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Referencing Wise et al. (2023), social determinants of health (SDH) encompass the economic, political, social, and physical environments that significantly influence health outcomes and quality of life across diverse populations. Unfortunately, socially marginalized individuals often bear a disproportionate burden of disease and health-related issues due to the adverse impact of these determinants. In recognition of this challenge, President Obama signed the Affordable Health Care Act (ACA) into law in 2010, aiming to incentivize a healthcare system that would mitigate the effects of adverse social and economic conditions on health disparities (Wise et al., 2023). The ACA sought to encourage value-based solutions, improve access to healthcare services, and promote the integration of social and healthcare services to address the multilevel factors contributing to health inequities.
In 2019, the National Academies of Sciences, Engineering, and Medicine proposed a comprehensive framework for the integration of social care into health care delivery. This framework outlines prescriptive activities in five key domains: awareness, adjustment, assistance, alignment, and advocacy (Wise et al., 2023). Nurses are pivotal in implementing this framework, beginning with raising awareness of patient social needs and available resources. Subsequently, healthcare providers must respond to these needs through adjustments within healthcare systems and assistance in connecting patients with local resources. Lastly, nurses are instrumental in facilitating alignment between health and service sectors within communities and advocating for policy changes to improve infrastructure and health outcomes across diverse communities (Wise et al., 2023).
Referencing Wise et al. (2023), in order to effectively address social determinants of health and promote health equity, it is imperative to diversify the nursing workforce intentionally and strategically. Nurses who reflect the diversity of the communities they serve are better equipped to understand and address the unique needs and challenges faced by marginalized populations (Wise et al., 2023). However, achieving this diversity requires concerted efforts in recruitment, training, and support. The World Health Organization emphasizes the importance of empowering nurses to lead efforts in strengthening nurse capacity and expertise in addressing social determinants of health. This entails providing nurses with the necessary tools, support, and resources to fully participate in implementing interventions that promote health equity and address the root causes of health disparities (Wise et al., 2023).
Reference
Wise, J., Caiola, C., & Njie-Carr, V. (2023). A fundamental shift in nursing is a requisite for achieving health equity: The Nurses’ role in addressing social determinants of health. Journal of the Association of Nurses in AIDS Care, 34(1), 125–131. https://doi.org/10.1097/jnc.0000000000000383
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