In nursing school, we spend countless hours learning how to care for patients, how to assess, plan, and intervene. But one of the most eye-opening lessons we learn is that health starts long before someone arrives at a clinic or hospital. It begins in everyday life, in the food people eat, the neighborhoods they live in, the schools they attend, and whether they feel safe and supported.
These are known as the Social Determinants of Health (SDOH), the conditions that shape a person’s life and directly influence their physical and mental health (Office of Disease Prevention and Health Promotion [ODPHP], 2020). SDOH are central to Healthy People 2030, a national initiative that sets science-based goals to improve health and reduce disparities over the next decade.
As nursing students, it’s easy to feel like the challenges around SDOH, like poverty, food insecurity, and lack of access to care, are too large for us to impact. But small actions make a difference. In clinical rotations, we can start by asking patients whether they face barriers like transportation or housing. Taking time to understand the barriers they face helps us care for the whole person, not just their diagnosis. We can even take our impact beyond the bedside by creating tangible tools that support patients and staff. For example, developing resource guides for our clinical sites that list nearby food pantries, shelters, low-cost clinics, or mental health services can be incredibly helpful for patients who might not know where to turn. These guides can also empower preceptors and fellow students to have more informed, compassionate conversations about social needs. Also, volunteering with local health departments or nonprofit clinics gives us a closer look at how public health efforts are carried out in real time, from vaccine drives to mobile screenings. Helping organize community wellness events such as health fairs, blood pressure clinics, or nutrition workshops also allows us to practice education and outreach while building trust within underserved populations.
Practicing nurses play a critical role in addressing social determinants of health, not just in theory, but in everyday care. Simple steps like asking patients if they have enough food at home or safe transportation to their appointments can open the door to meaningful conversations. Tools like the AHC-HRSN screening questionnaire make it easier to identify unmet social needs during routine assessments. From there, nurses can collaborate with case managers and social workers to connect patients with local food banks, housing programs, or transportation services. Even suggesting that SDOH questions be included in electronic health records is a step toward making these concerns part of standard care.
Outside the clinical setting, we can drive change on a broader level. Joining a hospital’s community health committee, helping lead quality improvement projects that focus on equity, or volunteering with local outreach programs are all ways to influence the systems we work in. Advocacy is another powerful tool, anyone can write to legislators about expanding Medicaid access, speak up at town halls, or get involved with the American Nurses Association (ANA), the National Student Nurses Association (NSNA), and other professional organizations to amplify their voice. Whether it’s inside a hospital or out in the community, nurses have the credibility, experience, and compassion to lead real change.
Whether you’re a student or a seasoned nurse, promoting health equity starts with awareness and action. SDOH aren’t just checkboxes, they’re the reality many of our patients live with every day. When we address those realities, we do more than provide care, we create change.
References
American Nurses Association. (n.d.). Home. https://www.nursingworld.org
American Nurses Association. (n.d.). Advocacy. https://www.nursingworld.org/practice-policy/advocacy/
Office of Disease Prevention and Health Promotion. (2020). Social determinants of health. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/social-determinants-health
Wisconsin Technical College System. (n.d.). Community health concepts [Image]. In Nursing: Mental health concepts. https://wtcs.pressbooks.pub/nursingmhcc/chapter/16-2-community-health-concepts/
