Introduction
The issue of the adverse influence of hypertension on the health status of the African American population remains unresolved because of the lack of attention to cultural and ethnic specifics. The health advocacy campaign proposed for managing the issue includes multiple steps that range from the integration of physician-led care teams for helping patients monitor their hypertension to coverage of the problem in the media to attract the support of multiple stakeholders. This means that newly integrated regulations should be put in place in order to address the challenge of hypertension in the African American population. Because the problem is serious and can lead to further complications and contribute to the declining health outcomes of the population, the creation of a new legislation is the most viable solution for enacting the proposed advocacy campaign.
New Approach Toward Policymaking
It is proposed to introduce a new regulation because of the differences between old and new paradigms within the context of health care. For example, a new regulation is more likely to implement a team approach, make nurses full members of teams, promote coordinated holistic care, focus on patient-centered home health, involve value-based organizations as well as “relevant professionals” that can help patients make informed decisions about their health (Milstead, 2016, p. 6). Therefore, in order to manage the problem of hypertension in African American population, there should be a firm action to support the integration of new policies and regulations that will follow the latest paradigms of healthcare and take into consideration the specific needs of the population group.
Role of Existing Legislations
The existing regulations on the management of hypertension as a problem are likely to contribute to the proposed campaign through providing a guideline, on top of which new efforts can be built. It is expected that the American College of Cardiology (2017a) guideline for high blood pressure in adults will influence the proposed regulations the most because it includes specific rules on how patients with hypertension should generally be approached, screened, followed-up, what are the most appropriate strategies of drug therapy, as well as how special populations should be treated. Also, it is important to mention that in November 2017, ACC and AHA lowered the definition of hypertension “from 140/90 mm Hg to 130/80 mm Hg […] to account for complications that can occur at lower numbers and to allow for earlier intervention” (American College of Cardiology, 2017b, para. 2). Therefore, when creating a regulation to address the issue of hypertension in African American population, it is important to take into account the recent developments in already existing policies.
Three-Legged Stool: Influencing Policymakers
In order to influence policymakers to support the implementation of the proposed regulation, extra attention should be given to national nurse groups that can play the roles of advocates for the target population. Since the proposed regulation targets the African-American population, the representatives of this ethnic group from the nursing profession are likely to better communicate the problem that the population faces to relevant policymakers. Cultural and ethnic representation of the target population should be the key strategy for influencing relevant policymakers because the issue has initially appeared from the lack of attention to the specific needs of this group.
For analyzing how policymakers will be influenced, it is important to mention Milstead’s (2016) three-legged stool of lobbying model. The first leg implies the act of influencing to make sure against what stakeholders should or should not vote. Influencing in the case of the campaign to manage the problem of hypertension in African American population can be done through getting feedback from real patients on how the condition influences their quality of life as well as what challenges they encounter when seeking care. Learning about the issue from the stories of those who are directly impacted by it will create a better idea of whether the proposed regulation is needed. The second leg is linked to grass roots (indirect) lobbying, which implies the influencing of the public opinion on the legislation and encouraging the general audience to take action. With the availability of such forms of information sharing as social media, the campaign can be lobbied on websites, local forums, Facebook profiles of relevant organizations (e.g., ACC or AHA), and so on (American Heart Association, 2014).
Getting the attention of the public will inevitably increase the awareness of the problem and subsequently lead to discussions about the need for introducing a regulation that will address the issue of adverse effects of hypertension on the African American population. The third leg of the lobbying stool refers to the financial contribution targeted at getting the legislative agenda to move forward. Larger organizations such as the American Heart Association or the American College of Cardiology should be involved in the financial support of the proposed regulation. In addition, public funding through charitable donations will also be encouraged because the more financial support the regulation gets, the easier it will be for the involved parties to facilitate its implementation in real life. In addition, strong financial support is especially high on the agenda for the proposed regulation because African American households have lower median incomes compared to other groups as reported by Long (2017) from the Washington Post. Overall, the three-legged model applied to the proposed regulation will take into consideration the key problems that exist in the context of African American health care because the cultural and ethnic needs of the populations remain unaddressed.
Challenges of the Legislative Process
Within the legislative process, several challenges and obstacles are expected to arise. The first potential obstacle relates to financial support of the proposed regulation because the distribution of governmental funds is significantly limited to the existing regulations and legislation and there may be not enough financial resources to address the needs of the proposed program. The second possible barrier to the implementation of the proposed program refers to the lack of nurses’ education on cultural and ethnic specifics of the African American population as well as why such patients are more likely to be susceptible to adverse risks of hypertension (Ortega, Sedki, & Nayer, 2015). For addressing the mentioned barriers, the proposed legislation should not only appeal to the public for gaining support but also encourage healthcare facilities to assess their professionals’ expertise in the specifics of care for diverse ethnic and cultural groups. With the appropriate education of nurses, the campaign is expected to gain momentum quickly. When it comes to financial support, state representatives should be contacted and asked to present the problem to the higher-standing legislations. Also, local efforts of different communities should become integral players in the campaign.
References
American College of Cardiology. (2017a). 2017 guideline for high blood pressure in adults. Web.
American College of Cardiology. (2017 b). New ACC/AHA high blood pressure guidelines lower definition of hypertension. Web.
American Heart Association. (2014). Unlock the doors and keep kids healthy. Web.
Long, H. (2017). African Americans are the only racial group in U.S. still making less than they did in 2000. Washington Post. Web.
Milstead, J. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.
Ortega, L., Sedki, E., & Nayer, A. (2015). Hypertension in the African American population: A succinct look at its epidemiology, pathogenesis, and therapy. NefrologÃa, 35(2), 139-145.