Addressing and eliminating healthcare disparities is a national goal in US initiatives such as Healthy People 2010. Nurses have been active in the development of these goals and in working toward reducing fetal and infant deaths, preterm births, and behaviors related to infant sleep positioning. Nurses have also developed multiple interventions specifically designed to reduce healthcare disparities. In my opinion, nurses do not perpetuate racial/ethnic disparities in maternal/ child healthcare but rather are working toward eliminating disparities. Healthcare disparities exist for numerous reasons, such as a lack of health insurance, socioeconomic status and educational level, patient beliefs, and past healthcare experience. Nurses know that certain populations continue to bear an unequal burden in relation to poor outcomes, such as preterm birth and infant death, and they have a long history of caring for underserved and vulnerable populations. Maternal/child health nurses have demonstrated throughout the generations that they believe in the core value of respect for human dignity that provides a foundation for our profession (Manthey, 2008).
Our use of evidence-based practice and guidelines also shows that we value consistency and equity in care. Nurses have coordinated and are involved in evidence-based community educational programs aimed at increasing awareness of the importance of prenatal care, vitamin consumption during pregnancy, and smoking cessation for pregnant women, among other important interventions to improve outcomes in pregnancy.
Nurses have played an active role in researching and developing evidence-based guidelines for practice aimed at eliminating these disparities, with numerous studies focused on reducing preterm and other high-risk births. For example, the National Institute of Nursing Research (NINR) has funded many studies aimed at improving the quality of care for persons in population groups affected by disparities. NINR has also developed interdisciplinary collaborative work groups to explore pregnancy outcomes in minority populations.
Other nursing interventions that have been successful in bridging the gap in healthcare disparities include the Nurse-Family Partnership (2008) program. This initiative is an evidence-based community nursing program that links nurses with low-income, first-time parents in an effort to improve overall health and well-being, self-sufficiency of pregnant women, and positive outcomes for infants and children. Nursing visits and interactions with mothers are the keys to the intervention and success of this program. This program demonstrates the impact that nurses can have on decreasing and eliminating healthcare disparities. Similar programs have been successful in decreasing the disparities in maternal/child health through nurse home visits. For example, Wells et al. (2008) demonstrated that African American women who received home visits by a nurse care manager were three times less likely to have a preterm birth than women who did not receive a home visit by a nurse. These are only a few of the many ways in which nursing is working to eliminate healthcare disparities in maternal/child health.
Nurses are working diligently to address the healthcare disparities that we all know and recognize in our current healthcare system. The history of nursing demonstrates a continual focus on excellent care for all, despite differences in race, ethnicity, religion, or any other demographic characteristic. The literature shows us that nurses have developed and continue to develop programs to specifically change current healthcare disparities that plague our nation. They also evaluate the effectiveness of these programs and use evidence to guide their practice. In my opinion, nurses do not perpetuate disparities in healthcare outcomes for women and children but rather work to reduce them.
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