Kneipp S
Department of Healthcare Environments & Systems, College of Nursing, University of Florida, Gainesville 32610-0187, USA.
J Community Health Nurs. 2000 Summer;17(2):65-73. doi: 10.1207/S15327655JCHN1702_1.
Community health nurses confront the health effects of public policies on a daily basis, particularly with respect to low-income populations. Despite this, the effects of public policies are often attributed to problems that are more proximal in the environment than the broad-ranging scope of "public policy." This article argues the need for a broader perspective of environment that encompasses public policies, and provides an example of how specific aspects (time limits and the Medicaid eligibility process) of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 may have harmful consequences for the health of low-income women. Finally, implications for community health nursing practice and the need for further nursing research are reviewed.
社区健康护士每天都面临着公共政策对健康的影响，尤其是对低收入人群的影响。尽管如此，公共政策的影响往往被归因于环境中比“公共政策”更直接的问题，而不是其广泛的范围。本文认为需要对环境有更广泛的视角，其中应包括公共政策，并举例说明1996年《个人责任与工作机会协调法案》（PRWORA）的具体方面（时间限制和医疗补助资格审核程序）可能如何对低收入女性的健康产生有害影响。最后，回顾了对社区健康护理实践的启示以及进一步开展护理研究的必要性。
