Pressing Health Care Problems in the Community and the Role of DNP Political Engagement
One of the most pressing healthcare challenges facing many communities in the United States is inequitable access to comprehensive, timely, and culturally responsive care, particularly among populations affected by socioeconomic disadvantage, chronic illness, and mental health conditions. Despite advances in medical technology and insurance expansion efforts, significant disparities persist in access to primary care, behavioral health services, and preventive interventions. These inequities disproportionately impact low-income individuals, racial and ethnic minorities, immigrants, older adults, and people with disabilities, raising substantial ethical and social justice concerns (Centers for Disease Control and Prevention [CDC], 2023).
Within my community, barriers such as underinsurance, fragmented mental health services, prolonged wait times, and limited availability of culturally competent providers continue to contribute to suboptimal health outcomes. Access to mental health care is particularly constrained due to workforce shortages, inadequate reimbursement structures, and persistent stigma, resulting in delayed treatment and preventable crises (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). Social determinants of health; including housing instability, food insecurity, transportation limitations, and immigration-related stressors; further exacerbate these disparities and undermine the effectiveness of healthcare services even when they are technically available (World Health Organization [WHO], 2023). From an ethical perspective, these inequities challenge the principles of justice, beneficence, and respect for persons, as those with the greatest needs often encounter the most significant barriers to care.
Doctor of Nursing Practice (DNP)–prepared nurses are uniquely positioned to address these challenges through sustained political engagement and policy advocacy. Beyond direct clinical practice, DNPs are equipped to analyze population-level data, evaluate health policy impacts, and translate evidence into actionable system-level reforms. Political engagement may include advocating for expanded access to mental health services, reimbursement reform for primary and behavioral healthcare, and policies that strengthen community-based prevention, workforce development, and care coordination. For example, DNPs can leverage local outcomes data to inform policymakers about the consequences of mental health workforce shortages or demonstrate the cost-effectiveness of early intervention and prevention programs (American Association of Colleges of Nursing [AACN], 2021).
This leadership role aligns directly with the AACN DNP Essentials, particularly Domain 3 (Population Health), Domain 5 (Quality and Safety), and Domain 8 (Policy and Advocacy), which emphasize systems thinking, ethical leadership, and engagement in health policy to improve health equity (AACN, 2021). Additionally, these responsibilities reflect AONL core competencies, including systems leadership, communication, and health policy advocacy, which are essential for influencing organizational and legislative change (American Organization for Nursing Leadership [AONL], 2021). Ethical leadership in this context requires not only identifying disparities but actively participating in policy processes that reshape healthcare systems to reduce inequities. Ultimately, sustained political engagement by DNP-prepared nurses is essential to transforming healthcare delivery from a fragmented, reactive model into one that is equitable, preventive, and responsive to community needs.
References
American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education.
https://www.aacnnursing.org/education-resources/aacn-essentials
American Organization for Nursing Leadership. (2021). AONL nurse executive competencies.
https://www.aonl.org/resources/nurse-leader-competencies
Centers for Disease Control and Prevention. (2023). Health equity.
https://www.cdc.gov/health-equity
Substance Abuse and Mental Health Services Administration. (2023). Behavioral health workforce report.
https://www.samhsa.gov
World Health Organization. (2023). Social determinants of health.
https://www.who.int