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Posted: April 4th, 2019
The Assignment: (1-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
Part 3: Narrative Fact Sheet
Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:
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Part 1: Agenda Comparison Grid
| Population Health Concern | Brief Description | Factors that Contribute |
|---|---|---|
| Opioid Overdose | Opioid overdose is a leading cause of death in the United States, claiming the lives of more than 70,000 people in 2020. | The opioid epidemic is a complex issue with many contributing factors, including the overprescribing of opioids by doctors, the availability of cheap and accessible opioids on the black market, and the lack of access to treatment for opioid addiction. |
Administrative Agenda Focus
| President | Administrative Agenda Focus |
|---|---|
| Biden | The Biden administration has made addressing the opioid epidemic a top priority. The administration has proposed a number of initiatives to address the epidemic, including increasing access to treatment, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
| Trump | The Trump administration also made addressing the opioid epidemic a priority. The administration’s efforts to address the epidemic included increasing funding for treatment and prevention programs, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
| Obama | The Obama administration also made addressing the opioid epidemic a priority. The administration’s efforts to address the epidemic included increasing funding for treatment and prevention programs, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
Allocations of Financial and Other Resources
| President | Allocations of Financial and Other Resources |
|---|---|
| Biden | The Biden administration has proposed a $10 billion plan to address the opioid epidemic. The plan would fund a number of initiatives, including increasing access to treatment, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
| Trump | The Trump administration allocated $6 billion to address the opioid epidemic. The administration’s funding was used to support a number of initiatives, including increasing access to treatment, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
| Obama | The Obama administration allocated $1.1 billion to address the opioid epidemic. The administration’s funding was used to support a number of initiatives, including increasing access to treatment, expanding access to naloxone, and cracking down on the illegal trafficking of opioids. |
How Each Presidential Administration Approached the Issue
| President | Approach to the Issue |
|---|---|
| Biden | The Biden administration is taking a comprehensive approach to addressing the opioid epidemic. The administration is working to increase access to treatment, expand access to naloxone, and crack down on the illegal trafficking of opioids. |
| Trump | The Trump administration took a more law enforcement-focused approach to addressing the opioid epidemic. The administration cracked down on the illegal trafficking of opioids and worked to prosecute those who were selling and distributing opioids illegally. |
| Obama | The Obama administration took a more public health-focused approach to addressing the opioid epidemic. The administration worked to increase access to treatment and prevention programs and to expand access to naloxone. |
Part 2: Agenda Comparison Grid Analysis
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
The Substance Abuse and Mental Health Services Administration (SAMHSA) would most likely be responsible for helping me address the opioid epidemic. SAMHSA is a federal agency that provides leadership in the prevention and treatment of substance abuse and mental health disorders. SAMHSA has a number of programs and initiatives that are designed to address the opioid epidemic, including the National Helpline, the National Institute on Drug Abuse, and the Center for Substance Abuse Treatment.
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
I think my selected healthcare issue, the opioid epidemic, got on the agenda for the current and two previous presidents because it is a major public health crisis. The opioid epidemic is claiming the lives of more than 70,000 people in the United States every year. The epidemic is also having a devastating impact on families and communities. I think the opioid epidemic will stay on the agenda for future presidents because it is a major public health crisis that needs to be addressed.
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
I would choose Dr. Nora Volkow to be the entrepreneur/champion/sponsor of the opioid epidemic for the current and two previous presidents. Dr. Volkow is the director of the National Institute on Drug Abuse (NIDA). NIDA is a federal agency that is responsible for conducting and supporting research on drug abuse and addiction. Dr. Volkow is a world-renowned expert on drug abuse and addiction. She has a deep understanding of the opioid epidemic and has been a leading voice in the fight to address it.
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Example topics NURS 6050 agenda comparison grid and fact sheet assignment:
Part 1: Agenda Comparison Grid
Population Health Concern: Opioid epidemic
Factors contributing to it: Over-prescription of opioid painkillers, introduction of fentanyl, lack of treatment options
Administration Agenda Focus Financial/Other Resources Approach
Current (Trump) 2017-2021 Declared public health emergency; focused on law enforcement and interdiction. Increased funding for treatment by $6 billion over 2 years. Sought to reduce over-prescription and make naloxone more available.
