Nurses, often hailed as the most trusted professionals in the United States, bring a unique perspective to healthcare policy and advocacy. Their frontline experiences make them witnesses to the real-world impacts of health policies. PCNA recognizes this potential for change, and through our Advocacy Committee, we empower nurses to influence public policy, fostering personal and professional growth while shaping the future of cardiovascular care.

Understanding the PCNA Advocacy Committee

The Advocacy Committee at PCNA is the driving force behind our mission to promote nurses as leaders in cardiovascular disease (CVD) prevention and management through policy advocacy. This dedicated group boosts the advocacy efforts of various organizations, formulates official position statements, provides public comments and testimonies, and, most importantly, offers PCNA members a voice in shaping crucial healthcare policies.

To recognize the issues at the forefront of the Advocacy Committee’s work, we have highlighted some of the most important initiatives PCNA has supported in the past year.

Championing Cardiovascular Health: The Policy Initiatives

Tobacco: Taking on a Leading Cause of Preventable Death

Tobacco use remains the leading cause of preventable death in the United States, claiming over 480,000 lives annually and imposing a staggering $241 billion (about $740 per person in the US) in healthcare costs. Shockingly, 16.5% of high school students and 19% of adults still use some form of tobacco. Youth e-cigarette usage presents a particularly alarming public health challenge, with 14.1% of high school students currently using e-cigarettes.

The connection to cardiovascular health is crystal clear. Smoking stands as a significant risk factor for heart disease, causing damage to the heart and blood vessels, and ultimately increasing the risk of atherosclerosis.

Initiatives in Action:

• Prohibiting the Sale of Flavored Tobacco Products: In January 2023, PCNA signed on to a statement from the Campaign for Tobacco-Free Kids’ calling for a ban on menthol cigarettes, flavored e-cigarettes, flavored cigars, and all flavored tobacco products.
• Support for Smoke-Free VHA Facilities: PCNA signed a letter to Congress supporting a recent bill aimed at making Veterans Affairs Hospital campuses 100% smoke-free was reintroduced in March 2023. This initiative seeks to overturn a 1992 law requiring indoor and outdoor smoking areas at VA hospitals.
• Opposing Harmful Provisions on Menthol Cigarettes and Flavored Cigars: In May 2023, the House Agriculture-FDA Appropriations bill was released with language prohibiting the FDA from implementing product standards on menthol cigarettes, flavored cigars, or a maximum nicotine level in cigarettes. We added our name to a letter opposing efforts to weaken or alter the FDA’s authority over tobacco products through the appropriations process.
• Urging Increased Funding for CDC’s Office on Smoking & Health: PCNA joined a letter urging Congress to increase funding for the CDC’s Office on Smoking and Health by $63.5 million, totaling $310 million. The focus is on combatting youth e-cigarette use and addressing the ongoing toll of tobacco on public health.

Supporting the Nursing Workforce: A Vital Pillar

The COVID-19 pandemic has exposed numerous systemic issues within the healthcare system, with its impact on nurses and the workforce being a critical concern. A survey by the American Association of Critical-Care Nurses found that 92% of nurses believe the pandemic has shortened their careers.[1] Furthermore, 19% of nurses intend to leave their positions within six months, and 27% are considering leaving.[2] Such trends are especially concerning for cardiovascular nurses who require strong support due to the demands of their profession.

Initiatives in Action:

