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The Role of Nurse Executives in Advancing Health Equity Practice and Policy

Health equity is more than a buzzword. It is the core component of some of the nation’s most wide-reaching health initiatives, like Healthy People 2030 and The Future of Nursing 2020-2030. The Center for Medicare and Medicaid Services, among others, emphasize that achieving health equity is a central focus for value-based care. Nurse executives are critical to advancing this goal by shaping health policy and creating solutions to eliminate health disparity.  

What Is the Nurse Executive’s Role in Advancing Health Equity?

The American Organization for Nursing Leadership (AONL) defines nurse leaders in executive practices as those who “set the vision for nursing practice in the delivery of safe, timely, efficient, equitable and patient-centered care.” Although titles and responsibilities differ, their primary role is to create a collaborative approach to coordinated, patient-centered, cost-effective care. Core competencies of a nurse leader that advance health equity include:

  • Creating an environment that values diversity (for example: age, gender, race, religion, ethnicity, sexual orientation and culture)
  • Establishing a culturally competent workforce
  • Integrating corporate cultural beliefs into care delivery
  • Encouraging an environment for sharing opinions and exploring ideas

Great nurse executives foster the development of a diverse and inclusive organization.

What Are Three Ways Nurse Executives Can Focus on Health Equity?

Today, nurse executives use a transformational leadership style to share the vision that relationships and collaboration are vital in bridging the health equity gap. Three critical strategies include diversifying their workforce, engaging community stakeholders and supporting budgets for solutions.

1. Create a Diverse, Non-judgmental Workforce

Workforce diversity refers to employees’ similarities and differences in age, cultural background, race, religion, gender, sexual orientation, physical abilities or disabilities. Nurse executives can support their team in recruiting and retaining employees from different backgrounds to cultivate a workplace that promotes inclusivity and strengthens relationships. To succeed, a healthcare organization’s employees must reflect the people they serve.

Great leaders respond to diverse scenarios with a non-judgmental mind, humility and bias awareness. Unfortunately, biases in healthcare are common. They may be implicit (where the person is unaware of their bias) or explicit (where the person is aware of prejudices and attitudes). Nurse executives are in a pivotal position to ensure that every person within their organization confronts implicit bias as a barrier to health equity.

2. Develop Robust Community Partnerships

To advance health equity in the community they serve, nurse leaders need to engage community stakeholders. A stakeholder is any individual or organization that might be affected by an initiative. Examples include advocacy groups, faith-based organizations, businesses, clients/patients, coalition partners or government leaders.

Organizations can move healthcare upstream through community engagement and use real-time data to support high-risk individuals with chronic illnesses. An “upstream” approach focuses on a disease’s root causes, such as social determinants of health (SDOHs). SDOHs are the social, economic and environmental conditions where people live, learn, work and play. For example, SDOHs include lack of access to healthcare, housing or transportation issues, violence, limited support systems, food deserts or inadequate open green space. While many factors contribute to health disparities, SDOHs create more barriers than race or ethnicity.

3. Advocate or Allocate Funds to Address Disparities

Innovative care delivery models and solid solutions to improve health equity require budget allocation. At first, budgeting and investing in health equity may be small steps, but real progress requires dedicated staff.

An example of a leader in health equity innovation is the Duke Cancer Institute (DCI), which received the prestigious Association of Community Cancer Centers’ Innovator Award. Over a decade ago, the DCI created the Office of Health Equity (OHE) to help eliminate cancer disparities. They formed a robust community advisory council of stakeholder representation from public and private agencies, community members and persons with cancer. Their community council represents diversity across race, ethnicity, class and religion, with support from over 150 churches.

The OHE’s primary focus is community outreach with health screening, education and community-facing navigation. In addition, the OHE provides education and training on health disparity, diversity, and inclusion in the workplace and works to improve cancer outcomes and minority participation in clinical trials.

Regardless of the practice setting, nurse leaders support solutions to address disparity. For example, they can improve productivity, satisfaction and marketplace awareness by supporting workplace diversity and addressing implicit bias and racism. In addition, they can advocate for internal and external policy changes.

How Can a Master of Science in Nursing (MSN) – Nurse Executive Leadership Help?

The Northern Kentucky University online Master of Science in Nursing (MSN) – Nurse Executive Leadership program can help prepare high-level nurse administrators in the fight for health equity. Studying diverse topics such as business management, leadership practices, organizational psychology, healthcare policy, economics and population health can prepare nurses to set the direction and inspire a vision for the future of health equity.  

Learn more about the Northern Kentucky University online MSN – Nurse Executive Leadership program.


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