Understanding Social Determinants of Health and Their Impact on Health Disparities in FNP Clinical Practice

For review let us first establish a good understanding of what Social determinants of health (SDOH) are and how they significantly influence health disparities in communities. With specific focus on the Family Nurse Practitioner (FNP) students, understanding these determinants is crucial for delivering comprehensive care to diverse populations. This blog post explores SDOH and their impact on health disparities, shaping how FNPs approach clinical practice.

What Are Social Determinants of Health?

Social determinants of health (SDOH) are lifestyle events and actions such as age, gender, upbringing, physical location, education and socioeconomic status that predetermine our health. These non-genetic, non-medical variables play a large role in how our health progresses. Dr. Grace Totoe (2024) states that these variables “are crucial in determining health outcomes and are at the heart of many health disparities we see today” (p.18).

Let us take a moment to truly understand what this means. One example of SDOH is literacy. Education plays an immense role in one’s health. for when we are educated, we understand the importance of good health and routine screenings and exams. This provides the best opportunity to maintain good health and prosper to the best of our ability. When illiteracy and lack of understanding come into play, health status suffers. “People with higher education levels often have better health literacy – they understand how to navigate the healthcare system, make informed decisions, and engage in healthier behaviors” (Totoe, 2024).

Another important SDOH that Dr. Totoe touches upon is income. For when we can afford to maintain health insurance, get routine health exams, purchase healthier foods, and even live in safer neighborhoods, we are more apt to maintain good health. She continues to say that people who can not afford these things traditionally “face higher rates of chronic diseases and a shorter life expectancy” (Totoe, 2024).

Understanding SDOH is essential for FNPs because it enables us to look at the full picture of our patients' lives. By considering these factors, we can address the root causes of health issues, rather than just treating symptoms.

The Link Between Social Determinants of Health and Health Disparities

When evaluating ones health status, it is important to consider the measurable gaps or differences in health outcomes, they are called health disparities. Health disparities are dependent on things like gender, ethnicity, or race. Which coincides with SDOH, and can sometimes be difficult to decipher between the two. Their webs are very much intertwined, they tend to go hand in hand.

• Social determinants of health = the “causes.”

• Health disparities = the “effects.”

To clarify, Social determinants of health (SDOH) are the conditions people live in (like poverty, housing, education, access to care).

Because these conditions aren’t equal across all groups, they often lead to health disparities or the unequal outcomes (like higher disease rates, shorter life expectancy, or worse access to treatment) (WHO, n.d.).

Should the SDOH be the responsibility of health professions?

The short answer here... yes. But this problem cannot completely fall on the shoulders of health professionals, there has to be a collaborative approach with systemic stakeholders. Health professionals have a responsibility to address SDOH at the patient level (screen, educate, connect, advocate), but the responsibility to fix SDOH is shared with policymakers, community leaders, and society at large.

Whitman et al. (2022) exhibit a great understanding of the dynamics between health care professionals and the stakeholders when procuring changes to SDOH issues. Check out the diagram below for their depiction of this 'ecosystem'.

Final Thoughts

Understanding social determinants of health is vital for Family Nurse Practitioners as we aim to deliver fair and complete care. By recognizing how these determinants contribute to health disparities, we can better meet our patients' needs and help reduce inequalities in health outcomes.

As FNP students, we have the responsibility to incorporate this knowledge into our clinical practice. By engaging with our communities and advocating for supportive policies, we can truly make a difference in our patients' lives and work towards a healthier society.

References

Totoe, G. (2024). Bridging the gap health equity and disparities in healthcare from a clinician's perspective. ISBN: 9798339738664

Whitman, A., De Lew, N., Chappel, A., Aysola, V., Zuckerman, R., and Sommers, B.D. (2022). Addressing social determinants of health: Examples of successful evidence- based strategies and current federal efforts. Assistant Secretary for Planning and Evaluation - Offie of Health Policy. https://aspe.hhs.gov/sites/default/files/documents/e2b650cd64cf84aae8ff0fae7474af82/SDOH-Evidence-Review.pdf

World Health Organization (n.d.). World report on social determinants of health equity: executive summary. https://www.who.int/publications/i/item/B09387