Week 6: Discussion
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The social determinants of health
The social determinates of health include factors other than access to health care, such as socioeconomic status, economic stability, access to quality education, physical environment, support networks, employment, etc. Although efforts to improve healthcare within the United States usually point to responsibilities within the healthcare system, there is a growing recognition that these social determinants of health are also critical—from the individual to the population level.
As a DNP-prepared nurse, you will consider and address the social determinants of health when working with patients. Think about the ways in which this will positively impact your patients’ experiences and outcomes, as well as the communities you serve.
Resources
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
PDF Creation Resources
· Lacoma, T. (2024, February 20). How to save a webpage as a PDF on desktop and mobileLinks to an external site. . Digital Trends Media Group. https://www.digitaltrends.com/computing/how-to-save-a-webpage-as-a-pdf/
· Microsoft. (n.d.). Save an Outlook message as a .eml file, a PDF file, or as a draftLinks to an external site. . https://support.microsoft.com/en-us/office/save-a-message-as-a-file-4821bcd4-7687-4d6d-a486-b89a291a56e2
· Apple. (n.d.). Save emails as files or PDFs in Mail on MacLinks to an external site. . https://support.apple.com/guide/mail/save-emails-as-files-or-pdfs-mlhlp1044/mac
Practicum Resources
Meditrek Resources
Ethics Resources
· Clark, K., Rödlach, A., Ballesteros, M., Davis, R., Holmes, L., Miller, J., Minnich, M., & Schultz, A. (2024). The role of doctor of nursing practice programs’ mission, vision, and values statements in the development of students’ professional identity: A qualitative studyLinks to an external site.. Nurse Education Today, 134, Article 106096. https://doi.org/10.1016/j.nedt.2024.106096
· Fornili, K. S. (2022). Expanded conceptual framework for ethical action by nurses on the “further upstream and farther downstream” determinants of health equityLinks to an external site.. Journal of Addictions Nursing, 33(3), 203–214. https://doi.org/10.1097/jan.0000000000000484
· Green, C. (2022). Applying the Nightingale pledge in reducing health disparities: A hospital-acquired pressure injury case studyLinks to an external site.. Advances in Skin and Wound Care, 35(3), 180–183. https://doi.org/10.1097/01.asw.0000815492.11595.61
· Khaghanizadeh M, Koohi A, Ebadi A, Vahedian-Azimi A. (2023). The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: A clinical randomized controlled trialLinks to an external site.. BMC Medical Ethics, 24, Article 58. https://doi.org/10.1186/s12910-023-00938-5
· Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizationsLinks to an external site.. Journal of Medical Ethics and History of Medicine, 13(17), 1–10. https://doi.org/10.18502/jmehm.v13i17.4658
Social Change Resources
· Abu, V. K., & Moorley, C. R. (2023). Social justice in nursing education: A review of the literatureLinks to an external site.. Nurse Education Today, 126, Article 105825. https://doi.org/10.1016/j.nedt.2023.105825
· Johanson, L., Urso, P. P., & Priode, K. (2022). Factors influencing the development of social change involvementLinks to an external site.. Journal of Excellence in Nursing and Healthcare Practice, 4(1). https://doi.org/10.5590/JENHP.2022.4.1.01
· Walden University. (n.d.). Social changeLinks to an external site. [Multimedia]. https://www.waldenu.edu/why-walden/social-change
· Walden University Center for Social Change. (n.d.). Scholars of changeLinks to an external site. [Videos]. https://academicguides.waldenu.edu/social-change/scholars-of-change Note: The approximate length is 15 minutes combined for these media pieces.
