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 NRS 428 Benchmark – Policy Brief

NRS 428 Benchmark – Policy Brief

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People’s productivity depends on their health statuses, and it is crucial to keep health at an optimal level always. Disappointingly, many problems hampering care provision at the global, state, and community levels make it challenging to achieve the optimization required. For instance, the world’s global warming level keeps on rising, risking the populace’s health. Due to the far-reaching effects of such problems, public health policies usually play a fundamental role in controlling the magnitude of damage and remedy situations. The declining state of air quality in California due to pollution is a worrying issue that can be remedied through policy interventions.

Policy Health Issue: Description

The respiratory system functions at the best level required when people breathe fresh air. Despite this general fact, not many people are guaranteed quality air as pollution levels increase progressively. As highlighted in the American Public Health Association (APHA) website, climate change over the years has been increasing ground-level ozone and other types of air pollution, and the state of California is among the most affected. Frankly, the entire population is affected, but the damage is more severe among older people due to their low immunity levels (Simoni et al., 2015; Chen et al., 2015). They appear the most affected since the direct consequences of air pollution such as air toxics and particulate matter increase their hospitalization and infection with asthma and bronchitis. California has eight out of the ten most polluted cities in the United States (American Lung Association, 2020). This figure implies that the problem is critical in California, and more interventions to supplement the current frameworks are crucial.

Problem Statement

The environment plays an instrumental role in keeping people healthy. Food production and quality of air depend, to a large extent, on the climatic patterns. When climate change is unfavorable, the entire population faces considerable risks, which typifies what has been happening in California. According to Cart (2020), air pollution has been worsening over time; its severity can be confirmed because staying at home during the Covid-19 pandemic has not decreased it to the level required in any notable way. Emissions that increase the danger have been increasing over time too. Sommer et al. (2020) noted that emissions, combined with hot and stagnant weather, make air pollution hit dangerous levels, particularly in the summer, leading to a scenario where California does not comply with federal air standards. Such situations need robust policies to remedy.

The current situation and notable efforts show that there has been an effort to reduce air toxicity in California, but there is a lot to be done. The extent of danger is greater than the control measures. For instance, pollution reductions under the Clean Air Act have prevented approximately 205,000 premature deaths (Revesz & Lienke, 2016). However, the general objective of policies and supplementary laws should be to accomplish a state where every population segment is safe. Policies should further protect the most vulnerable, which does not happen in California.

The Current Policy: Breathing Fresh Act of California

From a general viewpoint, this policy is anchored on the idea principle that a policy should define a vision for the future. The

NRS 428 Benchmark - Policy Brief

NRS 428 Benchmark – Policy Brief

Breathing Fresh Act follows a similar concept with the Clean Air Act but improves when it comes to reviewing. Unlike requiring the state to review its environmental protection guidelines after eight years like the Clean Air Act, the Breathing Fresh Act will obligate the state to review its rules every three years. Furthermore, all organizations should have elaborate social responsibility programs centered on environmental protection while concentrating on making the air free from pollution.

Initiating this policy follows the general procedure of policymaking. The first step is identifying the need, which has already been done. The damaging effect of toxic air should be minimized to health-friendly levels. The second step is delegating responsibility. A team should work on it to develop ways in which the authorities will be reached and informed. After that, a draft policy will be composed, followed by consultation with appropriate stakeholders. Here, the target stakeholders are the politicians and other government officials, particularly the Senator, who can sponsor the recommendations as a bill.  The main budgetary consideration to make is how to print copies of the act and distribute it to influential individuals at the community level.

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Impact on the Health Care Delivery System

Health care provision is centered on a patient-centered practice that prioritizes quality. In agreement with Bhatt and Bathija (2018), one way of ensuring that people get quality care is by reducing infections as much as possible and protecting the vulnerable populations with more resources. Health care providers should never be overburdened too. Implementing the Breath Fresh Act implies that the California health care fraternity and the government are committed to reducing respiratory infections in the state. Doing so will keep everyone safe from such infections and ensure that the state’s productivity does not decline as industrialization that increases air pollution grows at all levels.

Admittedly, no state can guarantee its people total protection from illnesses. Challenges must emerge often, and environmental damage has been a leading source of public health problems. In California, air quality has been declining due to continuous pollution, causing diseases such as asthma and bronchitis. The proposed policy recognizes the need for practical and long-lasting solutions to such problems. It is hoped to make a massive impact on keeping people productive at the community, state, and national levels.

NRS 428 Benchmark – Policy Brief


American Lung Association. (2020, Apr 21). Nearly half of US breathing unhealthy air; record-breaking air pollution in nine cities. Eureka Alert!. https://www.eurekalert.org/pub_releases/2020-04/ala-nho041720.php

Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic Medicine93(9), 1271-1275. doi: 10.1097/ACM.0000000000002254

Cart, J. (2020, Apr 12). As Californians stay at home, air quality improves – for now. Cal Matters. https://calmatters.org/health/2020/04/as-californians-stay-at-home-air-quality-improves-for-now/

Chen, Z., Salam, M. T., Eckel, S. P., Breton, C. V., & Gilliland, F. D. (2015). Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children’s Health Study. Journal of thoracic disease7(1), 46–58. https://doi.org/10.3978/j.issn.2072-1439.2014.12.20

Revesz, R. L., & Lienke, J. (2016). Struggling for air: Power plants and the “war on coal”. Oxford University Press.

