- Liz White-MacDonald
Nurses are faced with daily challenges to deal with an increased in acuity and complexities in regards to patient health outcomes. Nurses participate in advocacy and policy making in adjusting affordable housing to meet the demands of their patients. Policies by nurses have seen drastic changes in the housing communities which has seen an upsurge of low income families managing to secure affordable housing. These drastic changes are in realtion to the exceptional work done br registered nurses in adviacting and offering teacjing to these patients. Nurses are aware that health and poor hosuing had detrimental facets to our patients, and by provind hope and resilience to patients who are low income and lack hosuing security, we are forging an excellent nrand of nurisn gpreactice
Keyword: communication, caring, interaction, therapeutic relationship
Affordable Housing and Income Inequality
Access to affordable housing is a serious concern facing many households in Canada, particularly for low incomes households that are trying to keep up with the high rise of housing costs. This concern with the issues related to the supply of affordable housing have focused their approach to income inequality, unfair housing markets, lack of a national housing strategy in Canada , lack of growth in affordable housing options relative to low income families. In this paper, I intend to examine the link between income inequality and affordable housing in Canada and its effect on the quality of life of the residents using a family systems approach.
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An important aspect of the current Canadian economy is that of the dual income family. Many dual income families in Canada require both partners to work in order to provide secure housing, childcare and food security. Most Canadians that have a decent job and roofs over their heads and the income to afforde groceries do not hesitate to argue for affordable housing. However, for low-income families, whose income can be gone in trying to keep their family sheltered in an appropriate and acceptable home, this can be faced with many economical and health issues. Consequently, many families are working full time far below the poverty line in jobs that are unstable, without security, benefits or flexibility for family related responsibilities. To qualify for subsidized housing in Edmonton , an applicant must have a gross household income of atleast $48,000 for a two bedroom, 59,000 for a three bedroom and $64,000 for a fourn bedroom, besides the gross household income potential buyers must also possess a vefication letter of job and successfully pass a criminial background check, have thhe downpayment, and credit rating. In addition, during my interview, the interviewee insisted that if housing prices fall within a decent price range for a 3 bedroom house , she will be more than happy to adjust and prioritize her list of wants/needs to fit what they can afford, however housing costs are fluctuating every year in Edmonton, and recently the Canadian Mortgage and Hosuing Corpation( 2015) stated that, “ Effective June 1st, 2015, the mortgage loan insurance premium for homebuyers with less than a 10% down payment will increase by approximately 15% (Canada Mortgage and Housing Corporation [CMHC], 2015). This new change will make it tougher for low income families to access first time homes. Despite the relatively attainable steps in achieving homes in Canada, families are still facing economic issues in accessing homes. This is due to the fact that mortgages and housing policies have not been flexible in modifying their approach to allow low income households better options to buy newer homes.
Nurses can be advocates in helping patients achieve affordable housing and a safer health status by connoting policies or engaging in design standards that enable families of diverse economic means, racial/ethnic backgrounds or family compositions to live in housing and neighborhoods that enable then exercise to the fullest extent possible personal choice in housing, education and employment. This choice enables families to enjoy equal opportunity for economic and social mobility and enables communities to smoothly adapt to inevitable changes over time in employment, infrastructure and demographics .Affordable housing and income inequality involves nurses participation at all levels of their scope of practice, in doing so, nurses recognize factors that prevent and/or are detrimental to their patient’s health and attempt to address the social, economic( salary and wages) and environmental aspects ( neighbourhood and services available). In their article, Anderson et al. (2003) supports the idea that Affordability of housing is linked to the health and well-being of individuals and families. When a market lacks a sufficient supply of affordable housing, lowerincome families are often forced to limit expenditures for food, medical care, and other necessities in order to pay rent.The lack of affordable housing within a community can contribute to family residential instability, as families are forced to move frequently, live with other families in overcrowded conditions. (Anderson et al., 2003)
To be effective advocates, Registered Nurses will need to rely on their education and self-reflection on their own beliefs and practices surrounding income and poor housing and the effect it has on health. Nurses also need to bring awareness of poor housing and its complication on their patients’ health to the policy table. For the purpose of understanding our patient’s health it critical to advocate through policies on behalf of our patients. Advocacy presents a benchmark where health issues can be forwarded to the appropriate municipal, regional or government offices which may require policy changes. According to Goodman (2014), Opportunities for advocacy abound. Whatever one’s personal interests, commitments, and skills, there is an opportunity for every nurse to participate actively in shaping the future of nursing (p. 668). Despite the lack of affordable housing crunch, federal, municipal and government agencies have attempted to address issues related to affordable housing. However, polies or market changes have not been met to prevent the housing crunch. Nurses through advocacy can be an important mediator in this emerging issue.
Role of Advaocacy In nursing
Nursing Advocacy has been one of the most vital and basic roles of the nursing profession. Despite bring intricate in nature it promotes a form of representation for our patients, supports autonomy and respect for our patients regardless of their diagnosis. In addition, advocacy acts as a mediator between the patient and the health system. In our nursing profession, advocacy is guided by CARNA through its ethical codes. These codes influences the profession in a organize and professional way.
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In nursing literature and research on the subject, Cole, Wellard & Mummery (2014) states, “ advocacy in nursing is defined as a nurse actively supporting patients in relation to their rights and choices, clarifying their healthcare decisions in support of their informed decision-making and protecting basic human rights such as autonomy. (p. 577.
Nursing advocacy is usually discussed within the realms of patients right and the philosophy of nursing as a whole, however, it is critical to recognise that nursing advocacy can also be discussed as a professional approach that falls outside the therapeutic nurse patient relationship . There is always a constant call for nurses to be advacates in affordable hosuing for their patients, however most nursing advocacy are done within the span of the unit and hospital, Affordable housing advocacy encourages nurses to go beyond their normal physical space to municipal, government and federal meetings. To achieve this nurses must possess emotional strength and the right education to perform the needs of patient advocacy successfully.
Using a family center approach, Nurses must work with the family to develop strategies that provided opportunities for patients. By looking at factors that affect each family member and also be able to identify each family member strength and which helps in the sustaiblity of good hosuing. Despite the strength of the Canadian housing market, affordable housing and stable vvibrant communities remain unequally distributed. These inqualities stems from the shortages of affordable hosuing communities, income inequality and current state of the country’s economy. Bryant (2003) in his article argued that , “ The availability and affordability of housing plays an important role in relationship to other social determinants of health. People can go without many things, but going without housing is potentially catastrophic. If citizens are required to spend increasing proportions of available resources on maintaining a roof over their head, the resources available to support social determinants of health such as food and educational resources are diminished. (Bryant, 2003, p. 55).
Research by Krieger & Higgins (2002) supports the increasing body of evidence that has associated housing quality with morbidity from infectious diseases, chronic illnesses, injuries, poor nutrition, and mental disorders (Krieger & Higgins, 2002) . Affordable living and low income is a critical need in mitigating the devastating effects of poverty. People that lack adequate income fall prey to many diseases such as chronic diseases, hypetension, tuberculosis etc. For nurses to be successful advacates for patients in having affordable hsouing policies impemting. Nurses need to be educated and seek further nursing practice development.
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