Understanding the concept of social determinants of health (SDOH) is essential for those in healthcare systems working toward overcoming health disparities and advancing health equity. Nurses are uniquely positioned to assess and understand SDOH and incorporate that insight into patient care planning and delivery. To build this understanding, the online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program at the University of South Carolina Aiken (USC Aiken) dives into SDOH assessment and how that information can inform public health policies, patient care and interventions.
What Are Social Determinants of Health?
According to the World Health Organization, social determinants of health are “the non-medical factors that influence health outcomes,” such as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Some forces and systems affecting SDOH include economic policies, public health initiatives, political structures and social norms.
According to one Nursing 2023 article, SDOH can be categorized into five domains, including:
- Economic stability
- Education access and quality
- Healthcare access and quality
- Neighborhood and built environment
- Social and community context
The SDOH domains reach every aspect of individuals’ lives and can, directly and indirectly, impact their quality of life, well-being and overall health. According to the Robert Wood Johnson Foundation, 80% of a person’s health may be determined by these non-medical factors.
SDOH correlates closely to health inequities. People with lower SDOH typically have lower quality of life and health outcomes. However, these factors are also modifiable, so implementing policy or systemic changes at the local, state and federal levels — including within healthcare systems — can improve health outcomes for the most vulnerable individuals and communities.
What Is the Healthy People 2030 Framework?
The Healthy People 2030 framework is a public health initiative designed to address the five SDOH domains and develop objectives to improve each category. Communities and health professionals like nurses rely on this information to develop interventions for underserved and vulnerable populations and measure progress toward national public health goals.
Some of the overarching goals of Healthy People 2030 are:
- Reducing the number of people living in poverty, improving food security, job opportunities and access to affordable housing
- Increasing educational opportunities for children and adolescents so students, including low-income and those with disabilities, do well in school from an early age
- Improving timely access to high-quality healthcare services, such as preventive care, health screenings, emergency care and prescription medications
- Designing neighborhoods and communities that are free from violent crime and discrimination and have safe drinking water, clean air, sidewalks and bike lanes
- Fostering healthy family structures, interpersonal communication and strong social support networks within communities
How Can Nurses Address SDOH and Reduce Health Disparities?
Nurses have an essential role in addressing SDOH issues and health disparities, according to Nursing 2023. When working in direct care, nurses can complete comprehensive health assessments to identify factors that make it difficult for patients to adhere to treatment plans or healthy habits. These may include a lack of reliable transportation, personal safety concerns, financial instability and food and housing insecurity. Depending on the setting, nurses may conduct universal SDOH screenings or apply them to high-risk individuals before expanding the program to others.
Nurses in leadership positions can develop additional SDOH screening tools and integrate these practices into workflows to consistently identify vulnerable patients and targeted interventions, resources and services. Nurses may also participate in advocacy efforts and develop documentation strategies to ensure that SDOH data is accurately captured in the health record and accessible to the interdisciplinary care team. Earning a BSN through programs like USC Aiken’s online RN to BSN can help nurses assume careers in leadership, magnifying their potential impact on policy and systemic change.
Research continues to emerge about how SDOH can affect care outcomes and inform public health initiatives like Healthy People 2030. However, because nurses work in communities nationwide and often in patient-facing or leadership roles, they have a nearly unmatched capacity to reduce inequities by recognizing the many factors that can prevent individuals from living their most healthful lives.
Learn more about USC Aiken’s online RN to BSN program.
