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In addition to medical and genetic factors that affect human health, social determinants of health (SDOH) exist. They may be related to socioeconomic circumstances, the environment, the populations education, and governmental social and medical programs. Moreover, social determinants significantly affect access to proper medical care and cause health equity issues. Health equity implies recognizing that some population groups need additional assistance to receive equal health services. Recognition of this fact contributes to the reduction of the influence of the SDOH and the promotion of equity. Therefore, this paper will analyze the impact of social determinants on health and opportunities to improve equity in health care.
Social Determinants of Health
Social determinants of health are non-medical factors that can significantly affect the incidence of the population. These factors include education, employment, health systems and services, housing, income and wealth, the physical environment, public safety, the social environment, and transportation (National Academies of Sciences, Engineering, and Medicine, 2021, p. 32). SDOH can have both positive and negative effects on peoples health. However, in most cases, they have a negative effect, causing severe diseases and generating health inequalities.
One of the most common social determinants is the level of income and wealth of people. People with lower incomes are primarily concerned with meeting their basic needs, such as food and shelter, and often do not have enough money for regular medical examinations and treatment. It leads people with higher incomes to experience lower mortality, higher life expectancy, and slower declines in physical functioning (National Academies of Sciences, Engineering, and Medicine, 2021, p. 42). In addition, wealth determines the environment in which a person lives, his predisposition to smoking, alcohol and drug use, and malnutrition.
Another significant outcome for the health of people with lower incomes is the opportunity to access social services, education, and healthcare. First, the lack of quality education causes a low level of health literacy (Hill-Briggs et al., 2021). As a result, people pay less attention to their health and not seeking medical help on time. Second, the lack of education determines the possibility of employment and earnings at an older age (Hill-Briggs et al., 2021). In addition, poorer neighborhoods often have limited access to proper health care. Thus, a persons socioeconomic status is one of the leading causes of health inequity.
Improving Health Equity
Healthcare equity is necessary to ensure the proper health of all citizens and prevent serious diseases. Hill-Briggs et al. (2021) define equity as the absence of avoidable, unfair, or remedial differences among groups of people (p. 259). That means everyone should receive the same high-quality health care regardless of social, economic, demographic, or geographic characteristics. At the same time, the task of nurses is to reduce the impact of social determinants of health and provide equal healthcare services to all patients.
Since nurses interact most with patients and their families, their role in improving health equity is very significant. First, nurses can engage in patient information and education, increasing health literacy among the population. It makes patients more likely to follow instructions and change their behavior as directed by their doctor (National Academies of Sciences, Engineering, and Medicine, 2021). In addition, they may work with community services and organizations to promote public health. Secondly, improving health equity requires a change in the attitude toward patients and increased attention to emerging equity issues. Therefore, nurses can lead teams to improve the care and reduce the costs of high-need, high-cost patients and coordinate with other nurses (National Academies of Sciences, Engineering, and Medicine, 2021, p. 102). In addition, nurses can provide primary care to people who do not have access to medical facilities through telehealth or by visiting patients at their homes.
Self-Care for Nurses
The work of nurses is aimed at meeting the complex needs of patients, so there are often physical, psychological, and emotional challenges. Therefore, self-care is necessary to ensure nurses general well-being and prevent professional burnout. Moreover, nurses well-being improves their ability to address SDOH and improve health equity (National Academies of Sciences, Engineering, and Medicine, 2021). Often the stress and tension associated with work cause burnout and deterioration in the physical health of nurses, so it is necessary to use self-care strategies to improve their condition.
One strategy for improving mental health and preventing burnout is mindfulness. Horn and Johnston (2020) define it as the act of focusing on the present moment (p. 565). This practice helps assess mental state and reduce stress and anxiety. In addition, a critical strategy for improving nurses well-being is maintaining high-quality sleep and reducing caffeine intake. Nurses work schedules can often be hectic with heavy workloads, so sleep and recuperation are essential. Furthermore, Horn and Johnston (2020) note the impact of diet and exercise on nurses health. It helps maintain physical well-being and affects stress levels and mental health, reducing the risk of burnout.
Conclusion
Thus, social determinants are one of the critical determinants of the level of population health. They cause health inequity, as a result of which some groups of people do not receive the necessary medical services. Improving health equity should be one of the main areas for changing the health system. In addition, health professionals, particularly nurses, significantly influence the equality of healthcare services provided. However, nurses ability to address equity issues and reduce the impact of SDOH depends on several factors, particularly their physical and mental health.
References
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P.L., & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review. Diabetes care, 44(1), 258-279. Web.
Horn, D. J., & Johnston, C. B. (2020). Burnout and self care for palliative care practitioners. Medical Clinics, 104(3), 561-572. Web.
National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 20202030: Charting a path to achieve health equity. Washington, DC: The National Academies Press. Web.
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