Nursing Impact on Social Determinants of Health (SDOH) Part 1

Health Inequities and SDOH

In The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, a report by the National Academy of Sciences, health inequities are defined as:

Systematic differences in the opportunities that groups have to achieve optimal health, leading to unfair and avoidable differences in health outcomes, disproportionately impact people of color; the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community; people with disabilities; those with low income; and those living in rural areas. 

According to the report, growing evidence supports an association between inequities in both health and access to healthcare, and social determinants of health (SDOH). As outlined in the HIMSS SDOH guide, SDOH are the social and environmental conditions for which people live and include factors such as, food security, educational attainment, safe housing, transportation, social support and more. The variation in these conditions can geatly impact a patient’s ability to access or successfully complete treatments vital to their ongoing health.

Health and care

Why Nursing?

From the time we are in nursing school, we learn and understand that patient care is a holistic endeavor. It’s not just about the physcial needs, but also mental, spritual, and support as well.  As we go into practice, however, in our hosptial settings or specialty areas, we become more focused in our care. Still, we find ways to practice holistically, like taking a patient outside to feel the sun on their face for the first time in weeks or helping to arrange a visit with a special loved one. This understanding and ability to go the extra mile for patients can mean so much and is why nursing can have such a tremendous impact on health equity.

Nurses can see the big picture and have always been the patient advocate, so it’s a natural evolution for nursing to now consider SDOH in improving patient outcomes and health equity. 

Nursing’s impact on SDOH

Nurses have the advantage of encountering patients throughout the care continuum and being able to consider the individual needs of each patient to ensure successful health outcomes. What we need to remember is that up to 80% of a person’s health is determined by factors making up SDOH,¹ so these need to be assessed and prioritized along with any other physical aspects of care.

How to prioritize SDOH²

For clinical nurses

• Learn more about the organizational policies and procedures for SDOH.
• Explore electronic health record (EHR) documentation to identify where SDOH data may already be collected and the best locations to review data.
• Encourage colleagues to have discussions with patients to understand their comfort levels on sharing SDOH information.
• Support and advise organizational plans to implement SDOH into nursing workflows.
• Identify opportunities to conduct a nursing inquiry for SDOH interventions.
• Establish ways to triage support based on individual responses to SDOH-related questions by involving interdisciplinary team members such as social services, nutritionists and mental health professionals.

For nurse informaticists and nurse leaders

• Help support and promote the importance of SDOH through policy and workflow changes at your organization.
• Participate in committees and groups at a local, state and national level to advance standards, policies, and incentives for the collection, use, and sharing of SDOH data.
• Collaborate and establish partnerships within the community to support the identified needs of patients.

 

References

1. Robert Wood Johnson Foundation. Medicaid's role in addressing social determinants of health. (2019). rwjf.org/en/library/research/2019/02/medicaid-s-role-in-addressing-social-determinants-of-health.html.
2. Tiase, V., Crookston, C., Schoenbaum, A., & Valu, M. Nurses' role in addressing social determinants of health. (2022). Nursing 52(4): 32-37. https://journals.lww.com/nursing/pages/articleviewer.aspx?year=2022&issue=04000&article=00010&type=Fulltext

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Addressing Social Determinants of Health (SDOH) in Healthcare Part 2