Simoni, M., Baldacci, S., Maio, S., Cerrai, S., Sarno, G., & Viegi, G. (2015). Adverse effects of outdoor pollution in the elderly. Journal of thoracic disease7(1), 34–45. https://doi.org/10.3978/j.issn.2072-1439.2014.12.10

Sommer, L., Hersher, R., Jingnan, H., & Beniscasa, R. (2020, May 19). Traffic Is Way Down Because Of Lockdown, But Air Pollution? Not So Much. NPR. https://www.npr.org/sections/health-shots/2020/05/19/854760999/traffic-is-way-down-due-to-lockdowns-but-air-pollution-not-so-much

Topic 4 DQ 2

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

  1. “About the Affordable Care Act”
  2. “Health Care Transformation: The Affordable Care Act and More”

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

The Affordable Care Act can be defined as a comprehensive healthcare change signed by former U.S President Barack Obama. It is usually changed rarely to enhance and improve the health care given to the patients in the U.S. The affordable care act guarantees access to proper health care for all citizens and enhances sound clinical practices to guarantee coordination and quality. It also gives health professionals more information to make them better and also provides the patients with more details to ensure that they appreciate the health services and make observations on customers, hence changing the system of paying to reward value (McCarthy, 2017). The Affordable Care Act (ACA) law has transformed the American health care system by expanding health coverage to 20 million Americans and saving thousands of lives.

The ACA codified protections for people with preexisting conditions and eliminated patient cost sharing for high-value preventive services. And the law goes beyond coverage, requiring employers to provide breastfeeding mothers with breaks at work, making calorie counts more widely available in restaurants, and creating the Prevention and Public Health Fund, which helps the Centers for Disease Control and Prevention (CDC) and state agencies detect and respond to health threats. It is imperative to note that ACA protected roughly 135 million Americans with preexisting conditions, which could face discrimination if they ever needed to turn to the individual market for health coverage (Fang & Krueger, 2021). ACA generated one of the most significant health coverage expansions in U.S. history. In 2010, 16 percent of all Americans were uninsured; by 2016, the uninsured rate hit an all-time low of 9 percent.

Nurses historically respond to changes in regulation and financing of health care with innovation and professional responsibility. Nurses are integral in sustaining the financing of healthcare concerns through integrated activities with policy makers and other stakeholders due to the need to close the gap between funding the Medicare trust, health related expenditures, and insurance plan stability (Sutton, 2020). Nurses remain uniquely involved in shaping healthcare because of their team approach, proximity to the bedside, and understanding of patient care within the hospital and the community.


Fang, H., & Krueger, D. (2021). The Affordable Care Act after a Decade: Its Impact on the Labor Market and the Macro Economy. SSRN Electronic Journal, 65(9), 8–15. https://doi.org/10.2139/ssrn.3922514

McCarthy, M. (2017). Trump signs order targeting key elements of Affordable Care Act. BMJ, 31(7), j406-412. https://doi.org/10.1136/bmj.j406

Sutton, A. (2020). The Affordable Care Act And The Individual Market. Health Affairs, 39(5), 907–907. https://doi.org/10.1377/hlthaff.2020.00347

Clara, thanks for your descriptive post. The role of the nurse not only is to provide care and carry out orders. Nurses must educate the community on the risks of not seeking proper treatment. With the ACA, congress faced many challenges as well due to mandate for citizens to obtain health insurance or pay a penalty. Many people did not like being forced to purchase insurance or pay the penalty (Nurse Journal, 2021). As nurses, we must educate the community on the importance of healthy choices and although it is one’s right to refuse medical care and insurance, they must still be seen to prevent illnesses and hospitalization.

The Affordable Care Act and nursing. NurseJournal. (2021, October 26). Retrieved September 24, 2022, from https://nursejournal.org/resources/affordable-care-act-nursing-guide/#how-nurses-can-shape-healthcare-reforms

Hello Clara, thank you for sharing. The IOM report indicates that, with the passage of the ACA, nurses are in prime position to now practice as fully as possible, reducing barriers to advanced practice nursing. This has meant including nurse practitioners in Medicare compensation, just as physicians already were. The report urged states to revise their Nurse Practice Acts to remove barriers to advance practice. Among the recommendations was the reduction of barriers to furthering nursing education such as expansion of scholarships, loans, and grants, as well as recommendations for an increase in baccalaureate-prepared nurses and development of nurse residency programs. The advancement of nursing leadership includes meeting the recommendation of doubling the number of nurses with a doctorate, along with the expectation of all nurses to incorporate theory, research, clinical competency, and leadership development to meet the changing needs of health care (IOM, 2011b).


Institute of Medicine. (2011b). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.

Hello Clara, I agree with you, as nurses, we have some responsibilities and one of them is to keep up with the healthcare innovations, there is so much new information we must learn and put into practice. Thanks to the resources to help us learn we can provide education to our patients, according to our eBook, “conditions of this century’s current health care demand that nurses become knowledgeable about policies affecting health and health care. Nurses, as advocates with leadership abilities, are in a position to turn health care in the United States from being 11th to Number 1 in the world” (Grand Canyon University, 2018). Which is an amazing fact we advocate for and impact our patients.


Grand Canyon University (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

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