This year has been designated as the World Health Organization (WHO) International Year of the Nurse and Midwife in honor of the bicentenary celebration of Florence Nightingale. Nurses and midwives are the largest groups of healthcare workers globally, and as such are essential stakeholders in promoting world health, and have multiple opportunities to participate in and advance the United Nations Sustainable Development Agenda (UNSDA) as nurses and midwives connect more fully throughout the world (Rosa & Iro, 2019). It is highly appropriate that Nursing Outlook published a landmark series of articles focusing on nursing and midwifery advocacy to lead the UNSDA (Rosa & Iro; Rosa et al., 2019).

There is a common misconception that the UNSDA is applicable only to low- and middle-income countries, but critical goals for health and well-being are also unreached in the United States. For example, a recent study focused on maternal characteristics and infant outcomes in Appalachia and the Delta. Findings indicate that newborns of women giving birth in the Delta and Appalachia had worse outcomes such as higher infant mortality rates, preterm birth or low birthweight, when compared with newborns across the United States. Their mothers were more likely to be adolescents with low educational levels and less than adequate prenatal care (Driscoll & Ely, 2019). Another example is health disparities among American Indian/Alaska Native (AI/AN) childbearing women related to social determinants of health including poverty, low educational levels, limited access to healthcare, and adverse childhood events (Indian Health Services, 2019). Infant mortality rates are 9.21 deaths per 1,000 live births for AI/AN women compared with an overall U.S. rate of 5.79 deaths per 1,000 live births (Ely & Driscoll, 2019). Nurses and midwives are global citizens. Nurses and midwives should seek opportunities to extend their reach and improve the health and quality of life both within and beyond their clinical practice, their work as nurse educators, and their scholarly works.

One nursing college seeking to develop nurses who are global citizens is Brigham Young University, which offers a global health course that provides didactic and clinical opportunities to gain needed knowledge and skills. This year students have practicum options in Fiji, Taiwan, Czech Republic, Finland, Ghana, India, Spain, Ecuador, and with vulnerable populations locally (https://nursing.byu.edu/global/). A strong focus of this course is to understand the impact of social determinants of health. Nursing and midwifery organizations with an increasing emphasis on global citizenship in nursing include the American Academy of Nursing, American Association of Colleges of Nursing, International Council of Nurses, Nursing Now Campaign, Sigma Theta Tau, and WHO (2016, p. 13) which has called for increasing the "availability, accessibility, acceptable, quality and cost-effective nursing and midwifery care."

I invite readers of MCN to share examples of how as nurses and midwives we can extend our reach and become more actively involved as global citizens supporting the fulfillment of the UNSDA. Sharing your thoughts and experiences with vulnerable populations such as immigrants and refugees locally, and providing nursing and midwifery care globally would be helpful to the readers of this journal. Please contact me via email so we can begin a dialogue on this important topic.

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