The first level includes long-term structural changes that
promote equity at a national and global level. This includes
economic strategies and tax policies aimed at decreasing
gross income differences and promoting economic equity.
National education policy would also fall under this level.
Education strategies to improve health equity include
promoting early childhood education, school financing to
eliminate quality of education disparities, and increased
access to college education for low-income populations
(Adler & Stewart, 2007). Nurses might engage in this level
of intervention by educating legislators on the health impact
of education and taxation policies or running for state and
national offices themselves.