Social Determinants of Health

SDOH

Health Care and Quality, Neighborhood and Built Environment, Social and Community Context, Economic Stability, Education Access and Quality

SDOH defined

Why are they called “Social” Determinants?

• Out of our control

Are they modifiable? Who can change them?

• health care professionals, including nurses, are at the forefront of driving positive changes in health outcomes for populations

A C H I E V I N G H E A LT H E Q U I T Y B E G I N S W I T H

A S S E S S I N G S D O H I N E V E R Y C L I E N T E N C O U N T E R . ” - ” F u t u r e o f N u r s i n g 2 0 2 0 - 2 0 3 0 ”

SDOH: Economic Stability

 1 in 3 individuals can’t afford necessities

 Disproportionate impact on black, indigenous, and People of Color communities

 Living wage vs. minimum wage

 Clear link between SES and increased disease risk and premature death (ODPHP, 2020)

Nurse’s Role:

 Assess for poverty

 Advocate for more resources (tax credits, food assistance)

 Refer to housing, job, and health care assistance

 Champion fair wages, tax credits, improved food assistance, etc

S D O H : E D U C AT I O N A C C E S S A N D Q U A L I T Y

 Poorer neighborhoods have lower quality schools with lower scores

 ECI like Head Start are linked to higher educational attainment

 Completing high school linked to better paying jobs

 Racial/ethnic differences exist in educational attainment

Nurse’s Role:

 Work with schools and their data to influence local educational policy

 Advocate to expand ECI programs

 Support programs that prepare students for post-grad education

SDOH: Health Care Access and Quality

 Not as influential as you think: clinical care only accounts for 20% of a person’s health outcomes (ODPHP)

 Lack of access to quality healthcare due to costs, limited providers, or other barriers

Nurse’s Role:

 Assess pts for access to insurance, medications, able to get visits

 Advocate for policies that increase access and quality

SDOH: Neighborhood and Built Environment

 Both quality and stability

 Food access and food deserts

 Crime and violence, ACES

 Air and water quality, weather events

Nurse’s Role:

 Assess for housing stability and quality

 Advocate for affordable housing and green spaces, food access

 Educate patients on home risks (lead poisoning, indoor air quality, etc.)

SDOH: Social and Community Context

 Civic participation improves psychological well-being and combats adversity

 Discrimination leads to long term stress-related health outcomes

 Incarceration impacts entire family

 Social Cohesion prevents isolation and its risks

Nurse’s Role:

 Foster social networks

 Identify children at risk and connect with resources

 Advocate for rehabilitation for incarcerated individuals