• FY 2024 Title VIII and NINR Funding: PCNA continues to advocate for robust investments in Title VIII Nursing Workforce Development Programs and the National Institute for Nursing Research (NINR) in the 2024 fiscal year. This funding is essential to address current healthcare needs and prepare for future challenges.
• Improving Access to Workers’ Compensation for Injured Federal Workers Act: In May 2023, PCNA signed on to a letter from The Nursing Community Coalition calling for support in passing H.R. 6087, the Improving Access to Workers’ Compensation for Injured Federal Workers Act. This legislation would remove outdated barriers, enabling nurse practitioners to diagnose and oversee care for federal employees.
• National Nursing Workforce Center Act: With the nursing workforce facing unprecedented challenges, the National Nursing Workforce Center Act aims to establish a grant program supporting public-private partnerships to strengthen nursing workforce data collection and problem-solving at the state level. PCNA signed a letter of support for this Act in May 2023.
• Improving Care and Access to Nurses (I CAN) Act: H.R. 2713, the Improving Care and Access to Nurses (ICAN) Act, seeks to increase patient access to care by removing outdated federal barriers on services provided by advanced practice registered nurses (APRNs) under Medicare and Medicaid programs. PCNA signed a letter of support for this Act in May 2023.

Obesity and Health Equity: A Growing Epidemic

Obesity, a chronic disease affecting people of all ages, shapes, and fitness levels, is closely linked to CVD. Healthcare providers must adopt strategies similar to those used for other chronic conditions, including pharmacological agents, to manage obesity effectively. Significantly, communities of color bear a disproportionate burden of the obesity epidemic, emphasizing the urgency of providing them access to comprehensive obesity care and treatment.

• Support for Comprehensive Care and Coverage for Obesity Treatment: In January 2023, PCNA signed a position statement from The Nurses Obesity Network advocating for comprehensive care and coverage for individuals living with obesity, encompassing behavioral therapy, medical nutrition therapy, anti-obesity medications, and bariatric surgery when recommended by licensed healthcare professionals.
• Request for CMS to Address Obesity Epidemic in Health Equity Conference: PCNA joined a letter in June 2023 urging the Centers for Medicare and Medicaid Services (CMS) leaders to place the obesity epidemic at the forefront of critical conversations, particularly during the CMS Health Equity Conference. The goal is to expand awareness and access to obesity care and treatment, especially for communities of color disproportionately impacted by this crisis.

Bridging Gaps in Maternal Health: The Black Maternal Health Momnibus Act

The United States grapples with the highest maternal mortality rate among high-income countries, and significant disparities persist. The Black Maternal Health Momnibus Act presents a comprehensive solution, addressing every driver of maternal mortality, morbidity, and disparities in the country.

The connection between cardiovascular health and maternal health is undeniable. Pregnancy and postpartum symptoms often mimic early warning signs of CVD, leading to missed opportunities for intervention. Most pregnant women who die from cardiovascular complications have no formal CVD diagnosis, highlighting the need for early detection.

PCNA strongly supports the initiatives of the Black Maternal Health Momnibus Act and has signed two letters of endorsement for the bill in both May and July 2023. We will continue to look for opportunities to support this important legislation.

Advocating for Cardiovascular Health

The PCNA Advocacy Committee plays a key role in driving essential policy initiatives in the realms of tobacco control, nursing workforce support, obesity management, and maternal health. These areas are inextricably linked to cardiovascular health, making PCNA’s advocacy efforts indispensable.

As we reflect on the pivotal role nurses play in patient care, we’re reminded that their influence extends far beyond the bedside. By joining PCNA’s advocacy endeavors, healthcare professionals, policymakers, and the public at large can contribute to the betterment of cardiovascular care and the well-being of communities nationwide.

The path to a healthier, more equitable future begins with the unwavering commitment of organizations like PCNA and its Advocacy Committee, and it continues with the collective action of dedicated individuals who recognize the power of advocacy in shaping healthcare policies that save lives and promote well-being.

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[1] American Association of Critical-Care Nurses. (2021). Hear Us Out Campaign. Retrieved from: https://www.aacn.org/newsroom/hear-us-out-campaign-reports-nurses-covid-19-reality

[2] American Nurses Foundation. (2023). Three-Year Annual Assessment Survey: Nurses Needed Increased Support from their Employer. Retrieved from: https://www.nursingworld.org/~48fb88/contentassets/23d4f79cea6b4f67ae24714de11783e9/anfimpact-assessment-third-year_v5.pdf