Nurses and the Social Determinants of Health

Cox, Karen

doi:10.1111/phn.12244

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…[23, 31, 35, 36, 41, 80, 126, 145, 146] Authors also recommend that tools for socioeconomic data collection should be standardised, practical, validated, and evidence-based with no intellectual property restrictions. [18, 22, 92, 94, 99, 118] New guidelines and policies would help. [29, 80, 124, 146] So too would new data collection processes that are sensitive and culturally acceptable, [18, 26] time-efficient, [27] and integrated into clinical workflows, [36] while imposing minimal burden on clinicians, practices, and patients.…”

Section: Resultsmentioning

confidence: 99%

“…Although referral to social resources was the most often-cited reason for asking patients about their socioeconomic circumstances, it was acknowledged that such resources were limited [22] and too often unreliably funded. [114] Healthcare staff would need to be aware of local social resources [24, 27, 73] and feel able to make referrals.…”

Section: Resultsmentioning

confidence: 99%

“…[41] Compiling a list of community resources could be helpful, [25] or co-locating healthcare and community resources in the same physical space. [29] Some authors contended that asking patients about socioeconomic problems might be inappropriate if there were no relevant resources available, [22, 28] while acknowledging the danger of a cycle of inaction, for if enquiries are not made and needs are not identified, resources are unlikely to appear.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of reasons for and against asking patients about their socioeconomic contexts

Moscrop

Ziébland

Roberts

et al. 2019

Int J Equity Health

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Background People’s social and economic circumstances are important determinants of their health, health experiences, healthcare access, and healthcare outcomes. However, patients’ socioeconomic circumstances are rarely asked about or documented in healthcare settings. We conducted a systematic review of published reasons for why patients’ socioeconomic contexts (including education, employment, occupation, housing, income, or wealth) should, or should not , be enquired about. Methods Systematic review of literature published up to and including 2016. A structured literature search using databases of medicine and nursing (pubmed, embase, global health), ethics (Ethicsweb), social sciences (Web of Science), and psychology (PsychINFO) was followed by a ‘snowball’ search. Eligible publications contained one or more reasons for: asking patients about socioeconomic circumstances; collecting patients’ socioeconomic information; ‘screening’ patients for adverse socioeconomic circumstances; or linking other sources of individual socioeconomic data to patients’ healthcare records. Two authors conducted the screening: the first screened all references, the second author screened a 20% sample with inter-rater reliability statistically confirmed. ‘Reason data’ was extracted from eligible publications by two authors, then analysed and organised. Results We identified 138 eligible publications. Most offered reasons for why patients’ should be asked about their socioeconomic circumstances. Reasons included potential improvements in: individual healthcare outcomes; healthcare service monitoring and provision; population health research and policies. Many authors also expressed concerns for improving equity in health. Eight publications suggested patients should not be asked about their socioeconomic circumstances, due to: potential harms; professional boundaries; and the information obtained being inaccurate or unnecessary. Conclusions This first summary of literature on the subject found many published reasons for why patients’ social and economic circumstances should be enquired about in healthcare settings. These reasons include potential benefits at the levels of individuals, health service provision, and population, as well as the potential to improve healthcare equity. Cautions and caveats include concerns about the clinician’s role in responding to patients’ social problems; the perceived importance of social health determinants compared with biomedical factors; the use of average population data from geographic areas to infer the socioeconomic experience of individuals. Actual evidence of outcomes is lacking: our review suggests hypotheses that can be tested in future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of reasons for and against asking patients about their socioeconomic contexts

Moscrop

Ziébland

Roberts

et al. 2019

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…Understanding a patient's social background can also facilitate referral to community-based resources to address the underlying issue or issues. 26 To take the example above, when a health care provider learns that her patient is homeless, she can refer them to a community service that may assist them in finding housing and other services. Health care providers may refer patients to legal professionals, as many social determinants stem from unmet legal needs.…”

Section: The Recognition That Social Determinants Affect Healthmentioning

confidence: 99%

Facing the Need: Screening Practices for the Social Determinants of Health

Theiss¹,

Regenstein²

2017

J. Law. Med. Ethics

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Despite evidence that social factors can result in poor health outcomes, and the emergence of payment models that encourage the use non-medical interventions to improve health, many health care providers do not identify the social determinants of health within patient populations through routine screening. This Article explores the possible reasons for this inconsistency by considering screening practices in medical-legal partnerships (MLPs), the health care approach most concerned with identifying and treating the social determinants of health. Through an analysis of the results of a national survey and qualitative interviews with MLPs, we discovered that screening is not operationalized or consistent within many MLPs. We conclude that although health care providers may recognize the value of screening, they are not yet embracing the practice, perhaps because of an unspoken fear that fulsome screening identifies so many unmet social and legal needs that community-based resources cannot satisfy demand. This fear is unfounded. Approaches such as MLP demonstrate that social and legal needs can be efficiently treated through collaboration with other professionals, often within the health care setting. Nevertheless, providers must first operationalize screening to truly understand the scope of the need in their patient populations and collaborate to address those needs.

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“…The literature suggests that practitioners need to consider cultural influences of intergenerational trauma in refugee health care delivery systems (Hudson, Adams, & Lauderdale, 2016). Nurses are at the forefront of caring in the community and play a significant role in health promotion among diverse populations (Cox, 2016). Caring and holistic care are the central concepts of nursing in all settings (Enns & Sawatzky, 2016).…”

Section: Introductionmentioning

confidence: 99%

Bhutanese Older Adult Refugees Recently Resettled in the United States: A Better Life With Little Sorrows

2017

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The five identified themes included the following: a better life but with little sorrows, cultural tensions related to adaptation, language as a barrier to success in the United States, isolation and loneliness, and worries about citizenship and its impact on the future. Discussion/Implications for Practice: Psychological adjustment to life in the United States can have profound impact on the health of Bhutanese older adults. Nurses and health care providers should integrate culturally congruent health care, raise awareness of the unique needs, and advocate for policy changes that will benefit this group of older adult refugees whose lives have frequently been upended.

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Nurses and the Social Determinants of Health

Cited by 5 publications

References 7 publications

A systematic review of reasons for and against asking patients about their socioeconomic contexts

A systematic review of reasons for and against asking patients about their socioeconomic contexts

Facing the Need: Screening Practices for the Social Determinants of Health

Bhutanese Older Adult Refugees Recently Resettled in the United States: A Better Life With Little Sorrows

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