Previous (Obama) 2009-2017 Worked to address over-prescription, expand access to treatment, and support for people in recovery. Increased CDC funding for prevention by $1 billion over 2 years. Focused on public health approach including expanding access to treatment.
Previous (Bush) 2001-2009 Increased funding for law enforcement and interdiction. Did not significantly address over-prescription or expand treatment options. Took a criminal justice approach rather than public health.
Part 2: Agenda Comparison Grid Analysis
Agency responsible: The Department of Health and Human Services (HHS) through the Substance Abuse and Mental Health Services Administration (SAMHSA) would be responsible for helping address the opioid epidemic through funding treatment and prevention programs.
How issue gets/stays on agenda: Stories of lives lost to overdose help raise awareness and keep the issue in the spotlight. Advocacy from medical organizations and those in recovery lobby for evidence-based solutions and policies around pain management, treatment, and harm reduction. Public health data on the growing toll also contributes to maintaining it as a priority.
Entrepreneur/champion: Former Surgeon General Vivek Murthy who spoke openly about the need to curb over-prescription and advocated for a comprehensive public health approach including medication-assisted treatment. Advocacy groups like Facing Addiction also help bring personal stories to policymakers to illustrate the need for action.
Part 3: Narrative Fact Sheet
The opioid epidemic is a public health crisis that has taken hundreds of thousands of lives and torn apart communities across the U.S. Overdose is now a leading cause of death for Americans under 50. While the problem originated within the healthcare system due to over-prescription of opioid painkillers, it now requires a comprehensive, evidence-based public health solution (National Institute on Drug Abuse, 2021).
Nurses are on the frontlines of this crisis, caring for patients struggling with addiction. They understand that substance use disorders are chronic illnesses that often require long-term treatment and support for recovery. Medication-assisted treatment combining behavioral therapy and FDA-approved medications like buprenorphine has proven effective at managing symptoms, reducing cravings, and supporting recovery (Substance Abuse and Mental Health Services Administration, 2020).
Policymakers must address this as both a public health and humanitarian issue by expanding access to evidence-based treatment, removing barriers to lifesaving overdose reversal drugs, and implementing pain management guidelines that curb over-prescription (Trust for America’s Health, 2021). With sustained funding and multi-pronged policies, we can reduce the toll of this preventable epidemic. Nurses stand ready to work with legislators on solutions that will save lives.
References:
National Institute on Drug Abuse (2021). Opioid overdose crisis. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
Substance Abuse and Mental Health Services Administration (2020). Medication-assisted treatment improves lives. https://www.samhsa.gov/medication-assisted-treatment/treatment#evidence-based-approaches
Trust for America’s Health (2021). Prevention for a healthier America: Investments in public health work. https://www.tfah.org/report-details/prevention-for-a-healthier-america-investments-in-public-health-work/
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Example topics for NURS 6050:
Public Health Concern: Obesity in Children and Adolescents
Obesity among children and adolescents is a growing public health concern in the United States. According to the Centers for Disease Control and Prevention (CDC), obesity affects around 1 in 5 school-aged children and young people between the ages of 6-19 years old (CDC, 2022). Obesity in youth can have both immediate and long-term health impacts. Children and teens who are obese are more likely to have risk factors for cardiovascular disease such as high cholesterol or high blood pressure. In addition, obesity in childhood increases the risk of obesity, diabetes, and other chronic diseases in adulthood (CDC, 2022).
Factors that contribute to rising rates of childhood obesity are multifaceted. On the individual level, lack of physical activity and consumption of excess calories from sugar-sweetened beverages and foods high in fat, salt, and sugar play a role (CDC, 2022). However, contributing environmental factors at the community and societal level must also be addressed. These include lack of access to affordable healthy foods and safe spaces for physical activity, heavy marketing of unhealthy foods to youth, and policies that promote excess calorie intake and sedentary behaviors (CDC, 2022). A comprehensive, multi-pronged approach is needed to curb the obesity epidemic among America’s youth.
Presidential Agendas on Childhood Obesity:
The Obama Administration (2009-2017) made childhood obesity a public health priority. First Lady Michelle Obama launched the “Let’s Move!” initiative in 2010 to promote healthy eating and physical activity for children. The administration increased funding for programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and provided grants to develop healthier school meals and physical education standards (Kaiser Family Foundation, 2013). The Affordable Care Act also required chain restaurants to post calorie counts on menus (Kaiser Family Foundation, 2013).
