The Public Health Nursing Series is a 20-blog collection, written by William (Billy) Rosa, author of the recently released title, Nurses as Leaders: Evolutionary Visions of Leadership (June 2016), that sparks a dialogue about each and every nurse's role in advancing and creating the future of global health. With a focus on cultural considerations and the current status of healthcare in nations worldwide, nurses will learn how they are called to contribute to each of the United Nations' 17 Sustainable Development Goals, an international initiative that seeks to end poverty, protect the planet, and ensure prosperity for all over the next 15 years.This series makes the case that every nurse, regardless of title, position, or credential, is a public health leader.

                      Sustainable Development Goal #10 – Reduced Inequalities

Inequality negatively and powerfully impacts quality of life for people worldwide. Inhumane laws and enforced discriminatory norms bound African-Americans as slaves in the United States for more than 300 years, officially reduced them to second citizen status until the 1960s, and continues to be an impetus for racially-motivated bias and violence throughout the country. Legalized inequality kept same-sex couples from lawful marriage for generations, keeping human rights out of reach for thousands, and debilitating the overall socioeconomic and political well-being of life partners across the nation.

On a global scale, inequality and its counterpart, hatred, have become unfortunate and predominant threads throughout cross-cultural settings. Whether it's the sanction of female subservience in Saudi Arabia or the hostile schism between Sunni and Shia Islamic sects in countries such as Syria and Pakistan, inequality leads to the devastation of both humanity and the human spirit. The cultural and tribal fabric of Rwanda was deeply wounded when, over the course of generations and under the influence of colonization, Tutsis and Hutus were segregated, murder between civilians became protected under governmental rule, and the 1994 genocide resulted in the murder of over one million human beings. Genocide is the ultimate consequence of inequality and hatred, whether it be the attempted eradication of the Cambodian elite, the Armenians under the Ottoman empire, or the Jews throughout Europe in the early half of the 20th century, inequality leads to the categorization and institutionalization of human beings as “other,” “less than,” and “inhuman”. And once this happens, destruction in all its forms becomes possible and acceptable.

Sustainable Development Goal (SDG) # 10 seeks to “reduce inequality within and among countries (United Nations Sustainable Development [UNSD], 2016).  Some of the targets of SDG #10 by 2030 strive to:

  • Promote the social, economic, and political inclusion of all people, regardless of age, gender, disability, race, ethnicity, origin, religion, or economic or other status
  • Ensure equal opportunities by eliminating discriminatory legislation, policies, and practices
  • Achieve greater fiscal equality between members of differing economic groups throughout populations
  • Enhance and empower the voice of developing nations in making global decisions with partnering organizations and countries
  • Implement effective and well-planned migration policies in order to facilitate safe and responsible migration and mobility of peoples

Nursing must commit to its part in realizing SDG #10 by continually assessing, articulating, and identifying solutions that mitigate the effects of inequality on health and well-being. In order to do this, we must realize “that health and human rights are inextricably linked; and that social exclusion exacerbates the relationship between human rights violations and negative health impacts” (Tripathi, Hoodbhoy, & Rosenthal, 2011, p. 253).

As vanguards of human caring (Watson, 2008; 2012) and peacemakers in service to the dignity of the global village (Lane, 2016; Lane, Samels, & Watson, 2012), nurses have an ethical responsibility to address inequalities wherever they may exist and advocate for those who are vulnerable to the consequences. Nursing must make a moral commitment to procure human rights and social justice (Nicholas, 2015), foster effective partnerships and collaborations through trust-building and the identification of sustainability mechanisms (Sliney, 2015), and understand cultural contexts in order to promote community engagement (Dieckmann, 2012). By having honest conversations about the ways inequality deteriorates health and well-being on a global scale, public health nurses have the opportunity to lead initiatives that seek to heal individuals, populations, and nations.

A nursing sensibility goes a long way toward achieving the targets of SDG # 10. However, we must start by clarifying the harmful misnomers regarding nursing as a profession, which keep nurses servile and “less than” throughout global health infrastructures. We must learn self-advocacy; speak clearly and proudly about our practice; clarify our role to the public; empower colleagues across nations to become autonomous as knowledgeable and capable practitioners, researchers, and educators; mend the fences of interdisciplinary disagreement; and celebrate the unique contribution of nursing to the public’s health. By tending to the inequalities that enfeeble nursing, we take personal-professional accountability toward realizing the goals of SDG #10 as they relate our status as a discipline and our abilities to influence international health standards and outcomes.


Dieckmann, J.L. (2012). Challenges in program implementation. In A.L. Cupp Curley & P.A Vital (Eds.), Population-based nursing: Concepts and competencies for advanced practice (pp.              239-265). New York, NY: Springer.

Lane, M.R. (2016). Authentic and creative: Walking the Caritas path to peace. In W. Rosa, Nurses as leaders: Evolutionary visions of leadership (pp. 323-332). New York, NY: Springer.

Lane, M.R., Samuels, M., Watson, J. (2012). The caritas path to peace: A guidebook to creating world peace with caring, love, and compassion. United States: CreateSpace.

Nicholas, P.K. (2015). Health, human rights, and social justice: An interview with Paul Farmer and Sheila Davis. In S. Breakey, I.B. Corless, N.L. Meedzan, & P.K. Nicholas (Eds.), Global health nursing in the 21st century (pp. 73-83). New York, NY: Springer.

Sliney, A. (2015). Global health partnerships. . In S. Breakey, I.B. Corless, N.L. Meedzan, & P.K. Nicholas (Eds.), Global health nursing in the 21st century (pp. 103-111). New York, NY: Springer.

Tripathi, V., Hoodbhoy, M.O., & Rosenthal, M. (2011). Promoting human rights in public health programs: Lessons learned from HealthRight International. In E. Beracochea, C. Weinstein, & D.P. Evans (Eds.), Rights-based approaches to public health (pp. 253-269). New York, NY: Springer.

United Nations Sustainable Development (UNSD). (2016). Goal 10: Reduce inequality within and among countries. Retrieved from

Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). Boulder, CO: University Press of Colorado

Watson, J. (2012). Human caring science: A theory of nursing(2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

More About the Author

William (Billy) Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC, is currently Visiting Faculty, University of Rwanda and ICU Clinical Educator, Rwanda Military Hospital, Human Resources for Health Program in partnership with the New York University Rory Meyers College of Nursing. He currently has over 65 publications for refereed and non-refereed journals, newspapers, magazines, and national platform blogs and his book, Nurses as Leaders: Evolutionary Visions of Leadership, was recently published by Springer Publishing in June 2016. Billy currently sits on the US Advisory Board for the Nightingale Initiative for Global Health, and most recently received the American Association of Critical-Care Nurses' 2015 National Circle of Excellence Award and the Association for Nursing Professional Development's 2015 National Change Agent/Team Member Award.

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Part 1 -  Understanding the Nurse as a Public Health Leader

Part 14 - Sustainable Development Goal #11 - Sustainable Cities and Communities