Posted: August 21st, 2024

Policy and Advocacy for Improving Population Health NURS 6050 Paper

Policy and Advocacy for Improving Population Health
NURS 6050 Paper – Agenda Comparison Grid Examples

Table 1: Title and Course Information

Title	Information
First Name Last Name
Walden University
Policy and Advocacy for Improving Population Health	NURS 6050
Date
Policy and Advocacy for Improving Population Health	(The selected health issue is HIV/AIDs. This global pandemic continues to challenge healthcare systems worldwide. Globally, 38 million people are currently living with the virus according to 2019 reports. In America, 1.2 million Americans are infected while 14 percent do not know they have the virus and need testing. The cost of antiretroviral therapy (ART) and doctor’s visit costs individuals between $1,800 and $4,500 annually. Some of the contributing factors include having unprotected sex, sharing contaminated needles, and sexually transmitted diseases. President Trump focuses on enhancing the affordability of drugs, protecting patients with pre-existing conditions, and providing insurance for medication. Obama’s approach was to provide insurance and reduce the cost of care. President Bush initiated emergency treatment called The President’s Emergency Plan for AIDS Relief (PEPFAR). These varied approaches highlight the complexity of addressing HIV/AIDS and the need for multifaceted strategies that consider both domestic and global implications.)

Table 2: Part 1 – Agenda Comparison Grid (Population Health Concern: HIV/AIDS)

Administration (President Name)	President Trump	President Obama	President Bush
Population Health Concern	HIV/AIDS	HIV/AIDS	HIV/AIDS
Description and Contributing Factors	HIV/AIDS has been around for decades across all parts of the world. It disproportionately affects men who have sex with men and intravenous drug users. Globally, 38 million people are living with the virus according to 2019 reports. In the U.S., 1.2 million are infected, and 14% are unaware of their status. Treatment costs between $1,800 and $4,500 annually. Contributing factors include unprotected sex, sharing contaminated needles, and sexually transmitted diseases.	HIV/AIDS has existed for decades and has significantly impacted global health. The virus particularly affects marginalized communities. Factors contributing to the epidemic include unprotected sex, contaminated needles, and lack of awareness. Globally, 38 million people are infected, and 14% of Americans do not know their status. Costs remain high, but Obama’s administration worked to reduce care costs and expand access to testing and prevention services.	HIV/AIDS has impacted global health for years, affecting millions worldwide. Factors include unprotected sex, drug use, and poor access to care in many countries. Globally, 38 million people live with the virus, and treatment costs remain high. Bush’s administration focused on global relief, particularly through PEPFAR, which provided significant resources to African nations.

Table 3: Agenda Focus of Each Administration

Administration (President Name)	President Trump	President Obama	President Bush
Agenda Focus	The focus of President Trump was to enhance drug affordability, protect patients with pre-existing conditions, and insurance for medication. His administration aimed to reduce new HIV infections by 75% in five years and 90% in ten years. Trump initiated the ‘Right to Try’ initiative to give terminal patients access to life-saving care, even through experimental therapies.	Obama Care was the hallmark of President Obama’s administration. The Affordable Care Act expanded access to healthcare, including for those with HIV/AIDS. It aimed to reduce care costs and included programs for prevention, such as providing free condoms and access to antiretroviral drugs for expectant mothers. His approach was marked by the National HIV/AIDS Strategy to reduce infections and health disparities.	President Bush’s administration is credited with initiating PEPFAR, a global emergency treatment program. His administration emphasized treatment, prevention, and education, combining humanitarian aid with faith-based education programs focusing on abstinence and safe sex practices.

Table 4: Financial Allocations

Administration (President Name)	President Trump	President Obama	President Bush
Financial Allocations	Trump allocated $900 million to facilitate drug access, $2.3 billion for CDC funding to address HIV and other sexually transmitted diseases, and $332 million for the welfare and housing of people living with HIV/AIDS.	In 2011, President Obama’s healthcare budget allocated $5.8 billion for global HIV funding. His administration set aside $885 million for AIDS drug assistance programs, which helped to provide medication and preventive care to those in need.	President Bush allocated $48 billion for research and treatment globally. In 2001, he advocated for a further increase in global funding to $4 billion. PEPFAR continues to be one of the most successful global health initiatives, providing treatment and care to millions of people in Africa and beyond.