SDOH Resources
· Centers for Disease Control and Prevention. (2022, December 8). Social determinants of health (SDOH)Links to an external site. . https://www.cdc.gov/socialdeterminants/index.htm
· Davis S. (2022). The evolving role of social determinants of health to advance health equityLinks to an external site.. In D. Seibert, B. Malone, & P. DeLeon (Eds.), Shaping nursing healthcare policy: A view from the inside (pp. 1–102). Academic Press. https://www.sciencedirect.com/science/article/pii/B9780323999939000160
· National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020–2030: Charting a path to achieve health equityLinks to an external site. . National Academies Press. https://doi.org/10.17226/25982
· Reising, V., Diegel-Vacek, L., Dadabo, L., Martinez, M., Moore, K., & Corbridge, S. (2022). Closing the gap: Collaborative care addresses social determinants of healthLinks to an external site.. Nurse Practitioner, 47(4), 41–47. https://doi.org/10.1097/01.npr.0000822572.45824.3f
· Walden Library. (n.d.). What are the social determinants of healthLinks to an external site. . https://academicguides.waldenu.edu/Library/sdoh
· Walden University. (n.d.). Social determinants of health: Understanding vision health equityLinks to an external site. . https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/resource/social-determinants-of-health-understanding-vision-health-equity
· World Health Organization. (2022). Social determinants of healthLinks to an external site. . https://www.who.int/health-topics/social-determinants-of-health
Optional Resources
· Bryant, S. G. (2023). Screening for social determinants of health in transitional care patients and partnering with the faith community to address food insecurityLinks to an external site.. Professional Case Management, 28(5), 235–242. https://doi.org/10.1097/NCM.0000000000000613
· Davis, S. (2023). Leadership for meaningful transformation: The National League for Nursing/Walden University College of Nursing Institute for Social Determinants of Health and Social ChangeLinks to an external site.. Nursing Education Perspectives, 44(6), 384–385. https://doi.org/10.1097/01.NEP.0000000000001203
· Sheingold, S. H., Zuckerman, R. B., De Lew, N., & Chappel, A. (2023). Social determinants of health, quality of public health data, and health equity in the United StatesLinks to an external site.. American Journal of Public Health, 113(12), 1301–1308. https://doi.org/10.2105/AJPH.2023.307423
Previous
To prepare:
· Review the Learning Resources that address the importance and value of taking the SDoH into consideration as a DNP-prepared nurse.
· Consider why and how you intend to begin shifting your thinking and practice related to the SDoH from the relatively smaller scope of patient care to the broader perspective of organizations, communities, and the larger field of nursing (e.g., advocating at the policy level, meeting with stakeholders, utilizing esearch and data, etc.).
· Select one SDoH Domain that is of particular interest to you on which to focus for this Discussion.
· Using Walden Library and the internet, search for and identify three scholarly, peer-reviewed articles (within the last 5 years) that address the SDoH Domain you selected from the broader perspective of organizations, communities, and the larger field of nursing.
By Day 3 of Week 6
Post the following:
· An explanation of the importance and value of taking the SDoH into consideration as a DNP-prepared nurse.
· Identify the one SDoH Domain you selected and explain why it is particularly important to you.
· An explanation of why and how you intend to shift your thinking and practice related to the SDoH from the patient-level to the organizational, community, and/or larger field of nursing levels. Be specific, provide examples, and cite the three scholarly resources you identified to support your points.
Note: Your posts should be substantial (1000 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA Style. Personal anecdotes are acceptable as part of a meaningful post but cannot stand alone as the entire post.
RESPOND TO THIS DISCUSSION POST.
AM
The Social Determinants of Health (SDoH)
The SDoHs are the non-clinical components that impact health results, as well as financial standing, education, career, societal help, and accessibility to healthcare. Understanding and handling these factors is critical for DNP-prepared nurses who are poised to make a substantial impact on patient care, community health, and healthcare policy. The integration of SDoH into nursing practice allows healthcare providers to offer more holistic and effective care, advocate for systemic changes, and contribute to a more equitable healthcare system. Nurses, particularly those with DNP preparation, are uniquely positioned to bridge clinical care with community health interventions, providing a comprehensive approach to patient wellness that goes beyond the individual.
The value of considering SDoH is grounded in the fact that health results are shaped not only by genetics, but also by an individual’s lifestyle and circumstances of how they are born, develop, dwell, function, and mature (World Health Organization, 2023). For instance, someone’s ability to access nutritious food, safe housing, or quality healthcare significantly influences their overall health. Recognizing and addressing these social factors helps mitigate health disparities and promotes health equity, especially among vulnerable populations. The DNP-prepared nurse, with advanced clinical expertise and leadership capabilities, is in a prime position to advocate for and implement strategies that address these broader determinants of health.
SDoH Domain: Economic Stability
The SDoH domain that I have selected to focus on is economic stability. Economic stability includes factors such as income level, employment, expenses, and access to financial resources, all of which significantly affect a person’s ability to maintain health. Economic disparities are directly linked to healthcare access, health literacy, and the ability to manage chronic conditions. For example, individuals with low income or unstable employment may struggle to afford medications, healthy food, or transportation to medical appointments, all of which can negatively impact their health outcomes.
