1. Szulecki, Diane

Article Content

The gun violence epidemic. U.S. firearm homicide and suicide rates increased in 2021 (provisional data) to their highest levels in decades, according to a recent report from the Centers for Disease Control and Prevention (CDC). Rates of both each rose 8.3% since 2020, with a combined total of 47,286 deaths. The CDC notes that while increases in homicides occurred across most populations, racial and ethnic disparities continued to grow, with non-Hispanic Black or African American individuals experiencing the most deaths. Additionally, an analysis of CDC data in the New England Journal of Medicine found that, in 2020, firearm-related injuries surpassed motor vehicle crashes as the top cause of death among U.S. children and teens.

Figure. New York Sta... - Click to enlarge in new windowFigure. New York State Nurses Association members join a March for Our Lives protest in New York City in June, calling for stricter gun control laws in the wake of recent mass shootings. Photo by Richard B. Levine / Alamy Stock Photo.

Women's reproductive health. Following the Supreme Court's decision in June to overturn Roe v. Wade, the law that established a constitutional right to abortion, 13 states enacted full abortion bans and four banned the procedure after 15, 18, or 20 weeks. Other states responded by strengthening abortion protections and expanding access to care. At press time, bans in 11 additional states were temporarily blocked from implementation by the courts. Most state laws banning abortion include criminal penalties for health care workers who provide abortion care. According to an analysis by the Kaiser Family Foundation, the legal risk imposed by such penalties may result in "more limited access to services to manage miscarriages or stillbirths since almost all of the health care services used in these cases are identical to those used in abortions." Roe's overturning is expected to adversely affect maternal morbidity and mortality, especially among women of color, who face disproportionate barriers to reproductive health care.


A racial reckoning in health care. As more health care organizations continued to implement diversity, equity, and inclusion initiatives, some states-including Michigan-began requiring health care professionals to undergo implicit bias training for licensure. In July, the American Nurses Association (ANA) issued a statement, Our Racial Reckoning, to "acknowledge [the ANA's] own past actions that have negatively impacted nurses of color and perpetuated systemic racism" and to outline antiracist initiatives the ANA is undertaking to address "the harms that continue today." Earlier in the year, the ANA's National Commission to Address Racism in Nursing released survey findings in which 63% of nurse respondents said they have personally experienced racism in the workplace.


The border crisis. More than 2 million immigrants arrived at the U.S.-Mexico border in fiscal year 2022, up from 1.7 million the previous year, according to U.S. Customs and Border Protection data. Officials said the increase was driven in part by a surge in migrants fleeing instability in Venezuela, Cuba, and Nicaragua. In May, a federal judge blocked the Biden administration's plan to rescind Title 42, a Trump-era public health order implemented during the COVID-19 pandemic that allowed the government to quickly expel asylum seekers. In a policy about-face, however, the administration announced in October that it would use Title 42 to immediately expel Venezuelan migrants crossing the southern border. The governors of Florida and Texas made headlines in the fall for flying or busing migrants to nonborder states to call attention to what they view as insufficient U.S. border policies.


Antitransgender legislation. A June study by the Williams Institute at the University of California, Los Angeles, School of Law, found that the percentage of U.S. youth who identify as transgender has nearly doubled since 2017 (largely due to better data collection) to about 1.4% of young people (300,000) ages 13 to 17. But in 2022, state legislatures introduced more antitransgender bills-155-than ever before. The bills target a range of issues affecting youth, including restrictions on sports participation and gender-affirming medical care such as puberty blockers and hormone therapy. Arizona and Alabama passed laws criminalizing the provision of such care, joining Arkansas, which passed a law in 2021-though laws in the latter two states are currently blocked from implementation by the courts. In October, the Florida Board of Medicine became the first state medical board in the country to vote to ban gender-affirming care for minors; at press time, its ruling was in the process of being drafted and approved.


The war in Ukraine. Following Russia's invasion of Ukraine in February, an estimated 6,200 civilians have died and 9,400 have been injured as of October, according to the United Nations (UN) Office of the High Commissioner for Human Rights, though the office believes the actual numbers are much higher. The conflict has led to Europe's largest refugee displacement since World War II, with at least 7.8 million Ukrainians fleeing the country. In October, a UN commission reported evidence of war crimes and human rights violations against Ukrainian civilians, including "summary executions, unlawful confinement, torture, ill-treatment, rape and other sexual violence."-Diane Szulecki, editor