Table 5: Presidential Approaches to the Issue

Administration (President Name)	President Trump	President Obama	President Bush
Approach	President Trump implemented policies to fund communities affected by HIV/AIDS. His administration focused on high-risk areas and populations. He aggressively pursued drug affordability, research funding, and partnerships with pharmaceutical companies.	President Obama emphasized public education and reducing stigma surrounding HIV/AIDS. His administration lifted the ban on travel for people with HIV/AIDS and expanded healthcare access through the Affordable Care Act. The administration also worked to integrate HIV/AIDS care with other health services.	President Bush’s approach was to initiate global relief programs and research efforts, particularly through PEPFAR. He also incorporated religious values into education campaigns, focusing on abstinence, safe sex practices, and faithfulness. His approach combined humanitarian aid with religious principles, targeting prevention and treatment globally.

Table 6: Part 2 – Agenda Comparison Grid Analysis

Administration (President Name)	President Trump	President Obama	President Bush
Agency Responsible	The United States Agency for International Development (USAID), the CDC, and the National Institute of Health (NIH). The Department of Health and Human Services is also responsible for coordinating domestic HIV/AIDS efforts.	USAID, CDC, NIH, and the Office of National AIDS Policy were key in implementing Obama’s National HIV/AIDS Strategy.	USAID, CDC, and NIH, alongside the State Department’s Office of the U.S. Global AIDS Coordinator, which was responsible for overseeing PEPFAR.

| How Issue Might Stay on the Agenda | The best approach is to advocate for increased funding and awareness. Public support, media coverage, and continuous reporting on the epidemic will keep it on the agenda. Trump’s administration kept HIV/AIDS in focus by addressing high-risk populations. | Continuous public advocacy, media coverage, and government support helped keep the issue on Obama’s agenda. The Affordable Care Act’s connection to HIV/AIDS prevention and treatment helped maintain focus. | Bush maintained focus on HIV/AIDS by emphasizing the success of PEPFAR and seeking reauthorization from Congress. PEPFAR’s results and its impact on U.S. global health leadership helped keep the issue prominent. |

| Entrepreneur/Champion | Bill and Melinda Gates Foundation and CNN Chief Correspondent could champion the issue. Celebrity advocates such as Elton John or Magic Johnson could amplify the cause. | Bill and Melinda Gates Foundation, social media influencers, and LGBTQ+ organizations could advocate for the cause, aligning with Obama’s broader goals. | Bill and Melinda Gates Foundation, faith-based organizations, and conservative leaders would be effective champions, particularly in reaching global and religious communities. |

Table 7: Conclusion

Conclusion

HIV/AIDS affects 38 million people globally and 1.2 million Americans. Despite progress in treatment, high costs and unawareness remain significant challenges. Each presidential administration has taken unique approaches to the issue, with Trump focusing on drug affordability, Obama on expanding healthcare access, and Bush on global relief through PEPFAR. Continued bipartisan support is crucial for progress in combating the epidemic.

References

Burley, U. (2017). Addressing HIV/AIDS within a New Administration. Harvard Public Health Review, 12, 1-4.

Patel-Larson, A., Ledikwe, J. H., West, T., Cheever, L., Hauck, H., Andrews, G., … & Haddad, C. (2024). Looking back to see forward: multidirectional learning between the US Ryan White HIV/AIDS Program and the US President’s Emergency Plan for AIDS Relief. BMJ Global Health, 8(Suppl 7), e013953.

Davis, S. M., Hines, J. Z., Habel, M., Grund, J. M., Ridzon, R., Baack, B., … & Pordell, P. (2018). Progress in voluntary medical male circumcision for HIV prevention supported by the US President’s Emergency Plan for AIDS Relief through 2017: longitudinal and recent cross-sectional programme data. BMJ open, 8(8), e021835.

Fauci, A. S., Redfield, R. R., Sigounas, G., Weahkee, M. D., & Giroir, B. P. (2019). Ending the HIV epidemic: a plan for the United States. Jama, 321(9), 844-845.

Hood, J. E., Buskin, S. E., Anderson, B. J., Gagner, A., Kienzle, J., Maggio, D., … & Wortley, P. (2017). A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act. AIDS care, 29(4), 511-515.

Premnath, N., Reves, H., Pandey, U., Anderson, J., Afrough, A., Anderson, L. D., … & Geethakumari, P. R. (2023). Impact of the Affordable Care Act and Medicaid Expansion on Insurance Coverage and Outcomes in Patients with HIV‐associated Aggressive B‐cell Non‐Hodgkin Lymphomas. Hematological Oncology, 41.

Jadeja, S., Pai, G., Bhat, K., & Sathyanarayana, M. B. (2018). President’s emergency plan for AIDS relief. Systematic Reviews in Pharmacy, 9(1), 6-9.

Lally, M. A., van den Berg, J. J., Westfall, A. O., Rudy, B. J., Hosek, S. G., Fortenberry, J. D., … & Kapogiannis, B. G. (2018). HIV continuum of care for youth in the United States. Journal of acquired immune deficiency syndromes (1999), 77(1), 110.

