Nurses play a pivotal role in the healthcare system by maintaining frequent and ongoing contact with patients and witnessing their challenges and need for health equity. To actively combat the growing health disparities nationwide, nursing professionals must first understand how social determinants of health (SDOH) influence patients’ well-being and interactions with care services.

For nurses looking to make a greater difference in their patients’ lives and communities, the Eastern Michigan University (EMU) online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program is a worthwhile next step. The program curriculum offers a Health Disparities in the United States course as a foundation for nurses aspiring to address issues intensifying health inequities.

The Impact of Social Determinants of Health and Other Factors

SDOH encompass various factors, such as socioeconomic status, education, employment, literacy skills, and access to safe housing, healthcare and nutritious foods. These determinants often affect how individuals approach care and influence health outcomes, accounting for as much as 90% of a person’s modifiable risk factors, notes Nursing Outlook.

Besides SDOH, other factors leading to health disparities include systemic racism and discrimination, language barriers, and physician and nursing shortages, particularly in rural and underserved communities. Existing structural and systemic components of daily life, called environments, can drive healing and wellness or deepen health inequities.

The four environments are:

  1. Cultural: unique worldviews attributed to racial and ethnic populations
  2. Socioeconomic: social class or standing as it correlates to one’s income, education, occupation, gender, race and ethnicity
  3. Physical: impact of climate change and access to walkable, healthy communities and natural surroundings
  4. Political: health legislation and policies

Can Nurses Conduct SDOH Screenings to Improve Health Outcomes?

Nurses are instrumental in identifying patients experiencing social risk factors, like food instability and lack of reliable transportation, that impede their access to care and overall health. One way they do this is by conducting a social screening designed to uncover unmet needs and connect patients with community resources.

While healthcare systems may have a preferred screening tool, the Centers for Medicare and Medicaid Services developed a standardized assessment called the Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) Screening Tool. According to the Nursing 2024 journal, the “10-question tool assesses five key domains of health-related social needs, collecting a breadth of information that increases the likelihood of identifying significant needs. The tool can also be integrated into multiple clinical workflows and accessible across diverse patient populations.”

Does Patient-centered Care Improve Health Equity?

Nurses knowledgeable about SDOH risk factors and screening tools can strengthen individual patient health and health equity — both major goals of emerging public health initiatives. However, most nurses could benefit from additional education on the topic.

A Journal of Nursing Scholarship study assessed nurses’ SDOH knowledge and comfort in integrating screening tools into clinical practice. Of 768 nurses, 50% reported feeling more confident in their ability to discuss only one factor of SDOH with patients — access to care issues — compared to the many other SDOH concerns.

“Identified barriers to discussing the SDOH included insufficient time to address identified needs and unfamiliarity with internal and external resources,” the authors note. Study participants emphasized the need for further education and collaboration on SDOH screening, such as how to approach culturally sensitive conversations and more information on the role of social workers.

By proactively screening patients for SDOH, nurses can provide patient-centered care, such as customized interventions and referrals to community resources. Advancing their knowledge in this area with targeted coursework from EMU’s online RN to BSN program ensures they capture SDOH information accurately and with cultural sensitivity, ultimately promoting health equity and better patient outcomes.

Learn more about Eastern Michigan University’s online RN to BSN program.