Discussion: SDOH and Public Health

Discussion: SDOH and Public Health

Health Disparities

In the United States, there are populations with greater health disparities compared to others. These disparities are not only a result of fundamental differences in the health status of individuals and communities across different population segments but also due to inequities in factors that directly impact the health status of individuals, families, and communities, otherwise referred to as Social Determinants of Health(SDOH). Increasing access and opportunities to SDOH   can help to eliminate unfairness that leads to health inequities.Discussion: SDOH and Public Health

SDOH and Healthy People 2020

There exists a strong association between SDOH and Healthy People 2020 goals. SDOH are designed to identify ways of creating physical and social environments that promote universal healthcare so that every American has an equal opportunity to make the right choices that leads to good health.

SDOH, Individual Choices, and Behavior

A person’s health status partly depends on his/her choices and behavior. However, community-wide issues such as unemployment, poverty, poor public transport, poor education, and violence also cause health inequities, including the interplay of policies, structures, and norms that shape life. Nurses can help to address these inequities through social policies.Discussion: SDOH and Public Health


Impact of SDOH on Public Health in Florida (Miami)

In Florida, 18.0% of the population lives below the poverty level and 42.0% of the households have a low income, which are barriers to healthcare access and healthy nutrition. Low income continues to be a major cause of high rates of obesity among adults (22%) and physical inactivity (25%) (County Health Rankings and Roadmap, 2020). Physical inactivity increases the risk of obesity and subsequent chronic lifestyle diseases such as type 2DM, cardiovascular diseases and hypertension that are costly to manage, have a poor prognosis and high disease burden.

Ways Public Health Nurses and Departments Can Address SDOH To Improve Community and Public Health

Public health nurses (PHNs) and departments have always focused on SDOH. Perfect examples of nurses under this category are Florence Nightingale who emphasized social class, hygiene, social networking and nutrition, and Lillian Wald who established the Henry Settlement and cared for the poor through the Visiting Nurse Service in Newyork. Today, PHNs must first recognize and acknowledge that SDOH influence health outcomes and intervene as follows:

At patient level

  • ask patients about their social challenges in a caring and sensitive way
  • -referring patients and assisting them to access support and benefit services

At the organizational level

  • improve quality and access to care for hard-to-reach and underserved patient groups
  • -incorporate social support navigators for patients in primary care teams

At Community level

  • -partner with local and public health leaders and community groups through intersectoral collaboration to create healthier environments
  • -utilize clinical research evidence and experience to advocate for social change.
  • conducting community needs assessments and being involved in health planning
  • Empowering, engaging, and changing social norms in the community.Discussion: SDOH and Public Health

Incorporating Knowledge on SDOH in Daily Practice

The author will incorporate the knowledge obtained on the SDOH in daily practice by

-Conducting biopsychosocial needs assessments to identify individual, familial and community health disparities

-Creating awareness to identify the assets and social risks of specific populations and patients

-Adjusting clinical health practices such as providing literacy and language concordant services to prevent language barrier

-Integrate strategies that link patients who have social needs with community and government resources in practice

-Assess community social care assets and collaborate with other internal and external stakeholders to organize the assets to promote teamwork, synergy, and impact health outcomes positively.

-Form alliances with other nurses to advocate for policies to influence equitable distribution of resources


US Department of Health and Human Services (2010). Determinants of Health: A Framework for Reaching Healthy People 2020 Goals. Retrieved August 27, 2020, from https://www.youtube.com/watch?v=5Lul6KNIw_8

County Health Rankings and Roadmap (2020). Florida, Miami-Dade. Retrieved August 27, 2020 from https://www.countyhealthrankings.org/app/florida/2020/rankings/miami-dade/county/outcomes/overall/snapshot



Discussion: SDOH and Public Health