This paper presents the examination of a policy statement (access to women’s health care) with the aim of clarifying the underlying health issue and proposed interventions to address it. As declared by the American College of Obstetricians and Gynecologists (ACOG), this policy is significant at state and national levels since women’s health identifies the well-being of future generations. The key barriers to accessing care are a lack of insurance coverage, racial and ethnic discrimination, low income, ageism, and little attention to preventive services. The paper synthesizes the academic literature to provide relevant statistical data and support the importance of such interventions as a universal insurance coverage, developing diverse and realistic attitudes to women, and patient-centered care. To advocate for the given policy implementation, nurses should be aware of health disparities and the ways to overcome them, cooperate with organizations and interdisciplinary teams, as well as educate female patients through the work in communities.
Access to Women’s Health Care
Women’s health care is the basis for the well-being of current society and future generations. Chrisler et al. (2016) state that compared to men, women are likely to need more health care services throughout their lives. At the same time, they are more prone to economic barriers that impede or restrict their access to the necessary services, including unemployment, low income, and higher care costs (Borchelt, 2017). Namely, “more than 16 million women lived in poverty in 2016; 21.4 percent of Black women, 22.8 percent of Native women, 18.7 percent of Latina women, and 10.7 percent of Asian women” (Borchelt, 2017, p. 16). These figures also indicate the presence of racial discrimination, which can be accompanied by age, disability, a sexual status, and other biases faced by women.
To address this problem, there is a need to adopt a policy of ensuring the access to women’s health care at state and national levels. The mentioned policy should focus on health promotion since timely and proper access to care services would allow preventing many diseases in females. Considering that women often lack knowledge about their health and avoid visiting doctors due to bias, negative experience, and high costs, the mentioned policy should offer more opportunities to receive health care services. It is important to share information about the importance of monitoring women’s health, provide timely treatment, and extend the options to access a full range of clinical services.
Nurses, as the care providers who directly interact with patients, are responsible for the above goals. By being aware of social determinants that act as barriers, they can help patients in overcoming them. While more than 90% percent of women had insurance coverage in the US in 2016, one out of ten females remains uninsured, which creates additional burden on the system (American College of Obstetricians and Gynecologists, 2019). There are legislations that, for example, restrict the rights of women to abortion: in 2011-2015, 288 abortion restrictions were adopted (American College of Obstetricians and Gynecologists, 2019). Therefore, it is critical for the nursing profession to promote the provision of affordable and appropriate health care to every woman. Nurses can make a significant impact on addressing the problem of poor access to females’ health care by advocating for policy change and contributing to the establishment of care equity.
Health Policy Overview
The American College of Obstetricians and Gynecologists (ACOG) is the key representative organization that provides qualified care to meet the unique needs of women. This organization calls for making sure that every American female has an access to a full range of medical services across her life. Care provision should be ensured regardless of women’s age, perceived gender, cultural and ethnic background, geographical location, and legal barriers (Alexander et al., 2020). In other words, the policy proposes a bias-free care delivery, which is especially important in the US, the country that involves a wide range of diverse people. The recent studies show that the greatest health disparity exists among the Hispanic population that represents 19% of the US population, but it is also more than 30% of its uninsured patients (Lathrop, 2020). The study of the disadvantaged populations from the nursing perspective is the intervention that should be integrated into care.
Affordability and adequacy of care to women is another goal set by the ACOG, which is expected to achieve through proper insurance coverage. Despite the initiatives of the Affordable Care Act (ACA) and Trump’s decision to undermine it and change Medicaid, a lot of women still lack the opportunity to have insurance (Norton, 2016). It restricts them from visiting doctors and monitoring their health, resulting in the inability to access preventive services and avoid many diseases. For example, Borchelt (2017) emphasizes that many women with low incomes have no or restricted opportunities to use insurance for reproductive health needs, including abortion. Espey et al. (2019) note that women with low income would rationally prefer spending their money to buy food and pay for housing instead of visiting doctors. The ACOG proposes a universal insurance coverage to enhance the collective health of the American society. It is declared to be a priority to expand the health coverage to all populations of the US.
The quality of women’s health care is another goal that implies the improvement of a females’ health status by providing various programs at state and national levels for women of all ages and backgrounds. For example, according to Chrisler et al. (2016), aging women have to encounter problems with physical and mental health. Most importantly, they face negative stereotypes and disrespectful treatment from nurses, who can state that it is “just an old age” or use baby talk. This generates self‐fulfilling prophecies, when aging women start perceiving themselves as too frail, infantile, and generally unable to lead a healthy life. The US Department of Health and Human Services defines health equity as the “attainment of the highest level of health for all people” and occurs when everyone has the opportunity to live a healthy life” (Lathrop, 2020, p. 3). The promotion of more diverse and realistic attitudes towards older females would decrease disparities and improve nurse-patient relationships.
