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Social determinants have been the focus of our profession since the dawning of nursing time. As health care providers, we know that health starts in our homes, schools, communities, and workplaces, which are heavily influenced by the availability of access to societal and economic opportunities. If I live closer to orchards or fields, I’m more likely to pay less for fresh fruits and vegetables. If there are low-cost medical providers near my work, I’m more likely to be seen before my illness exacerbates. The conditions of our environments shape not only our health but the overall quality of life we perceive. Having nurses actively engaged in the communities they serve can help improve these determinants.
Intending to create social and physical environments that promote good health for all, the Office of Disease Prevention and Health Promotion (DPHP) created HealthyPeople.gov to lay the blueprint for communities to address health issues and disparities among their people. Daily resources such as safe housing, local food markets with healthy choices, access to educational and economic opportunities, access to affordable health care, and the need for improved public safety are all examples of social determinants that improve with focused attention.
Enter the public health nurse. This specialized role focuses on improving population health by focusing on prevention while addressing the multi-focal determinants listed above. As community health nurses, these RNs apply systems-level thinking to assess not only the actual assets, needs, and opportunities of the individuals and communities, but also the potential needs and inequalities within the population. Then they take action. Yet, these actions are not reserved for the specialty of Public Health Nursing; as we have learned, these are actions for all nurses:
• Get educated: Learn the social determinants in your area that affect the population you serve. Is there a lack of medical care or access to dental services? What are the immunization rates in your neighborhood? How about safe, reliable public transportation from your community to essential services such as the grocery store? The more you know, the more efficient you will be in your efforts to make an impact.
• Get political: I’m not talking about red vs. blue politics or social media memes. Learn what policies are up for a vote in your local area and either volunteer to advocate for – or against – the policies that will affect the social determinants of your space. Seek nursing appointments or positions that help form social change for the community and beyond.
• Get cultural: Competence in other cultures includes allowing yourself to be vulnerable enough to say, “I don’t know – teach me.” Work within people’s cultural norms to highlight where you can add value to improve their quality of life. Don’t be afraid to ask clarifying questions.
• Get moving: Once you determine what or who needs your focused nursing attention, organize fundraisers, health fairs, or awareness around the issue. High rates of diabetes in your community? Consider cooking classes featuring healthy items you’d find in the local markets. Plan a ‘Mom’s Night Out’ with childcare so you can provide healthy snacks as you educate women in your neighborhood on hypertension or the importance of immunizations.
Nurses are the past, present, and future health care providers of our communities. We are charged with improving the lives of those around us and addressing – one by one, if needed – the social determinants that are negatively affecting lives. No matter our nursing specialty, we can all make a difference to move the needle to improve the social determinants of health.
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