Shifts in power within the nursing profession and the health care system raise questions as to how nursing will develop and use its power. As a model for political action, empowerment involves the development of three dimensions; (a) raising the conscious of socio-political realities; (b) positive self-esteem; and (c) political skills needed to negotiate and change the health care system. This paper discusses these dimensions as they relate to nurses within a feminist context.

Limited access to health care and a system fraught with discriminatory practices inhibit some racial and ethnic minorities from gaining access to health care and assurance of equal treatment once they enter the health care system. The purpose of this chapter is to critically and systematically analyze the research literature to determine what impact individual and institutional racism has had on the prevailing health disparities across racial and ethnic minority groups. The chapter includes the following: (1) a review of the term racism and a brief overview of the history of racism in health care; (2) a review of the research literature analyzing the impact of racism on health disparities; and (3) recommendations to end the systematic institutional racism in scientific research, which is necessary to end health disparities.

Leadership is required to ameliorate the gaps in health disparities that exist in the United States. Many experiential pathways exist for acquiring the leadership knowledge and skills required to lead change that results in healthcare improvement. Nurses who lead professional nursing associations and work with community organizations are capable of leading such community change efforts. Community leadership is a viable pathway for developing nurse leaders.

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