When it comes to predicting the lifespan of anyone living in the United States, there are many factors to consider, including gender, genes, diets, and exercise. But there's one factor that's only recently been examined but is proving critical to determining one's longevity: zip code.
That's because social determinants of health (SDoH)—like access to food, jobs, childcare, and stable housing—can vary greatly from state to state, city to city, and even neighborhood to neighborhood. In fact, research from the New York University School of Medicine has found that life expectancy for Chicago residents can vary by more than 30 years, depending on where they live within the city.
The data is clear: Social determinants of health result in poorer Americans developing a variety of chronic illnesses and succumbing to them more often than their wealthier peers. As a result, more still needs to be done to reduce the impact that social determinants have in determining health care outcomes. And nurses, stationed at the front lines of healthcare, are in a prime position to holistically address the social determinants of health and drive positive patient outcomes.
Nursing and SDoH intervention
The role of nursing in addressing SDoH cannot be understated, given that nurses are key players in promoting health in ways both direct and indirect—helping to prevent illness and injury while also serving as advocates for better care. But the role of nurses in supporting social determinants of health is by no means a new or emerging practice.
"Nursing has always had a strong focus on [SDoH]," writes Ellen F. Olschansky, founding chair of the Department of Nursing in the University of Southern California's School of Social Work, in a 2017 American Journal of Nursing article. "Florence Nightingale emphasized the importance of hygiene, nutrition, social network, and social class. Lillian Wald, the founder of public health nursing, established the Henry Street Settlement, out of which developed the Visiting Nurse Service of New York, which provides health care to the poor. The Code of Ethics for Nurses of the American Nurses Association includes principles of social justice and emphasizes the need to integrate social concerns into nursing and health policy."
Although nurses have a longstanding tradition of incorporating social needs into the care they deliver, the rapid pace of change in today's healthcare sector poses unique challenges in how organizations support nurses in addressing SDoH. And without that support system in place, nurses may not know the right course to chart when addressing SDoH in their care delivery.
Nursing and SDoH: Asking questions, building relationships
The ability to assess a patient's social determinants of health is one of the best ways to predict the chance of developing conditions like asthma, COPD, and diabetes, as well as determine the risk of heart attack, stroke, and cancer. So how can nurses support SDoH and ensure those determinants are factored into their patients' care? It all comes down to asking the right questions.
Assessing the social factors that affect a patient's life is the first point of order for nurses. They'll need to ask about a patient's access to:
- physical and mental healthcare
- stable housing
- fresh, nutritious food and clean drinking water
- educational resources
- job opportunities
- affordable, reliable transportation
- social support
When it comes to addressing a patient's social needs, like food insecurity to lack of transportation or employment, it's clear that the U.S. healthcare system cannot cover all of the bases. That's where collaboration and communication beyond the healthcare realm play a critical role—and luckily, nurses are highly skilled in both areas.
Using these skills, nurses are in a position to help build teams that go well beyond the traditional boundaries of healthcare to include sectors such as social work, philanthropy, housing, business development, and local government. Fostering strong communication systems and sharing resources among cross-sector stakeholders can help define the strategic vision and tactics needed to drive positive patient outcomes by addressing SDoH.
Nurses hold the power to make change happen—both as healthcare professionals and community citizens. Looking outside of the healthcare system, nurses can amplify their voices and advocate for SDoH interventions. From working with community-based agencies on initiatives that make change happen at the local level to influencing policy makers on drafting legislation that makes SDoH a priority for their city or state, nurses bring to these conversations the knowledge, empathy, and first-hand experience needed to identify the social services their local communities need.
Empowering people and organizations to better address SDoH
A patient's health shouldn't be determined by the zip code they live in, and nurses across the country are working tirelessly to ensure that it's not the case. But nurses can't go it alone—and that's where organizations like Healthify enter the scene.
Since our founding, our mission has been clear: Help build a world where no one's health is hindered by their need. We're fundamentally rethinking how healthcare organizations and communities work together to help people thrive—whether it's building partnerships that identify social needs, leveraging new technologies that make data around social services and population needs at the community level more accessible, or coordinating care with an integrated network of community partners to improve outcomes.
Learn more about the ways Healthify is supporting end-to-end care coordination across our networks of healthcare and community-based organizations.