Sustainable Development Goals

Adopted in 2015 by the United Nations, the 17 Sustainable Development Goals (SDGs) encompass a broad range of sustainable development issues for the world, such as ending poverty, hunger, improving health and education, combating climate change and many others.

Although there has been vast improvements in health outcomes globally, health inequities remain a significant challenge. The health inequities result from the social determinants of health. The social determinants of health are the conditions and the set of forces and systems shaping life and health throughout life’s journey.

The 191 UN Member States have agreed to achieve these new goals by 2030.

A world of unequals

There are gross differences in health and well-being between countries. In Swaziland for example, the life expectancy is over 30 years shorter than Japan. In Angola approximately 1 in 6 children will die before the age of 5 whilst in the USA it is 3.6 per 1,000 children. [i]
These differences also exist within countries. The lower the socioeconomic position the higher risk of poor health and increased likelihood of premature death.
The root causes of these differences cannot be explained by genetics or biological reasons and in many cases even access to health services. The growing body of evidence demonstrates that the real causes of these differences are the differences and inequalities in social and economic factors. When a person is lower in the socioeconomic position, generally the worse the health. There is a social gradient in health that runs from top to bottom of the socioeconomic spectrum.

References

[i] Gapminder. Gap Minder World Poster. 2016 [cited 2016 23 December]; Available from here.

Goal 1: No Poverty

Extreme poverty rates have been cut in half since 1990, but there are still one in five people in developing regions that live on less than $1.25 a day. Poverty is not just a problem for low and middle income countries. In many developed countries such as the US, 17% of the population is below the relative poverty rate. [i]
Poverty disempowers individuals, families and communities. It manifests itself in hunger and malnutrition, limited access to health and education services, social discrimination and exclusion as well as the lack of participation in decision making. There are profound impacts on health and wellbeing. [ii]
The voice of nursing is a commanding one when it addresses poverty because it understands the health needs of the patient beyond the medical diagnosis.

References

[i] Nippon.com. Japan’s Worsening Poverty Rate. 2014. http://www.nippon.com/en/features/h00072/

[ii] United Nations. Goal 1: End poverty in all its forms everywhere. 2016 http://www.un.org/sustainabledevelopment/poverty/

Goal 2: Zero Hunger, Improved Nutrition

There are few challenges facing the world today that can compare with the scale of malnutrition. It affects one in three people and has been estimated to be the underlying cause of 45% of child deaths. [i]
Malnutrition can be classified as ‘under nutrition’ and ‘over nutrition.’ It affects all countries of the world and is considered one of the biggest risks to health and wellbeing. [ii]
At all levels of practice, whether it is front line care, or in policy decision making, nurses all over the world are tackling these issues. There is much to be done, but change is possible, and it must come.

References

[i] European Parliament. The social and economic consequences of malnutrition in ACP Countries. 2016 November.

[ii] Food & Agriculture Organisation of the United Nations. (2014). Understanding the true cost of malnutrition.

Goal 3: Good Health and Well Being

Universal health coverage is one of the most powerful social equalizers among all policy options. It is the ultimate expression of fairness. If public health has something that can help our troubled, out-of-balance world, it is this: growing evidence that well-functioning and inclusive health systems contribute to social cohesion, equity, and stability. They hold societies together and help reduce social tensions. – Dr Margaret Chan [i]

Progress is being made in health and wellbeing. Since 1990 there have been major advances in life expectancy and reduced child mortality. There have been improvements in clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV/AIDs.

A lot can still be done! Access to quality and affordable health care is one of those big steps that will improve the health and wellbeing of millions of people around the world.

The nursing workforce is the enabler of this vision to become a reality. How the nursing profession reacts, is empowered and enabled will determine the success of universal health coverage.

Reference

[i] Chan, M. (2015). WHO Director-General addresses ministerial meeting on universal health coverage. Retrieved from http://www.who.int/dg/speeches/2015/singapore-uhc/en/

Goal 4: Quality Education

Education is pivotal in improving peoples lives. The level of education attainment has been recognised as an important social determinant of health. It influences our decision making, our choices and it enables social and personal resources that are vital for physical and mental health. In fact, the level of education attainment is a strong predictor of long-term health and quality of life.

Find out how nurses around the world are addressing this issue.

Goal 5: Gender Equality

The Universal Declaration of Human Rights, adopted by the United Nations General Assembly in 1948 holds ‘Gender equality’ as a fundamental human right. [i]

Despite this, women and girls are not treated as equals. This inequality persists everywhere in varying degrees and stops sustainable social progress.

As a female dominated profession and one that witnesses the disparities in health between the genders, nursing can make a key contribution to reducing these inequalities.

Reference

[i] United Nations. Universal Declaration of Human Rights. Retrieved from http://www.un.org/en/universal-declaration-human-rights/

Goal 6: Clean Water and Sanitation

At the very heart of sustainable development is access to clean water and sanitation.

2.4 billion people around the world currently do not have access to this valuable resource. [i]

Tragically even health facilities around the world do not have access to clean water and sanitation.

As nurses we know full well that hand hygiene is one of the most cost effective interventions to protect health. [ii]

Find out how nurses are working to improve peoples access to clean water and sanitation.

References

[i] United Nations. (2017). Sustainable Development Goal 6. Retrieved from https://sustainabledevelopment.un.org/sdg6

[ii] WHO &UNICEF. Water, sanitation and hygiene in health-care facilities: Status in low- and middle-income countries and way forward – WASH in Health Care Facilities for better health care services. 2015.

