Racism as a public health issue. In a statement to the media last spring, Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, pronounced racism "a serious public health threat that directly affects the well-being of millions of Americans," and pledged the agency's support for efforts to mitigate its harms and address disparities in health care. The announcement came amid ongoing reports of racial violence, including attacks on Asian Americans during the COVID-19 pandemic, and calls to address structural racism in health care. In January 2021, leading nursing organizations formed the National Commission to Address Racism in Nursing to analyze racism's impact and the ways individual nurses can confront this issue. Martha A. Dawson, president and chief executive officer of the National Black Nurses Association, a lead organization of the commission, commented in a press release that "we are witnessing the evolution of the nursing profession at the intersection of overdue and delayed action to address racism, political and social determinants of health, and health inequities." She called on nurses to embrace these goals "so that the next generation of nurses can carry the torch boldly."
Abortion access. In July, the Guttmacher Institute reported that 2021 saw 90 abortion restrictions passed by state legislatures, more "than in any year since the Roe v. Wade decision was handed down in 1973." In September, the Supreme Court allowed a Texas law to take effect that limits all abortions after about six weeks, when most women don't yet know they're pregnant, and empowers citizens to sue anyone who assists a woman in obtaining an abortion. As we went to press, the Supreme Court was scheduled to hear a case from Mississippi that challenges the federal right to abortion precedent. In response, some states, including New Mexico, California, Virginia, Washington State, Colorado, and Connecticut, have moved to protect and expand access to abortion care and insurance coverage, and Hawaii passed a law in April allowing advanced practice nurses to provide abortion care.
Child migrant conditions. The complex crisis at the U.S. southern border continued unabated last year as people fled nations devasted by the economic fallout from COVID-19 and natural disasters. An estimated 1.7 million migrants tried to enter the United States illegally in 2021, a record since the government began tracking numbers in 1960. This included 150,000 unaccompanied children. Children are kept in detention centers until they're released to U.S. sponsors; as of late October, nearly 11,000 children were still living in these facilities. A July BBC investigation into one Texas border facility described "alarming conditions," including alleged "sexual abuse, COVID and lice outbreaks, a child waiting hours for medical attention, a lack of clean clothes, and hungry children being served undercooked meat."
State laws that discriminate against transgender individuals. President Joe Biden signed an executive order on his first day in office to prevent discrimination on the basis of gender identity or sexual orientation, specifically mentioning access to health care. But at the state level, 2021 saw a record number of laws enacted that limit access to certain health care services and in other ways curtail the ability of lesbian, gay, bisexual, and transgender (LGBT) people to fully participate in school and society. In late October, Texas governor Greg Abbott signed a bill banning transgender youth from participating in sports, making it the 25th state to enact anti-LGBT legislation last year, according to Human Rights Watch, which notes 13 such laws in eight states target transgender people specifically.-Corinne McSpedon, senior editor