1. Division of Nursing’s Workforce Diversity and Health Equity Agenda Mary Beth Bigley, DrPH, MSN, ANP Director, Division of Nursing Bureau of Health Professions April 23, 2014 Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of Nursing

2. Outline 1.Overview of HRSA Mission and focus on health equity 2.Present a conceptual model linking health equity, social determinants of health (SDOH) and nursing workforce diversity (NWD) 3.Describe a Division of Nursing (DN) specific initiative to utilize the SDOH to increase NWD and improve population health equity 4.Conclusions and next steps HRSA, BHPr, Division of Nursing 2

3. HRSA Mission To improve health and achieve health equity through access to quality services, a skilled health workforce and innovative programs. HRSA, BHPr, Division of Nursing 3

4. Health Equity  Attainment of the highest level of health (includes population health) for all people  Valuing every individual equally  Focused and ongoing societal efforts to address:  avoidable inequalities  historical and contemporary injustices  Elimination of health and health care disparities Healthy People 2020 HRSA, BHPr, Division of Nursing 4

5. Cascading Strategic Initiative on Health Equity Improve Health Equity Achieve Health Equity HHSHRSABHPr HRSA, BHPr, Division of Nursing 5

6. DN Structure Division of Nursing Nursing Practice and Workforce Development Nursing Workforce Diversity Nurse Education, Practice, Quality and Retention Advanced Nursing Education ANE/ANEE NAT/AENT NFLP HRSA, BHPr, Division of Nursing 6

7. Division of Nursing’s Workforce Diversity and Health Equity Agenda Shanita D. Williams, PhD, MPH, APRN Chief, Nursing Practice and Workforce Development Branch Bureau of Health Professions April 23, 2014 Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of Nursing

8. Division of Nursing Mission To provide national leadership to assure an adequate supply and distribution of qualified nursing personnel to meet the health needs of the Nation. HRSA, BHPr, Division of Nursing 8

9. Division of Nursing Goals  Enhance the composition, skills and distribution of the nursing workforce  Ensure program accountability through focused performance and outcomes assessment  Promote effective communication with the public and stakeholders on nursing workforce development  Increase diversity and cultural and linguistic competence of the nursing workforce HRSA, BHPr, Division of Nursing 9

10. Nursing Workforce Diversity (NWD) Program Legislation Title VIII Section 821 of the Public Health Service Act; 42 U.S.C. 296m, as amended by the Patient Protection and Affordable Care Act (Affordable Care Act), P.L. 111-148 Legislative Definition of Diversity Create and expand nursing education opportunities for individuals from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses) HRSA, BHPr, Division of Nursing 10

11. Nursing Workforce Diversity (NWD) Program  Increase nurse education opportunities for individuals from disadvantaged backgrounds using stipends, scholarships, and mentoring  Achieve a culturally-aligned and competent workforce that is reflective of the population  Develop innovative pipeline programs to recruit, retain, and help graduate nurses (RN programs) 11 HRSA, BHPr, Division of Nursing

12. Workforce Diversity to Achieve Health Equity HRSA, BHPr, Division of Nursing 12

13. Vision  Leadership Role in Workforce Diversity:  Support portfolio of next generation NWD projects and evaluation  Partner with other federal agencies, foundations, and public and private organizations  Models of Best Practice:  Grantees/Awardees develop and rigorously evaluate innovative NWD programs  Clearinghouse of exemplar programs and evaluation methodologies HRSA, BHPr, Division of Nursing 13

14. Vision  Incorporating Social Determinants of Health (SDOH) in Workforce Diversity efforts  Increase diversity of portfolio of grantees  Expand outreach efforts:  Tribal colleges and universities (TCU)  Historically Black Colleges and Universities (HBCU)  Minority Serving Institutions (MSU)  Hispanic Serving Institutions (HSI) HRSA, BHPr, Division of Nursing 14

15. Workforce Diversity to Achieve Health Equity HRSA, BHPr, Division of Nursing 15

16. Health Resources and Services Administration. (2006). The rationale for diversity in the health professions. A review of the evidence. HRSA, BHPr, Division of Nursing 16

17. Health Resources and Services Administration. (2006). The rationale for diversity in the health professions. A review of the evidence. HRSA, BHPr, Division of Nursing 17

18. Transformation from Health Disparities to Health Equity 18

19. ACHIEVING HEALTH EQUITY: UNDERSTANDING BHPr’s ROLE 19

20. Social Determinants of Health  Conditions in which people are born, grow, live, work and age  Shaped by the distribution of money, power and resources  Global, national and local levels  Influenced by policy choices  Responsible for health inequities  Unfair and avoidable differences in health status  Observed within and between countries  World Health Organization HRSA, BHPr, Division of Nursing 20

21. Social Determinants of Health  Contribute to or detract from health of individuals and communities  Includes a living standard:  Health  Food  Clean water  Participation in society  Benefits of societal progress HRSA, BHPr, Division of Nursing 21

22. SDOH: The Transition from individual-level to multi-level approaches and strategies… HRSA, BHPr, Division of Nursing 22

23. SDOH and Nursing Workforce Diversity  Multi-level strategies are needed to:  address the larger social and structural forces that impede efforts to diversify the nursing workforce  increase access to quality care  reduce health disparities  improve health equity HRSA, BHPr, Division of Nursing 23

24. The Nursing in 3D Summit HRSA, BHPr, Division of Nursing 24

25. Nursing in 3D Journal Supplement  Public Health Reports  Integration of the 3D’s  15 invited manuscripts  3D Summit presenters  HRSA staff HRSA, BHPr, Division of Nursing 25

26. Towards Health Equity NWD 2013 and 2014 Funding Opportunity Announcements:  Develop innovative workforce diversity strategies that would facilitate the entry, retention and graduation of racial and ethnic minorities from Schools of Nursing  Create “new” partnerships/alliances  Integrate diversity, disparities, and social determinants (3D) HRSA, BHPr, Division of Nursing 26

27. What’s Next…  Engage stakeholder groups  NACNEP  Professional Associations etc.  Continue to shape the vision  Develop “new” partnerships  Nontraditional  Multiple disciplines, sectors HRSA, BHPr, Division of Nursing 27

28. Contact Information Shanita D. Williams, PhD, MPH, APRN Chief, Nursing Practice and Workforce Development Branch, Division of Nursing Bureau of Health Professions Office: 301-443-1253 Email: swilliams3@hrsa.govswilliams3@hrsa.gov www. http://bhpr.hrsa.gov/nursing/index.htmlhttp://bhpr.hrsa.gov/nursing/index.html 28