The Trump Administration (2017-2021) did not maintain childhood obesity as a key agenda item. Proposed budget cuts targeted programs like WIC that provide nutritious foods to low-income families (Center on Budget and Policy Priorities, 2019). The administration rolled back school nutrition standards set by the Obama era that aimed to reduce sugar, salt, and fat in school meals (Center on Budget and Policy Priorities, 2019). However, private sector commitments to change food marketing to children continued during this time (Yale Rudd Center, 2022).
The Biden Administration (2021-present) has renewed focus on addressing childhood obesity. The American Rescue Plan Act provided $28 billion to help schools adapt to COVID-19, including improving nutrition (White House, 2022). The administration aims to strengthen nutrition standards in federal food programs, limit marketing of unhealthy foods to children, and increase access to physical education (White House, 2022). The proposed budget also includes funding increases for obesity prevention and community programs (White House, 2022).
Agency Responsible:
The Department of Health and Human Services (HHS) and specifically the CDC would be responsible for helping address childhood obesity at a national level. As the leading national public health institute, the CDC conducts critical research, monitoring, and programs focused on nutrition and weight status in the U.S. (CDC, 2022). The agency provides grants to state and local organizations to develop and implement obesity prevention initiatives in areas like schools, childcare centers, and communities. HHS and the CDC would continue championing policy and environmental strategies to curb obesity trends among America’s youth.
Entrepreneur/Champion:
An ideal entrepreneur/champion to promote the issue of childhood obesity on presidential agendas would be a respected pediatrician or children’s health advocate. A prominent figure like Dr. Robert Kushner, a pediatrician who studies childhood obesity, its comorbidities, and community-based interventions, could effectively communicate the urgency and public health impacts of the issue (Northwestern University). As an expert in his field with experience developing evidence-based programs, Dr. Kushner could advise presidents and policymakers, generate public support, and help secure necessary funding and policy changes. His medical expertise and reputation would lend credibility in agenda-setting discussions.
Narrative Fact Sheet:
Childhood obesity is a serious public health problem in the United States that requires attention and action from our political leaders. Nearly 1 in 5 children aged 6-19 years have obesity, putting them at risk for health issues like diabetes, heart disease, bone and joint problems, sleep apnea and social and psychological problems (CDC, 2022). As nurses, we see firsthand the effects of this epidemic and the challenges faced by families trying to establish healthy behaviors. Environmental factors like limited access to healthy affordable foods and opportunities for physical activity in some communities exacerbate this crisis.
Nurses are well-positioned to advocate for policy solutions and help place childhood obesity higher on the national agenda. Through research, clinical practice, and work in schools and community centers, nurses understand the complex factors contributing to obesity trends and what strategies can effectively address them (American Nurses Association, 2015). This includes policies to improve nutrition in federal food programs, strengthen physical education standards, and restrict unhealthy food and beverage marketing to children. As trusted health professionals, nurses can educate policymakers on this issue and champion funding for evidence-based community programs. With nurses leading the way, our political leaders can create meaningful change to support families and reverse the childhood obesity epidemic. The health of our nation’s youth depends on it.
References
Centers for Disease Control and Prevention. (2022). Childhood obesity facts. https://www.cdc.gov/obesity/data/childhood.html
Center on Budget and Policy Priorities. (2019, August 7). Trump administration’s harmful changes to SNAP nutrition standards hurt those struggling with hunger. https://www.cbpp.org/research/food-assistance/trump-administrations-harmful-changes-to-snap-nutrition-standards-hurt
Kaiser Family Foundation. (2013, February 15). The role of Medicaid in childhood obesity policy. https://www.kff.org/medicaid/perspective/the-role-of-medicaid-in-childhood-obesity-policy/
Northwestern University. Robert Kushner Lab. https://www.feinberg.northwestern.edu/sites/robertkushner/index.html
White House. (2022, March 28). Fact sheet: The Biden-Harris administration is committed to addressing nutrition and food insecurity. https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/28/fact-sheet-the-biden-harris-administration-is-committed-to-addressing-nutrition-and-food-insecurity/
Yale Rudd Center. (2022). Pledges. https://www.pledgetochange.com
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