The attention is to be paid to the unique needs of women, which is planned to accomplish by applying the principles of patient-centered care. Depending on social determinants, geographical location, and other particular factors, females may need more knowledge about the services they can receive. In this connection, traditional patient-physician and patient-nurse relationships should be strengthened. More to the point, Alexander et al. (2020) stress that the work within the communities should also be conducted to make sure that not only women but also their offspring would have an appropriate health status. In terms of nursing, patient-centered care promotes humanistic principles to meet the needs of patients and involves a transition from the traditional model, when medical professionals are fully responsible for a patient’s health (Mason et al., 2020). Every woman has a fundamental right to health care that respects her personal values and priorities and helps maintain health and quality of life at the highest achievable level.
The provision of and proper access to preventive services is one of the interventions that are mentioned in the policy statement. The importance of early diagnosis tends to grow today as it saves costs for the prevented treatment (American College of Obstetricians and Gynecologists, 2019). A comprehensive diagnostic process should involve not only laboratory tests and examinations, but also the determination and assessment of the individual factors of every female, including lifestyle, previous diseases, and relationships (Norton, 2016). A balanced approach aimed at working as efficiently as possible should bring together teams of the best specialists from various fields of medicine. Namely, teams from nurses to therapists and surgeons, who provide a high level of patient-centered care and help them improve their quality of life.
Today, nurses are the members of one of the most reliable and promising professions that play a leading role in health promotion. To effectively act as advocates of policy change and adoption, nurses should be aware of the care access challenges faced by women, including a variety of factors that may affect them (Mason et al., 2020). Accordingly, the first step is continuous learning about the existing disparities, which should be based on research analysis, conferences, participation in studies, and knowledge sharing with colleagues (White-Farnham, et al., 2019). Knowledge is a powerful instrument that would equip these health care professionals with relevant information and arguments to promote change.
The second step is to cooperate with organizations that are committed to improving the access of women to care services. For example, the ACOG calls for quality health care delivery, while making sure that females would have them without costly delays or any biases. In their turn, the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) is another organization that supports policy change initiatives to provide comprehensive health care services as a fundamental right of every woman. The Council on Resident Education in Obstetrics and Gynecology (CREOG) is responsible for providing resources for the education of women’s health providers (Espey et al., 2019). The cooperation with these and similar organizations seems to be useful to receive guidance about advocacy initiatives, and they also can be considered as powerful institutions that can impact the implementation of the policy.
The collaboration with an interdisciplinary team is the third step that is recommended to follow to provide a full range of services. According to a holistic approach, female patients should be provided with care that encourages them to participate in health improvement by building trust between patients and care providers (Alexander et al., 2020). To meet this agenda, the combined efforts of an interdisciplinary team develop respect, openness, and diversity awareness, which is beneficial for offering a high-quality care. This also creates a sense of acceptance and allows patients to be more responsive to establish nurse-patient relationships. One more step is working with communities to support female patients, educate them, identify the underserved communities, and help them in improving their access to care. The education of women should be based on valid information from reliable sources to develop positive health behaviors (Norton, 2016). Using interpersonal communication skills, nurses can present information via brochures, presentations, small group meetings, family discussions, and any other ways that would help women to evidently understand the value of their health.
To conclude, the access to women’s health policy is of great importance to ensure that females can practice their basic human right to receive a high-quality, comprehensive care services. Low income, a lack of insurance coverage, the need to access more services compared to men, and various biases restrict women’s access to the necessary services. To address this health problem, the ACOG proposes the policy and clarifies that affordability, timeliness, comprehensiveness, and professionalism should be the main principles to improve women’s health status. Among the interventions that should be implemented in care practice, there are patient-centered care, promoting diverse and realistic attitudes to women, and a universal insurance coverage. As advocates, nurses are expected to engage in continuous learning about health inequity and the ways to overcome it, educate female patients working in communities, cooperate with organizations, and collaborate with an interdisciplinary team.
According to the opposing view, the provision of care services for all women can be expensive and damaging to the US healthcare system. However, all patients should have access to the services they need as it is their right, regardless of their health condition and a socioeconomic status. Future research perspectives should take into account patients’ education, employment, and family issues, which influence their access to health care services. Every nurse is expected to advocate for the policy change, acting at a personal level, using available resources, and considering women’s needs.
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