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PechaKucha Presentation

Abstract

Background: Health is a concept with multiple definitions, and it is influenced by a range of determinants. Social determinants of health (SDOH) are societal systems and resources that cause health consequences, by influencing the distribution of health-supporting factors and risks across populations (Hahn, 2021). SDOH are widely associated with health outcomes (Enard et al., 2023; Glauser et al., 2022; Vince et al., 2023), and they are recognised in various national (Flaubert et al., 2021; Kuehnert et al., 2022) and international health strategies (United Nations, 2015; World Health Organization, 2019). SDOH affect on individual’s health regardless the effectiveness of the care, making them essential to be integrated into clinical practice. This umbrella review aims to analyze current integration of SDOH into clinical practice.

Method: Systematic literature search was conducted on January 2024 in Pubmed, Cinahl and Cochrane -databases. Inclusion criteria were as follow: SDOH mentioned in title or abstract, investigation of SDOH intervention or screening, clinical healthcare context, adult patients and literature review as a study type. Data were analysed with inductive content analysis.

Results: Out of 560 identified studies, 31 reviews (which included a total of 1166 papers, ranging from 5 to 214 papers) published between 2016-2023 met the inclusion criteria. SDOH are integrated into the clinical practice through 1) screening: SDOH are usually screened in clinical practice with standard screening tools or other assessment methods, 2) multisectoral efforts: collaborations are established between hospitals and communities to improve care, as well as medical-legal partnerships to help patients resolve legal issues affecting their health, 3) social prescribing and community linkages: patients are directed to resources for needs identified in clinical practice, but which cannot be addressed within it, and 4) interventions targeting specific SDOH in clinical practice: typically through patient education or material support.

Conclusion: Integrating SDOH into clinical practise is increasingly recognized as essential for providing comprehensive, patient-centred healthcare. Screening tools and assessments serve as foundational steps for identifying and addressing SDOH. With multisectoral efforts, interventions and connecting patients to community resources, healthcare systems can better address the broader SDOH affecting on health outcomes.

Notes

References:

1. Enard, K. R., Coleman, A. M., Yakubu, R. A., Butcher, B. C., Tao, D., & Hauptman, P. J. (2023). Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review. Journal of the American Heart Association, 12(3), e026590. https://doi.org/10.1161/JAHA.122.026590

2. Flaubert, J. L., Le Menestrel, S., Williams, D. R., & Wakefield, M. K. (Eds.). (2021). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. National Academies of Sciences, Engineering, and Medicine. https://doi.org/10.17226/25982

3. Glauser, G., O’Connor, A., Brintzenhoff, J., Roth, S. C., Malhotra, N. R., & Cabey, W. V. (2022). A Scoping Review of the Literature on the Relationship Between Social and Structural Determinants of Health and Neurosurgical Outcomes. World Neurosurgery, 158, 24–33. https://doi.org/10.1016/j.wneu.2021.10.109

4. Hahn, R. A. (2021). What is a Social Determinant of Health? Back to Basics. Journal of Public Health Research, 10(4), jphr.2021.2324. https://doi.org/10.4081/jphr.2021.2324

5. Kuehnert, P., Fawcett, J., DePriest, K., Chinn, P., Cousin, L., Ervin, N., Flanagan, J., Fry-Bowers, E., Killion, C., Maliski, S., Maughan, E. D., Meade, C., Murray, T., Schenk, B., & Waite, R. (2022). Defining the social determinants of health for nursing action to achieve health equity: A consensus paper from the American Academy of Nursing. Nursing Outlook, 70(1), 10–27. https://doi.org/10.1016/j.outlook.2021.08.003

6. United Nations. (2015). Transforming our world: The 2030 Agenda for Sustainable Development. https://wedocs.unep.org/20.500.11822/9814

7. Vince, R. A. J., Jiang, R., Bank, M., Quarles, J., Patel, M., Sun, Y., Hartman, H., Zaorsky, N. G., Jia, A., Shoag, J., Dess, R. T., Mahal, B. A., Stensland, K., Eyrich, N. W., Seymore, M., Takele, R., Morgan, T. M., Schipper, M., & Spratt, D. E. (2023).
Evaluation of Social Determinants of Health and Prostate Cancer Outcomes Among Black and White Patients: A Systematic Review and Meta-analysis. JAMA Network Open, 6(1), e2250416. https://doi.org/10.1001/jamanetworkopen.2022.50416

8. World Health Organization, Government of South Australia. (2019). Adelaide Statement II (2017) on Health in All Policies (p. 14). https://www.who.int/publications/i/item/WHO-CED-PHE-SDH-19.1

Description

Social determinants of health are affecting on health outcomes, and they have been a focus in recent health strategies. This umbrella review aimed to analyse the current integration of SDOH into clinical practice, revealing increasing recognition of its importance across various levels — from gathering information on patients' SDOH to implementing diverse methods for addressing these factors.

Author Details

Jenna Poraharju, MHSc, BHSc, RN; Saija Inkeroinen, MHSc, BHSc, PH, RN; Heli Virtanen, PhD, RN; Helena Leino-Kilpi, PhD, MEd, RN, FAAN, FEANS, MAE, FRCN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Health Equity or Social Determinants of Health, Sustainable Development Goals, Clinical Practice

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Integrating Social Determinants of Health Into Clinical Practice

Seattle, Washington, USA

Background: Health is a concept with multiple definitions, and it is influenced by a range of determinants. Social determinants of health (SDOH) are societal systems and resources that cause health consequences, by influencing the distribution of health-supporting factors and risks across populations (Hahn, 2021). SDOH are widely associated with health outcomes (Enard et al., 2023; Glauser et al., 2022; Vince et al., 2023), and they are recognised in various national (Flaubert et al., 2021; Kuehnert et al., 2022) and international health strategies (United Nations, 2015; World Health Organization, 2019). SDOH affect on individual’s health regardless the effectiveness of the care, making them essential to be integrated into clinical practice. This umbrella review aims to analyze current integration of SDOH into clinical practice.

Method: Systematic literature search was conducted on January 2024 in Pubmed, Cinahl and Cochrane -databases. Inclusion criteria were as follow: SDOH mentioned in title or abstract, investigation of SDOH intervention or screening, clinical healthcare context, adult patients and literature review as a study type. Data were analysed with inductive content analysis.

Results: Out of 560 identified studies, 31 reviews (which included a total of 1166 papers, ranging from 5 to 214 papers) published between 2016-2023 met the inclusion criteria. SDOH are integrated into the clinical practice through 1) screening: SDOH are usually screened in clinical practice with standard screening tools or other assessment methods, 2) multisectoral efforts: collaborations are established between hospitals and communities to improve care, as well as medical-legal partnerships to help patients resolve legal issues affecting their health, 3) social prescribing and community linkages: patients are directed to resources for needs identified in clinical practice, but which cannot be addressed within it, and 4) interventions targeting specific SDOH in clinical practice: typically through patient education or material support.

Conclusion: Integrating SDOH into clinical practise is increasingly recognized as essential for providing comprehensive, patient-centred healthcare. Screening tools and assessments serve as foundational steps for identifying and addressing SDOH. With multisectoral efforts, interventions and connecting patients to community resources, healthcare systems can better address the broader SDOH affecting on health outcomes.