When the topic for this issue was first conceived, the downturn in the US economy had just begun. No prognosticators were anticipating that in the spring of 2003 the economy would still be relatively unstable. The rampant unethical and illegal actions of corporations had not yet been publicly exposed, and evidence of growing disparities between the rich and the poor had not yet reached a point of generating a general public outcry. Even as this issue goes to press, grassroots awareness and action are just beginning to emerge, and organized private and public sector changes are just beginning to be put into place to curb fraudulent transactions.
The economic events of the past few years have affected everyone, but none more seriously than those who were already disadvantaged. The economic boom of the 1990s, which turned out to be at least in part an illusion created by fraudulent accounting practices, benefited those who already held impressive economic and class privilege. Those who were disadvantaged before the boom only suffered greater disadvantage, sometimes disaster. By the time manuscripts for this issue of the journal were due, the realities of the economic recession were crystal clear, and appalling health care disparities were imposed on growing numbers of citizens. Yet, when the deadline for this issue of Advances in Nursing Science arrived, there were fewer manuscripts on my desk than at any time since the first year of the journal's existence.
Nurses have a long tradition of responding to the needs of those who suffer from economic and social discrimination. Nurses care for people in places and in circumstances where no other provider is found. Nurses maintain a perspective that embraces social and economic conditions as health variables. Even in the current broken health care nonsystem, in which nursing is seldom practiced as the nurses who are there would prefer to practice, nurses still do whatever is possible to help people address economic and social issues in their lives.
So I have to ask: where are the nurse scholars, the thinkers, the movers and shakers, when a journal calls for work that focuses on economics and class as a health care variable? I know that fortunately, these nurses do exist. Many are immersed in political, administrative, bedside, chairside, and curbside work * to diligently address these very issues. Several have contributed to this issue of Advances in Nursing Science. There are articles in this issue that challenge the status quo, bringing to our awareness the fundamental fact that the status quo is not acceptable when one considers the plight of millions of people worldwide who suffer the negative health effects of economic and class disadvantage. Some of the perspectives of the authors in this issue are not widely shared, and some may generate strong responses from readers. But the ideas and the perspectives in this issue will certainly challenge all of us to consider alternatives, to move from complacency to action, and to contribute further scholarship that can influence social and political action to address economic and class issues.
*Appreciation to Mary Ann Anderson, RN, PhD, Associate Professor of Nursing, Weber State University, for the phrase “bedside, chairside and curbside.”