Siuki, H. A., Peyman, N., Vahedian-Shahroodi, M., Gholian-Aval, M., & Tehrani, H. (2019). Health education intervention on HIV/AIDS prevention behaviors among health volunteers in healthcare centers: An applying the theory of planned behavior. Journal of Social Service Research, 45(4), 582-588.

U.S. FDA. (2020). Right to Try. Food and Drug Administration.

Youde, J. (2018). The securitization of health in the Trump era. Australian Journal of International Affairs, 72(6), 535-550.

Holst, J., & van de Pas, R. (2023). The biomedical securitization of global health. Globalization and Health, 19(1), 15.

Zang, X., Krebs, E., Mah, C., Min, J. E., Marshall, B. D., Feaster, D. J., … & Nosyk, B. (2020). Can the ‘Ending the HIV Epidemic’initiative transition the USA towards HIV/AIDS epidemic control?. Aids, 34(15), 2325-2328.

Guilamo-Ramos, V., Thimm-Kaiser, M., & Benzekri, A. (2023). Is the USA on track to end the HIV epidemic?. The Lancet HIV, 10(8), e552-e556.

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Sample Paper II

Title	Content

References

White House. (2019). Presidential Proclamation on National Physical Fitness and Sports Month, 2019. White House. Retrieved from https://www.whitehouse.gov/presidential-actions/presidential-proclamation-national-physical-fitness-sports-month-2019/

Thomson, K, & Carman, T. (2015). A healthful legacy: Michelle Obama looks to the future of ‘Let’s Move. The Washington Post. https://www.washingtonpost.com/lifestyle/food/a-healthful-legacy-michelle-obama-looks-to-the-future-of-lets-move/2015/05/03/19feb42c-b3cc-11e4-886b-c22184f27c35_story.html

Singleton, C. R., Li, Y., Duran, A. C., Zenk, S. N., Odoms-Young, A., & Powell, L. M. (2017). Food and beverage availability in small food stores located in Healthy Food Financing Initiative eligible communities. International journal of environmental research and public health, 14(10), 1242.

Kreig, J. A., Gangrade, S., Rastogi, D., & Daniels, R. J. (2019). Modernizing animal agriculture for a cleaner and healthier America: A policy memorandum to the Congress of the United States. Journal of Science Policy & Governance, 14(1).

Pan, L., Freedman, D. S., Sharma, A. J., Castellanos-Brown, K., Park, S., Smith, R. B., & Blanck, H. M. (2016). Trends in obesity among participants aged 2–4 years in the Special Supplemental Nutrition Program for Women, Infants, and Children—United States, 2000–2014. Morbidity and Mortality Weekly Report, 65(45), 1256-1260.

Rodgers, A., Woodward, A., Swinburn, B., & Dietz, W. H. (2018). Prevalence trends tell us what did not precipitate the US obesity epidemic. The Lancet Public Health, 3(4), e162-e163.

Ward, Z. J., Bleich, S. N., Cradock, A. L., Barrett, J. L., Giles, C. M., Flax, C., … & Gortmaker, S. L. (2019). Projected US state-level prevalence of adult obesity and severe obesity. New England Journal of Medicine, 381(25), 2440-2450.

Ludwig, D. S., Glanz, K., & Bartlett, S. J. (2013). A systematic review of primary research evaluating the effectiveness of interventions to promote physical activity and healthy eating in preschool children. Preventive Medicine, 57(2), 113-120. doi: 10.1016/j.ypmed.2013.05.002

Psota, T., Maniscalco, S., Kijek, M., & Ohlhorst, S. D. (2023). Driving transformative change to end hunger and reduce diet-related diseases and disparities: the White House Conference on Hunger, Nutrition, and Health. The American Journal of Clinical Nutrition, 117(4), 649-658.

Vilsack, T. J. (2023). Healthy School Meals for All: The Role of Food Law and Policy. J. Food L. & Pol’y, 19, 8.

Cohen, J. F., Stowers, K. C., Odoms-Young, A., & Franckle, R. L. (2023). A call for theory to guide equity-focused federal child nutrition program policy responses and recovery efforts in times of public health crisis. Journal of the Academy of Nutrition and Dietetics, 123(1), 15.

Hughes IV, R. (2024). The Path To Prevention: Charting The Course For A Healthier Nation. Health Affairs Forefront.

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Tags: Agenda Comparison Grid, Global Health Funding, HIV/AIDS Policy, NURS 6050, PEPFAR (President's Emergency Plan for AIDS Relief)