Economic stability is particularly important to me because it is a foundational determinant that influences multiple aspects of an individual’s health. As a nurse, I’ve seen how financial insecurity exacerbates chronic illness and contributes to poor health outcomes. Economic instability often forces individuals to decide between investing in healthcare and other essential necessities, like meals and housing. As a future DNP-prepared nurse, I feel a responsibility to advocate for policies and interventions that address these inequities, ensuring that economic stability is not a barrier to health.
Shifting from Patient-Level to Organizational and Community-Level Practice
As I transition into my role as a DNP-prepared nurse, I plan to shift my approach to SDoH from a patient-level focus to one that influences organizational, community, and larger nursing systems. This shift requires moving from simply addressing individual needs to advocating for structural changes that create environments conducive to better health outcomes for entire populations.
1. Organizational Level: On an organizational level, I intend to leverage my DNP education to advocate for policies that promote economic stability within healthcare systems. For example, I could work within healthcare organizations to implement more comprehensive financial assistance programs for patients who struggle with out-of-pocket costs. This might include creating partnerships with social services to offer direct financial support or counseling to help patients navigate healthcare-related expenses. Additionally, I will advocate for policies that offer paid family leave, sick days, and other benefits that support workers’ health and financial stability, particularly for low-income or marginalized communities.
According to a study by Gage et al. (2021), healthcare organizations that recognize the impact of economic stress on patient outcomes can improve both patient satisfaction and adherence to treatment plans by providing financial resources or support. This approach aligns with the broader healthcare goals of reducing disparities and promoting a more equitable system.
2. Community Level: At the community level, my goal is to foster collaboration between healthcare providers, local businesses, and community organizations to address economic disparities. One way I would do this is by partnering with local food banks, employment services, and housing support organizations to create a comprehensive care model that addresses economic stability. For example, I could help facilitate health screenings and educational programs in community centers or at local job fairs to help individuals access resources for both healthcare and economic support. A focus on addressing economic factors such as unemployment or underemployment would help individuals regain the financial stability necessary to manage their health more effectively.
A study by Cohen et al. (2022) demonstrated that community-based initiatives that address economic factors, such as workforce development and access to affordable housing, can reduce health disparities and improve overall community health outcomes. By integrating these economic interventions with healthcare services, I would be taking a more holistic approach to patient care and community health.
3. Larger Field of Nursing: On a larger scale, I intend to advocate for policy changes at the local and federal tiers that address economic stability as a SDoH. This might include supporting legislation that increases the minimum wage, expands access to affordable housing, or improves the availability of social safety nets like unemployment insurance. As a DNP-prepared nurse, I can use my platform to influence policy discussions and advocate for health equity. This would involve collaborating with other healthcare professionals, policymakers, and advocacy groups to push for systemic changes that address the root causes of health disparities.
Research by Martinez et al. (2021) highlights the need for nurse leaders to engage in policy advocacy to address SDoH at a macro level. By using my leadership role, I can advocate for public health policies that not only address clinical care but also the social factors that impact patient outcomes on a larger scale.
Conclusion
As a DNP-prepared nurse, addressing the social determinants of health is a critical component of providing holistic, equitable care. By focusing on the economic stability domain, I plan to support interventions that decrease wellness disparities and promote the welfare of people and society. Shifting my practice from a patient-level focus to organizational, community, and policy-level interventions will allow me to create meaningful change in healthcare systems and enhance health results for underserved groups. By solving the culprit of health gaps, such as economic instability, we can build a more just healthcare system that promotes health equity for all.
References
Cohen, A. J., Zimmerman, S. A., & Brashers, M. (2022). Community-based health interventions: Addressing economic disparities. *Journal of Community Health Nursing*, 39(2), 150-160. https://doi.org/10.1080/07370016.2021.1924456
Gage, M. D., Parikh, R. S., & Shah, M. A. (2021). The role of healthcare organizations in addressing social determinants of health. *American Journal of Health System Pharmacy*, 78(6), 405-413. https://doi.org/10.1093/ajhp/zxab186
Martinez, H., Thompson, A. M., & Wilson, P. A. (2021). Nurses’ role in policy advocacy for social determinants of health. *Policy, Politics, & Nursing Practice*, 22(1), 9-16. https://doi.org/10.1177/1527154421991744
World Health Organization. (2023). Social determinants of health. https://www.who.int/social-determinants/
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