ISAPN Discusses the Social Determinants of Health
Many factors contribute to a person’s overall health, including genetics and environment. While these are important to examine when determining health, in an editorial recently published in The Journal of Nursing Education, Dr. Teri A. Murray, PhD, APHN-BC, RN, FAAN proposes that we examine another factor: social determinants of health.
At the Illinois Society for Advanced Practice Nursing, we believe that it is important to investigate all factors when determining health. Because of this, we spoke with some of our members to get their insights on the interesting and important topic of social determinants of health.
SOCIAL DETERMINANTS OF HEALTH -- WHAT ARE THEY?
Social determinants of health are aspects of one’s environment that can have an influence on lifestyle and, therefore, overall health. In the editorial “The Future of Nursing 2020--2030: Educating the Workforce,” Dr. Murray defines social determinants of health as “disparities (that) are often rooted in the environmental contexts and conditions in which people live, most often shaped by structural realities such as the distribution of wealth, power, social mores and cultural norms, economic, and political forces.”
ISAPN’s member Max Button, DNP, APRN, FNP-BC cites many concrete examples of social determinants of health and the effects that they can have. “A person’s level of education is one example of social determinants of health. The more degrees one has beyond high school diploma, the longer life expectancy one has, and this has been proven scientifically. An educated person has different and frequently lower stress levels which affect one’s life than one with no or with minimal education. Highly educated people also tend to have jobs with less environmental stressors and higher compensation. This allows them more flexibility in making healthier choices and can lead to a healthier lifestyle. This also has an influence on medical care, as a higher paying job allows one to have health insurance and receive more preventative services as compared to an uninsured or underinsured poor person.”
COVID-19 AND SOCIAL DETERMINANTS
While social determinants of health have always been present in the American healthcare system, COVID-19 has exacerbated many of these challenges. According to the Center for Disease Control, positivity rates for Black or African Americans for COVID-19 is 2.6 times higher than it is for white persons. Hospitalizations are 4.7 times higher and deaths are 2.1 times higher.
Overall, many Americans have been negatively affected by COVID-19.
“COVID 19 has shed light on a lot of disparities in healthcare,” said member Melissa Murphey. “Providing affordable care to all is so important. The underinsured and uninsured need to be aware of programs that are in place that will assist them in receiving care.”
WHAT CAN NURSES DO?
For a long time, nurses faced challenges impacting patient health outside of the acute care setting—especially with regards to social determinants of health. However, this is quickly changing through nursing education.
“I believe all APRNs should work with underserved populations, at least temporarily or in a clinical rotation during their education, to fully understand the extent of need with this population,“ said Iesha Nwagwu, APRN. “While in school for my RN, my program assigned a project during the public health unit where each group of students were assigned to different communities in Chicago. Each group had a list of things to find out about the community such as certain foods that were available, restaurant choices, property value, school reports cards, playgrounds for kids, and crime. The experience was really a light bulb moment for some students and they were able to really see the disparities and the lack of accessibility that exists in certain communities. I think that all nursing education programs should include something like this.”
ISAPN ADVOCATES FOR QUALITY HEALTHCARE
The Illinois Society for Advanced Practice Nursing recognizes that social determinants of health negatively affect certain populations. That’s why we strive to encourage providing affordable healthcare to all.
Member Wamaitha Sullivan DNP, FNP-BC said it best: “ISAPN supports underserved populations by helping individuals talk about the pandemic in a safe space, providing ongoing support of the NP teams as they march on, having good leaders that we can talk to, and communicating that ISAPN is available to advocate for the NPs who care for our communities.”