he Role of the Nurse in Global Health

he Role of the Nurse in Global Health

In this week’s media presentation, Dr. Louise Fitzpatrick shared how health and disease are global issues. She pointed out that with the mobility of today’s population, health issues experienced in one area of the world are easily brought to other areas of the world through such means as travel and immigration. They can also be brought to a nation’s doorstep through the migration of animals, insects, and birds. Consider the spread of infectious diseases such as HIV/AIDS, avian flu, H1N1, or SARS. These diseases have quickly crossed oceans and spread to multiple countries. They are a public health concern in the United States as well as other countries. Post your analysis of one health problem between one developed and one developing country in comparison with the United States in terms of the WHO outcomes and criteria listed above. State your opinion about how well the United States is doing in terms of public health. Share what you think countries with worse outcomes could learn from countries with better outcomes. Explain the nurse’s role in public and global health and why nurses should be concerned with global health issues. Conclude by summarizing your view of the role of the nurse in public health.

Support your response with references from the professional nursing literature


CASE A: In the 1970’s the AIDS pandemic struck the United States.  Advances in technology, medications and education regarding safe sex and routine testing for STI’s have contributed to a lower incidence of HIV/AIDS in the United States and a longer life expectancy for individuals living with this disease.  Although the incidence of HIV/AIDS has improved in the United States as a whole, it remains a critical problem for some countries and within certain minority groups in the United States.

HIV/AIDS is the 7th leading cause of death among African Americans in the United States.  This may be due in part to health disparities and issues with access to health care for many individuals in the United States.  In terms of overall public health, the United States has a life expectancy of approximately 79 years and the leading causes of death are heart disease, responsible for 28.5% of deaths, followed by malignant tumors, responsible for 22.8% of deaths (Holtz, 2017).

Compared to the United States, the developed country of Japan has instituted mandatory health insurance for all citizens.  Japan has a higher life expectancy than the United States.  The average life expectancy for Japanese males is 80 and 87 for females.  The incidence of HIV/AIDS in Japan is very low at 0.1%.  Japanese citizens may also choose to see any provider they want while premiums for health care are based on income and the ability to pay(Holtz, 2017).

South Africa is a developing country with a high incidence of HIV/AIDS.  HIV/AIDS remains a leading cause of death in South Africa with 17.9% of the population living with this disease (Holtz, 2017).  Since the mid 1990’s the life expectancy of South Africans has decreased by about 20 years due to HIV/AIDS.  The life expectancy is low, with an average of 49.2 years.  Basic health insurance is available to everyone in South Africa with specialized health care available at an additional cost.

Countries with poor outcomes, such as South Africa for example, may improve health outcomes for citizens by determining what countries with improved outcomes do best.  The United States does well in preventative care, while cost of health care and access to care can be improved.  Japan sees longer life expectancy among males and females, lower incidence of diseases like HIV/AIDS and has instituted mandatory health care for all.  A common theme among countries that perform well in public health seems to be access to care.  Countries that offer access to quality health care to all individuals tend to see higher life expectancies and lower incidence of certain diseases.

Nurses play an important role in public health and global health care.  Nurses have a responsibility to educate the public on how to remain healthy and manage health conditions, while empowering individuals with the resources they need to manage their own health for the long term.  Nurses should be aware of the public health issues faced by the United States and globally.

CASE B: Every single country in the world is affected by the global health problem of malnutrition (World Health Organization, 2020). The term malnutrition refers to both undernutrition and over-nutrition (World Health Organization, 2020). According to The World Health Organization (2020), in recent years, approximately 462 million adults and 155 million children under the age of five are undernourished annually, while 1.9 billion adults and 41 million children under the age of five are over-nourished annually. Furthermore, around 45% of child deaths under the age of five are due to undernutrition (World Health Organization, 2020). Malnutrition has been shown to cause several diet-related non-communicable diseases such as heart disease, cancer, and diabetes; Furthermore, malnutrition during pregnancy or adolescence causes various congenital disabilities, anemia and significantly decreases both the mothers’ and babies’ chance of survival (World Health Organization, 2020). Undoubtedly, malnutrition is a major global health problem that will continue to burden the world with its devastating effects if not addressed by the world as a whole.

Malnutrition has no mercy and, in the form of either over-nutrition or undernutrition, affects all countries in the world (World Health Organization, 2020). One developed country affected by malnutrition is Switzerland; according to The World Health Organization (2021) country report on malnutrition, the approximate annual percentage of obese adult males is 9%, and adult females in Switzerland is 8%, and in children less than 3% are malnourished. Comparing data to that of the country of Chad in central Africa, where according to Szmigiera (2021) in the Global Hunger Index of 2020, Chad is the number one affected country in the world by hunger and malnutrition in the form of undernourishment. An estimated 43% of children under the age of five alone in Chad were malnourished in 2018 (Dell, 2019). Meanwhile, overall the malnutrition rate for people living in Chad grew by 25% from 2017 to 2018 (Dell, 2019), and an additional 20% increase in the rate of malnourishment was seen from 2018 to 2019 (U.S Agency for International Development, 2020). It goes without saying that malnourishment in the form of under-nutrition is a significant health problem in the developing country of Chad in central Africa. Compared to the United States of America, where the malnutrition problem presents itself drastically in the form of over-nutrition (Centers for Disease Control and Prevention, 2021). In 2018 42.5% of adults over the age of 20 were found to be obese in The United States of America; and an approximated 21% of all children in the united states were found to be obese in 2018 in The United States of America (Center for Disease Control and Prevention, 2021).

Throughout my research on this topic, the most prominent themes I was able to uncover were food insecurity, workforce availability, and resources. In the developed country of Switzerland, their government initiatives of making fresh fruits and vegetables readily available and affordable, laws for proper marketing of high sugar, high salt, and high fat in food and beverages have been in place since 2016, and extensive inclusion of physical activity both in the workplace and in school has been seen to be the leading factors of bringing down the rate of malnutrition (World Health Organization, 2021). In the United States, a correlation between education income and food insecurity can be seen (CDC, 2021). Adults without a college education and low-income households are seen to have higher levels of obesity which are linked to food insecurity (CDC, 2021). Lastly, in the developing country of Chad, the main causes of food insecurity I was able to uncover are the effects of regional conflicts in the area, environmental events such as droughts affecting crops, low income/poverty rates, and lack of social services such as food programs (U.S. Agency for International Development, 2020).

Throughout my research, the common theme of food insecurity became apparent, although quite different from the countries researched. In the developing country of Chad, poverty and lack of social services are vital issues attributing to the prevalence of malnourishment in the country (U.S. Agency for International Development, 2020). While in the developed country of Switzerland, the tremendous availability of social services and government laws on food marketing greatly aid in decreasing obesity rates to a mere 9% (World Health Organization, 2021). And in The United States of America, the prominence of obesity rates seems to have a direct correlation to education and affordability of making healthy food choices (CDC, 2021).

In my opinion, the United States could learn from Switzerland in taking more government initiatives to make healthy food choices more available and nutritional education more readily available. I believe that the United States has all the workforce necessary to make these changes and lower the drastically high rates of obesity in the United States. Meanwhile, in the country of Chad, I believe that they simply do not have the resources they need to mitigate this global health issue. More social services and food availability needs to be made available, and this is one of many countries that needs help from developing countries such as The United States and Switzerland to do it. I believe malnutrition is a very preventable global health issue, with the availability of food, social services, and nutritional education globally. I believe the role of the nurse in this health problem and global health as a whole is not to settle and accept the norm, our duty is to ask why and volunteer by providing nutritional education and resources as much as possible, not only to our local communities but to the world as a whole.