Online Program

Public health nursing interventions for social determinants of health

Wednesday, November 6, 2013 : 10:50 a.m. - 11:10 a.m.

Background: The social determinants of health (SDOH) such as poverty and racism are well documented; however PHN interventions related to SDOH have not been standardized and described. The objective of this study was to explore the extent of PHN practice and influence regarding the SDOH at individual, community, and system levels.

Methods: A descriptive and correlational study of self-reported public health nursing (PHN) interventions. PHNs from 100 tribal- and local-health departments in 16 states responded e- professional list servs invitations to complete an internet survey of 53 SDOH interventions. The survey was developed by a Midwestern Public Health Nurse Council using clinical expert consensus and the Omaha System. Survey data were analyzed using descriptive and correlational methods. Publicly available staffing and financial data were then added to the survey response database.

Results: All 53 SDOH interventions were reported by PHNs, with responses varying by population and level: individual level for maternal-child health (85.4%), adults (85.1%) and families (84.6%); community level (49.4%), and system level (36.4%). An additional 34 interventions were reported in free text. Analysis of financial and staffing data showed that the number of PHNs was more strongly associated with the total number of SDOH interventions (r=.38) than either the organization's total budget (r=.11) or the total number of LPNs, RNs, and PHNs (r=.30).

Conclusions: PHNs address SDOH among diverse populations at individual, community, and system levels. Agencies employing a higher ratio of PHNs may have greater focus on addressing SDOH. The Omaha System supports documentation of SDOH interventions.

Learning Areas:

Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Describe individual, community, and system level PHN interventions for social determinants of healh

Keyword(s): Social Inequalities, Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an international expert in Omaha System data use and public health nursing. I have authored 28 data-based publications on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.