Improving Sanitation, Uganda

Goal 7: Affordable and Clean Energy

…the annual death toll from indoor air pollution will still be over 1.5 million people – a higher rate than that from both malaria and tuberculosis…
– United Nations

Today, 42% of the world’s population does not have access to clean fuels and technologies for cooking. This leads to indoor air-pollution and this is ranked in the top ten risks to health. [i]

The WHO attributes 22% of COPD deaths to indoor air-pollution and solid fuels.[ii]

The impact of insufficient access to energy has an even greater effect on health than just COPD.

Find out more on how access to energy influences health and what nurses are doing about this issue.

References

[i] Forouzanfar, M.H., et al., Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 2016. 388(10053):p. 1659-1724.10

[ii] WHO. Burden of disease from Household Air Pollution for 2012. 2014.

Addressing COPD, China

Goal 8: Decent Work and Economic Growth

I hear nurses say, ‘I am just a nurse.’ Can you imagine that? The most important person in a hospital and we discount our value. Nurses are the cornerstone of healthcare, and yet they don’t respect what they do.”
– Margaret McClure (Former chief nursing officer at NYU Medical Centre and pioneer researcher of Magnet Hospitals.)

A High-level Commission on ‘Health Employment and Economic Growth’ [i] stated that investments in the health workforce improves a countries’ economic position.

Investment will be crucial in the health workforce as it has been estimated that by 2030, without it, there will be a shortage of 40 million health workers.

The health workforce is vitally important to the health of a country.

Find out what is happening around the world regarding this issue for nurses.

Reference

[i] High-level Commission on Health Employment and Economic Growth, Working for Health and Growth: Investing in the Health Workforce. 2016, WHO: Geneva.

Goal 9: Industry, Innovation and Infrastructure

For countries to achieve Universal Health Coverage and address the challenging demands of health and healthcare provision, there must be change and innovation to the health industry.
The former National Health Service (NHS) Institute for Innovation and Improvement stated that “innovation is about doing things differently or doing different things to achieve gains in performance.” [i]
As first hand witnesses to the needs of patients and the challenges of the health system, nurses are well positioned to provide innovative solutions. From new models of care, to new technologies, nurses are leading this change.

Reference

[i] UK NHS. Institute for Innovation and Improvement; Innovation Making it Happen. 2011.

Goal 10: Reduced Inequalities

There are many different types of inequalities. However, the outcomes for health are generally the same. Those who are socially disadvantaged have higher rates of suicide, mental health problems, heart disease, lung disease, obesity and many other conditions of ill health. In addition, those who are most disadvantaged are most likely to need healthcare but are less likely to receive it. [i]

Nursing has a strong history of advocating for the rights of the vulnerable and disadvantaged. The profession has often had to stand in the gap to provide care when others can’t or won’t.

Reference

[i] Marmot, M., The Health Gap. 2015, London:Bloomsbury

Goal 11: Sustainable Cities and Communities

The progressive move of populations towards urban areas means global health will be determined increasingly by cities.

Cities are a mixture of culture, class and status and with rapid growth in these areas, it is predicted that the disparities within these groups will escalate.

The poor are more likely to be excluded from social equity and will have less access to important public infrastructure. [i]

Nurses provide services to vulnerable population groups such as the homeless within cities.

They are partnering with a range of stakeholders to improve the health of people who live in the city.

Find out more about nurses who are transforming cities.

Reference

[i] London School of Economics. Cities and Social Equity: Implications for policy and practice. 2009.

Goal 12: Responsible Consumption and Production

According to the WHO, only 58% of healthcare waste is disposed of in the correct way. [i]

This puts communities at risk from cross contamination from infectious and pathological waste.

As leaders within health care settings, it is important that nurses support action on this issue.

Reference

[i] WHO &UNICEF. Water, sanitation and hygiene in health-care facilities: Status in low- and middle-income countries and way forward – WASH in Health Care Facilities for better health care services. 2015.

Goal 13: Climate Action

As Kofi Annan, former Secretary General of the UN said, “Climate change is not just an environmental issue… it is an all-encompassing threat.”

In 2012, it was estimated that 12.6 million deaths were attributed to the environment. As conditions continue to change, it is expected that this number will dramatically increase.

Nursing organisations and alliances are actively pursuing for action in this critical area.

Alliance of nurses for healthy environments, USA

Goal 14: Life below Water

Oceans, lakes and other marine resources have an essential role in human well being.
37% of the world’s population lives in costal communities. It is a rich source of food and income that are being affected by environmental degradation, overfishing, climate change and pollution.
As the Food and Agriculture Organization stated, “The health of our planet as well as our own health and future food security all hinge on how we treat the blue world.” [i]

Reference

[i] Food and Agriculture Organisation of the United Nations. The State of World Fisheries and Aquaculture. 2014.

Goal 15: Life on the Land

According to the United Nations, between 1990 and 2015, the world’s forest area diminished from 31.7% of the world’s total land mass to 30.7% [i]

This has a significant effect on the stability of our ecosystems, which has profound effects on our health and wellbeing.

References

[i] United Nations. (2016). Goal 15: Sustainably manage forests, combat desertification, halt and reverse land degradation, halt biodiversity loss. Retrieved from http://www.un.org/sustainabledevelopment/biodiversity/

Goal 16: Peace, Justice and Strong Institutions

Conflict, violence and injustices are destructive oppressors of health and wellbeing.

Nursings’ voice is strong in providing solutions to aid individuals, communities and nations.

Peace and justice can transform societies and enable its citizens to flourish.

Goal 17: Partnership for the Goals

Across the globe, there is a dramatic increase in non-communicable diseases.

Their root causes reside mainly in non-health sectors and often escape the direct influence of health policies.

For the health sector to make significant inroads into reducing non-communicable diseases, it must partner with industry and other government departments.

There are nursing leaders around the world who are leading this charge and making a difference.