During the COVID-19 pandemic, the issues of health equity and disparity have been thrown into sharp relief because of rapid changes in national and international healthcare, economics, and social structures. In particular, the disparate impact of the pandemic and its associated sequelae-including increases in mental health problems (Stamatis et al., 2022) and gender-based violence (Sediri et al., 2020), decreased resources for individuals with disabilities (Gignac et al., 2021), and reduced access to reproductive health care (Lindberg et al., 2020)-on marginalized and underserved groups, has prompted professional interrogation of the ways in which health equity can be enhanced. For forensic nurses, these issues have always had special relevance, given the role of forensic nursing in supporting health equity and reducing disparity for particularly vulnerable populations.

There are many definitions of health equity. The Robert Wood Johnson Foundation defines health equity to mean "that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care" (Braveman et al., 2017). The field of forensic nursing is deeply invested in removing barriers to health equity. The specialty grew out of a desire to improve the care provided to patients after trauma, to reduce revictimization, in essence, to make things better, without making them worse. In caring for survivors of violence and abuse, those experiencing debilitating mental illnesses, incarcerated persons, and the families of the deceased, forensic nurses inherently seek to reduce the impacts of marginalizing and disempowering events on the health and well-being of our patient populations. Moreover, the science and practice of forensic nursing necessarily illuminates disparities in health and health-related conditions. In this issue, the work of forensic nursing with regard to health equity is highlighted and shown across diverse contexts and through a variety of applications.

The depth and breadth of forensic nursing practice is reflected in the articles included in this issue, many of which report work with populations that are often underrepresented in the scientific literature. For example, in this issue, there are three articles discussing the provision of forensic nursing in a gender-affirming manner. One of these, authored by Mackler, Williams, and Sharpe, reports an initiative to enhance education on the provision of gender-affirming and trans*-specific care training to sexual assault nurse examiners. Notably, the authors found that only 18.2% of participants had received such content in their sexual assault nurse examiner training. This highlights a critical issue in forensic nursing and the importance of attending to the needs of an increasingly diverse patient population.

Elsewhere, Draughon Moret, Choe, and Anderson report on a community-based sample of men who sought care for sexual assault-a population long omitted from the forensic nursing literature, in part because of the difficulty of capturing this particular demographic. This article provides vital insight into the perspectives of male survivors and suggests how forensic nurses can better serve this group. Also heretofore little discussed in the literature are women with disabilities, a population examined in the article, "Reproductive Coercion Among Women With Disabilities: An Analysis of Pregnancy Risk Assessment Monitoring Systems Data" (Amos et al., this issue). This work brings together the issues of reproductive coercion and abuse among women with disabilities and uses a large data set to elucidate the impact of these intersecting concerns on health risk and overall social and economic potential. Furthermore, it reveals the potential of large data set analyses to provide insights into both the experiences of underrepresented populations and the need for expanded and enhanced forensic nursing practice.

Two articles also add to the oftentimes complex and nuanced literature describing care of incarcerated persons. Reeder's meta-ethnography of qualitative studies describing experiences of accessing mental health care within the carceral system illuminates the importance of therapeutic relationships in accessing mental health services. Given the necessarily system-oriented structure of custodial health care, another primary theme discussed the lack of patient-centered mental health care. These findings show that forensic nurses working within custodial health systems can improve care for individual patients, while simultaneously calling for better alignment between patient needs and system priorities.

Ultimately, the current issue makes manifest the multifaceted nature of forensic nursing and its necessity in the provision of person-centered care after traumatizing and disempowering experiences. This is of special importance to populations already affected by structural stressors, community and historical traumas, and other biases. Two articles here describe how women of color consider the issues of intimate partner violence and/or sexual assault in the context of their cultures, families, and environments. One of these describes how college women of color envisioned supportive resources and options after such an experience, noting the potential for retraumatization by system responses as well as expectations of dismissal and silencing from organizations with historic racial biases (Gepshtein & Burton, this issue). Similarly, the other article explores how an insular immigrant community perceives the risks associated with seeking help from healthcare workers and law enforcement officials outside the community, rather than following more traditional pathways such as through family or religion (Prasad et al., this issue).

Clearly, the work of forensic nursing encompasses a wide variety of avenues to increase health equity and to improve the lives of marginalized populations. This work is challenging in the best of circumstances, and among those who train as forensic nurses, less than 40% are still practicing after 2 years (Iritani, 2016). In addition, in the United States alone, there is both a critical shortage and an urban concentration of forensic nurse examiners-further reducing access among low-resource and ruralized populations. There are thus significant disparities in who has access to forensic nursing services, and these are often exacerbated by socially constructed structural factors such as race, gender, and socioeconomic privilege. The articles in this issue highlight the ways forensic nurses are working within current structures and institutions to improve the care provided to historically marginalized groups and point toward ways we can as a profession work to improve care for all of our patients.

References