On June 10, 1924, 6 cardiologists met in Chicago to form the American Heart Association (AHA) to combat heart disease, America's no. 1 killer. The association eventually transformed from a professional, scientific society into a nationwide voluntary health organization composed of scientists, clinicians, and lay volunteers supported by experienced staff. The Cardiovascular and Stroke Nursing Council (CVSN) is one of the 16 councils of the AHA. An inclusive group of volunteers and staff is essential to the association's objective-to be a relentless force for a world of longer, healthier lives. The AHA aspires to be an organization that incorporates diverse perspectives from investigators and participants of AHA-funded research, which is essential for improving health and clinical outcomes for all.
American Heart Association Presidential Advisory on Structural Racism
The AHA published a presidential advisory1 in 2020 on structural racism, characterized by racial hierarchy favoring Whites and resulting in inequalities of power, access, and opportunities for people of color. The authors identified structural racism as a root cause of persistent health disparities in the United States and an impediment to health equity. The COVID-19 pandemic and the police killings of George Floyd, Breonna Taylor, and others in the spring of 2020 heightened awareness of the consequences of structural racism. Structural racism results in marginalized communities, which have a higher risk of COVID-19 infections due to housing insecurities, overcrowding, poverty, environmental hazards, and lack of access to healthcare. Structural racism additionally affects health research in that race and ethnicity, assessed through self-report, may improperly be presumed to reflect biological or genetic differences. The AHA presidential advisory stresses that affected individuals cannot dismantle structural racism alone. The AHA will work to support awareness of structural racism and promote a national reconciliation around race. The association will additionally advocate for public health funding to understand and address racism as a public health crisis.
Benefits of Diversity
Diversity is associated with improved science, clinical and education outcomes, effective communications, and innovation.2 Furthermore, individuals with varied backgrounds and experiences can expand the range of perspectives and approaches to combating the complexities of health disparities. AlShebli et al3 analyzed 9 million articles and 6 million scientists and found that diversity can increase scientific impact. They also found that ethnic diversity was associated with an impact gain of 10.63% for articles and 47.67% for scientists.
Diversity, Equity, and Inclusion in Nursing
Nursing has a pivotal role in reducing disparities and addressing social determinants of health in managing patient care. Nurses typically enter the profession because they view their calling as addressing health and social needs, promoting disease self-management, and empowering patients and families to collaborate with their healthcare team. Nursing is well positioned to advocate for healthcare equity. However, it is essential to appreciate that racism impacted the foundational nursing profession. When Florence Nightingale founded the first formalized training school for nurses in 1860, she selected White European women although England had abolished slavery in 1833, 27 years earlier.4 The first professional nursing organization in North America, the Nurses Associated Alumnae of the United States and Canada, which evolved into the American Nurses Association, refused to include or support nurses of color.4
Our current nursing workforce has little resemblance to the diverse populations they serve, with 80.8% of registered nurses being White, 7.5% Asian, 6.2% African American, 5.3% Hispanic, 0.5% Native Hawaiian/Pacific Islander, 0.4% American Indian/Alaskan Native, 1.7% having 2 or more races, and 2.9% other.5 Increasing underrepresented groups in the nursing workforce is now a high priority for the American Nurses Association. Increased diversity within the nursing profession may be advantageous in addressing disparities in health outcomes among marginalized patients, including non-White race/ethnicity and lesbian, gay, bisexual, transgender, or queer, and provide quality and appropriate care.
Cardiovascular and Stroke Nursing Council
The CVSN is committed to supporting AHA's mission to create longer, healthier lives with equitable health outcomes for all. Dr Terrie Black, DNP, MBA, FAHA, FAAN, highlighted the importance of diversity, equity, and inclusion in her first monthly message in July 2021. Her message included links to the AHA Presidential Advisory and the AHA's Structural Racism and Health Equity Language Guide to promote understanding and appropriate language related to health equity.
Some of our strategies to increase diversity, equity, and inclusion include the following:
* Our Council created a strategic plan for 2021-2024 to increase membership from diverse backgrounds and identify best practices for engaging these nurses.
* Our strategic plan includes partnerships with the National Coalition of Ethnic Minority Nurse Associations.
* Our Council will feature nurses with diverse backgrounds, including international members, on our Web page and ensure that nursing education, conference topics, and speakers indicate diversity, equity, and inclusion.
* The CVSN will encourage abstract submissions that target cardiovascular disparities.
* We will advocate equitable health outcomes for all by sending a nursing-related "You're the Cure" action item twice per year.
* In addition, we will highlight the work of CVSN members as it relates to diversity, equity, and inclusion initiatives on social media and the AHA's Connection newsletter.
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