Addressing Social Determinants of Health – A DNP Perspective on Economic Stability

Addressing Social Determinants of Health – A DNP Perspective on Economic Stability

Social Determinants of Health (SDoH) are non-medical factors that influence health outcomes, including economic stability, education, neighborhood conditions, healthcare access, and social context. As a DNP-prepared nurse, incorporating SDoH into advanced practice is essential to achieving equitable, patient-centered care and improving population health outcomes. The traditional focus on clinical treatment alone is insufficient to address the broader challenges patients face. Flaubert et al. (2021) emphasize that health is significantly influenced by factors beyond medical care, such as the neighborhood one lives in, economic status, education level, and access to healthy foods and reliable transportation. Identifying and engaging with these determinants helps nurses expand their practice from the clinical perspective of patient care, tackling the drivers of healthcare at systems and policy levels. By addressing the entire continuum of health, from disease prevention to management and cure, DNP-prepared nurses are able to fill the identified gaps in these areas to transform health and advance nursing practice through their advocacy, leadership, and collaboration with other healthcare professionals.

Among the key SDoH domains, economic stability is especially significant to me. Economic insecurity influences nearly every aspect of a person’s life, including their ability to afford nutritious food, maintain stable housing, access preventive care, and adhere to treatment regimens. I have personally witnessed patients delay or forgo medical appointments and medications due to financial hardship. This SDoH domain particularly appeals to me because poverty and unemployment perpetuate poor health among vulnerable populations. According to Kirkbride et al. (2024), economic disadvantage is a significant factor that increases the prevalence of chronic disease, mental conditions, and preventable hospitalization. Eradicating this determinant also serves the welfare of individual patients who seek medical care and the overall community and results in decreased healthcare expenditures in the long run.

To move from a patient-centered focus to a broader organizational and community-level approach, I intend to implement several strategies. First, I will advocate for the routine integration of SDoH screening tools into clinical workflows and electronic health records (EHRs). These tools assist in the provision of information that helps identify patients, especially those in economic hardship, and link them with resources such as financial resources, food pantries, housing, and employment. Chen et al. (2020) provided an example of how SCM that included SDoH screenings had the benefit of increasing patient participation and avoiding ED admissions. Using EHRs for social risk data may help organizations design necessary interventions and distribute resources properly.

Secondly, I plan to engage in community partnerships that address economic challenges at the grassroots level. This may involve working with staff from the workforce development agency, community health workers, and non-profit organizations responsible for programs on employment, income, and financial skills development. As a nurse leader, I can help establish referral systems between healthcare settings and community-based services. These partnerships empower patients beyond clinical settings and foster community resilience. Additionally, promoting employment pathways in underserved communities can enhance long-term health outcomes and reduce reliance on emergency care.

From a systems and policy perspective, I would like to participate in any advocacy for progressive changes such as raising the minimum wage, expanding Medicaid, or creating affordable housing schemes. The National Academies of Sciences, Engineering, and Medicine (2021) emphasize that nurses must engage in policy reform to tackle upstream causes of health disparities. I will use data-driven research and clinical outcomes to support legislative efforts that enhance economic security for low-income populations. For example, Kirkbride et al. (2024) advocate for aligning social care with healthcare delivery to improve outcomes while lowering costs—a principle I intend to champion in professional forums and policy discussions.

In conclusion, it is essential and beneficial for NDNPs to include SDoH in their area of practice as a practice mandate and to play a role in fostering change. However, if the focus is placed on the economic aspect, this makes it possible for change to be made at a structural level that positively impacts not only the clients but also the overall health systems and the general population’s health. Suppose, through providing direct care, narrative change, and policy advocacy for patients, DNP-prepared nurses are the leaders in this transformation.

References

Chen, M., Tan, X., & Padman, R. (2020). Social determinants of health in electronic health records and their impact on analysis and risk prediction: A systematic review. Journal of the American Medical Informatics Association, 27(11), 1764–1773. https://doi.org/10.1093/jamia/ocaa143

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021, May 11). Social determinants of health and health equity. The Future of Nursing 2020-2030 – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK573923/

Kirkbride, J. B., Anglin, D. M., Colman, I., Dykxhoorn, J., Jones, P. B., Patalay, P., Pitman, A., Soneson, E., Steare, T., Wright, T., & Griffiths, S. L. (2024). The social determinants of mental health and disorder: Evidence, prevention and recommendations. World Psychiatry, 23(1), 58–90. https://doi.org/10.1002/wps.21160

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. In National Academies Press eBooks. The National Academies Press. https://doi.org/10.17226/25982

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Addressing Social Determinants of Health – A DNP Perspective on Economic Stability

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.

Addressing Social Determinants of Health – A DNP Perspective on Economic Stability

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.

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.

SDoH References below:

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 (500 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.

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