In May of this year the National Academies of Sciences, Engineering, and Medicine released the highly anticipated publication, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.1 This report is the third in a series on the future of nursing. The first report, The Future of Nursing: Leading Change, Advancing Health,2 published in 2011, and the second report, Assessing the Progress on the Institute of Medicine Report on the Future of Nursing,3 published in 2016, focused on the role of nursing in addressing the issue of health equity for all people in the United States. While this latest report was originally set for release in 2020, the COVID-19 pandemic delayed the publication, to address the anticipated needs of the nursing profession for the next decade and provide recommendations that would better prepare nurses for future disasters.
The vision that informs this report is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. The authors sought to "produce a report that would anticipate the needs of the population and the nursing profession for the next decade while advancing a set of recommended actions that can make a meaningful impact on deploying the profession more robustly, so that nurses will be both prepared for disasters in the future and prepared to engage in the complex but essential work of advancing health equity, addressing SDOH, and meeting social needs of individuals and families."(1pp. xiv-xv) The US Department of Health and Human Services defines social determinants of health (SDOH) as the conditions in the environment in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Resources that can enhance quality of life include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins.4
The framework of the report identifies key areas for strengthening the nursing profession to meet the challenges of the decade ahead. The areas include the nursing workforce, leadership, nursing education, nurse well-being, emergency preparedness and response, and responsibilities of nursing as it relates to structural and individual determinants of health. There are 9 recommendations calling for change to the nursing workforce at all levels and settings and for action from policy makers, educators, and health care system leaders and payers to enable the changes. For example:
Recommendation 2: By 2023, state and federal government agencies, health care and public health organizations, payers, and foundations should initiate substantive actions to enable the nursing workforce to address SDOH and health equity more comprehensively, regardless of practice setting.
Recommendation 3: By 2021, nursing education programs, employers, nursing leaders, licensing boards, and nursing organizations should initiate the implementation of structures, systems, and evidence-based interventions to promote nurses' well-being, especially as they take on new roles to advance health equity.
Recommendation 8: To enable nurses to address inequities with communities, federal agencies, and other key stakeholders within and outside the nursing profession in an aim to strengthen and protect the nursing workforce during the response to such public health emergencies as the COVID-19 pandemic and natural disasters, including those related to climate change.
This report provides guidance to address health equities and the need for commitment and investment from health care systems, policy makers, and insurers, to name a few, to transform the nursing profession and achieve health promotion and well-being for the largest segment of the health care workforce.
By working together, we'll be able to meet the challenges in the decade ahead.
Mary Alexander
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