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WK 1 RES ALLEGORY

Allegory of the Orchard

The Allegory of the Orchard presents barriers and challenges of underserved, vulnerable, or marginalized populations and communities. These barriers and challenges highlight the importance of understanding the impact of political determinants of health on such groups. This allegory encourages an identification, understanding, analysis, and response to these factors as members of the healthcare community.

For this Discussion, consider the role of the political determinants of health on underserved, vulnerable, or marginalized populations and communities. How might advocates address the health disparities to promote equity and access to high quality healthcare?

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 


WEEKLY RESOURCES

Required Resources

Readings

· Dawes, D. E. (2020). 
The political determinants of health. Johns Hopkins University Press.

· “Foreword (pp. ix–xi)

· Chapter 1, “The Allegory of the Orchard: The Political Determinants of Health Inequalities” (pp. 1–17)

· Porche, D. J. (2023). 
Health policy: Applications for nurses and other healthcare professionals (3rd ed.). Jones & Bartlett Learning.

· Chapter 1, “Policy Overview” (pp.1–20)

· Chapter 6, “Healthcare Systems” (pp. 81–92)

· Walden University Oasis: Writing Center. (n.d.). 

Citations: OverviewLinks to an external site.

. 

· Walden University Oasis: Writing Center. (n.d.). 

Common assignments: Discussion postLinks to an external site.
.

Media

· Satcher Health Leadership Institute. (2021, April 19). 

The allegory of the orchard: The political determinants of health by Daniel E. DawesLinks to an external site.
 [Video].

Note: The approximate length of this media piece is 6 minutes.

· Satcher Health Leadership Institute. (2021, April 19). 

The allegory of the orchard—part II: The political determinants of health by Daniel E. Dawes, part 2Links to an external site.
 [Video].

Note: The approximate length of this media piece is 7 minutes. 

· Satcher Health Leadership Institute. (2021, February 2).
 

The political determinants of health: Jessica’s storyLinks to an external site.
 [Video].

Note: The approximate length of this media piece is 5 minutes.

·
Document: 
Welcome to the DNP Program
 Download Welcome to the DNP Program(PPT)

·
Document: 
Welcome to the DNP Program Narrative
 Download Welcome to the DNP Program Narrative(Word document)

To Prepare:

· View and read the Learning Resources regarding The Allegory of the Orchard.

· Consider the role of political determinants of health on disparities in health for some groups. 

· Consider if advocates should be more concerned with policies that promote equality or equity. 

· Explore your role, as a nurse, in addressing these determinants in our policy advocacy efforts.

By Day 3 of Week 1

Post a response detailing the following: 

Use 
The Allegory of the Orchard to discuss how the political determinants of health negatively impact the health outcomes of a group of patients for whom you care. Why are you, as a nurse, the right person to become politically involved in addressing these determinants?

RESPOND TO THIS DISCUSSION POST

K N R

The Allegory of the Orchard

The Allegory of the Orchard vividly illustrates how political determinants of health influence underserved, vulnerable, or marginalized populations, perpetuating health disparities. These determinants laws, policies, and governance significantly shape access to resources and opportunities, affecting health outcomes. For homeless patients frequently utilizing the emergency department (ED) for care, the interplay between social determinants of health (SDOH) and political barriers presents unique challenges. As nurses, our professional role extends beyond direct patient care; it includes advocacy for equitable health policies. This discussion will explore the negative impacts of political determinants on homeless individuals’ health outcomes and why nurses are uniquely positioned to drive policy changes that promote equity and access.

Political Determinants of Health and Their Impact on Homeless Patients

The Allegory of the Orchard highlights how political determinants of health laws, policies, and governance contribute to health disparities in vulnerable populations. Homeless patients, who frequently utilize EDs for basic care, are disproportionately affected by political determinants of health. Policies that limit funding for affordable housing, mental health services, and addiction recovery programs perpetuate the challenges faced by these individuals (Dawes, 2020).

A lack of supportive policies addressing the root causes of homelessness perpetuates this cycle. For example, policies that restrict Medicaid expansion exacerbate chronic illnesses and mental health conditions among homeless populations (Formosa et al., 2021). Additionally, these patients often lack access to preventive care and consistent follow-up, which leads to frequent ED visits and poor health outcomes (Rhodes et al., 2021). Political determinants, therefore, act as significant barriers to achieving equitable health outcomes for homeless individuals (Satcher Health Leadership Institute, 2021).

The Nurse’s Role in Addressing Political Determinants of Health

As a nurse, I am uniquely positioned to address the political determinants of health affecting homeless patients. Nurses are on the frontlines of care, witnessing firsthand the challenges and inequities that patients face (Winnett, 2022). For instance, my experiences caring for homeless patients in the ED have revealed how inadequate discharge planning and limited access to social services contribute to recurring health crises (Winnett, 2022). Nurses bring credibility and trust to advocacy efforts, making them powerful agents of change. Through professional organizations and legislative advocacy, nurses can lobby for policies that promote equity, such as increased funding for affordable housing initiatives (Porche, 2023). Advocacy for expanded Medicaid coverage is also essential to ensuring homeless populations receive the necessary preventive care (Formosa et al., 2021). Equity-focused policies recognize the need to allocate resources based on the unique challenges faced by vulnerable populations, such as the homeless (Dawes & Gonzalez, 2023). The importance of advocating for equity rather than equality, aligning resources with the specific needs of underserved groups, is further emphasized (Satcher Health Leadership Institute, 2021). By leveraging their expertise and commitment to patient care, nurses can drive systemic changes that address political determinants of health and promote equity.

Conclusion

The Allegory of the Orchard underscores the profound influence of political determinants of health on underserved populations. Homeless individuals face significant health disparities due to systemic barriers, which perpetuate cycles of poor health and reliance on emergency services. Nurses, equipped with firsthand knowledge and advocacy skills, are well-suited to champion policies that address these inequities. By focusing on equity and advocating for systemic change, nurses can play a critical role in reducing health disparities and improving access to high-quality care for marginalized populations.

References

Dawes, D. E. (2020). 
The political determinants of health. Johns Hopkins University Press.

Dawes, D., & Gonzalez, J. (2023). The politics of population health. 
Milbank Quarterly, 101(S1), 224–241.
  to an external site.

Formosa, E. A., Kishimoto, V., Orchanian-Cheff, A., & Hayman, K. (2021). Emergency department interventions for homelessness: A systematic review. 
CJEM, 23(1), 111–122.
  to an external site.

Porche, D. J. (2023). 
Health policy: Applications for nurses and other healthcare professionals (3rd ed.). Jones & Bartlett Learning.

Rhodes, H. M., Simon, H. L., Hume, H. G., Strief, D., Knutson, A., Webber, M. C., & Robertshaw, D. C. (2021). Safety-Net Accountable Health Model Partnership drives inpatient connection to outpatient social services, reducing readmissions in a population experiencing homelessness. 
Professional Case Management, 26(3), 150–155.
  to an external site.

Satcher Health Leadership Institute. (2021). 
The allegory of the orchard: The political determinants of health by Daniel E. Dawes [Video]. YouTube.
Links to an external site.

Satcher Health Leadership Institute. (2021). 
The allegory of the orchard—Part II: The political determinants of health by Daniel E. Dawes, Part 2 [Video]. YouTube.
to an external site.

Winnett, R. (2022). The experiences of hospital social workers who care for homeless patients: An interpretive phenomenological analysis. 
Social Work in Health Care, 61(1), 52–68.
  to an external site.

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