics, it is estimated that one in every three people in the state is pre-diabetic. The reported statistics do not reflect the actual rate of diabetes in the state. For example, a larger percentage of the population of the state have not been tested for the disease. Consequently, it is projected that up to 600, 000 people in Arizona could be at a risk or have been affected by the disease. The health issue is also relevant to my population due to the fact that it affects them disproportionately. In specific, people of ethnic minorities are highly at a risk of developing it when compared to the natives. Consequently, it increases the need for interventions that aim at eliminating the inequalities in the prevalence of the disease. It also increases the need for the adoption of interventions that raise awareness about the disease in the population for them to embrace the desired lifestyle and behavioral modifications.

Proposed Legislation

One of the proposed legislations in the state of Arizona to combat the issue of diabetes is increasing the access of the population to safe as well as affordable active living in their environments. This includes safe and affordable active living in places where people leave, work, learn, worship, and play. According to the state department of health, this legislation aims at ensuring that the citizens engage in active physical activity as a way of preventing and managing diabetes. Active physical exercises are needed to increase glucose metabolism, decrease insulin resistance, and prevent obesity in the population. The other legislation adopted by the state of Arizona is increasing the access of the population to affordable health beverages and foods. This provision ensures that people have access to health foods and beverages in places where they work, live, worship and play. The need for this policy action arises from the fact that unhealthy eating habits contribute significantly to the rise in the cases of obesity in the state. Therefore, increasing access to health beverages and foods could reduce the proportion of the population at a risk of developing the disease (ADHS, 2019).

My Stance

I support the implementation of the proposed legislations to fight against the rising cases of diabetes in Arizona. The legislations aim at promoting the health and wellbeing of the people of Arizona. It also aims at addressing the issue of health inequalities in the state. A number of issues must be considered to ensure the success of the legislations. Firstly, inputs from all the stakeholders to be affected by the legislations should be taken into consideration. An example is the involvement of the healthcare providers in the analysis of the ways in which the legislations can be implemented. The other way is their active involvement in the determination of the critical resources that should be available for the successful implementation of the legislations to be achieved. There is also a need for the active involvement of the public to ensure sustainability of the aims of the legislation alongside empowerment of the adopters.

Methods to Track Bill

A number of methods can be used to track the above legislations. One of them is the use of a bill number. The legislations are assigned with bill numbers, which can be used for tracking purposes. The other way is using media sources that are covering the bill. This includes radio, television, and websites that are interested in the bill. They provide crucial information on the progress of the adoption of the legislations, thereby, informing any further changes in the process. The other way is following a reporter who is covering the bill. He or she will provide first-hand information concerning the adoption progress of the legislations. The government agencies also have legislative tracking sites for the bills. One can use the sites to learn more about the progress of the adoption process. There is also the use of paid services such as professional news tool. This is more applicable in cases where one is tracking multiple bills at the same time. Lastly, experts involved in the legislation can be used for tracking the bill. This includes people such as senators who are involved in ensuring that the bills are passed. They can provide information on the extent in which the bills have been adopted in the state (Bensley & Brookins-Fisher, 2017).

Participating in Lobbying Efforts

Grassroots and direct lobbying will be utilized in getting the legislations implemented. In grassroots lobbying, the focus is placed on creating awareness among the public on the legislations to stimulate interest among them. The strategy works on the premise that the adopted will drive the implementation process of the legislations. A number of grassroots strategies can be utilized. They include using media outreach, mobilizing masses, use of opinion polls, running distributors campaigns, and initiating public participation in forums related to the legislation. Direct lobbying is the other strategy that can be utilized. In this case, the advanced practice nurse faces the legislators and provides them with facts concerning the legislations. This strategy enables the legislators to understand the facts related to the legislations, hence, the development of effective frameworks to address the needs of the majority (Alemanno, 2017).

Lobbying Remarks

In the above statement, the need for the legislation has been made evident. The legislators and the public have been made aware of the threats of diabetes in the state. This is important as it has paved way for the need for legislations to address the issue. In this case, the emphasis has been placed on creating safe environments and increasing access to and affordable healthy beverages and foods.

Implications if it does not Succeed

Failure of the proposed legislations will have significant implications. One of them is wastage of resources. There will be a loss of resources allocated for the implementation of the policies. The resources will include time, money, and skills used for implementation purposes (Brandebo & Alvinius, 2019). The other implication is failure in the realization of the goals of the legislations. One of the goals is the lack of behavioral and lifestyle change among the public. As shown earlier, effective management of diabetes is dependent on the adoption of interventions such as active physical activity and dietary modification. The public should be made aware of these modifications. However, failure of the legislations will imply that the public’s lifestyle and behaviors will not be changed. The consequences of these effects will include an increase in the disease burden in the state as evidenced by the rise in the number of people affected by diabetes.