2.3 Social and economic factors contributing to health disparities
9 min read•august 20, 2024
Social and economic factors significantly impact health outcomes, driving disparities between population groups. These non-medical determinants, including income, education, and social context, shape access to resources and opportunities that promote well-being.
Understanding these factors is crucial for nurses to provide equitable care. By recognizing how social and economic conditions influence health, nurses can better address patients' needs, advocate for vulnerable populations, and work towards reducing health disparities in their communities.
Social determinants of health
Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health
These non-medical factors influence health outcomes and are major drivers of health inequities
Understanding social determinants is crucial for nurses to provide equitable care and advocate for vulnerable populations
Economic stability factors
Top images from around the web for Economic stability factors
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
United Nations Development Programme: Key trends in global poverty and health - Journalist's ... View original
Is this image relevant?
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
United Nations Development Programme: Key trends in global poverty and health - Journalist's ... View original
Is this image relevant?
1 of 3
Top images from around the web for Economic stability factors
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
United Nations Development Programme: Key trends in global poverty and health - Journalist's ... View original
Is this image relevant?
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
Poverty in the United States, 2014: Key charts from the U.S. Census Bureau - Journalist's Resource View original
Is this image relevant?
United Nations Development Programme: Key trends in global poverty and health - Journalist's ... View original
Is this image relevant?
1 of 3
Income and wealth distribution impact access to resources that promote health (nutritious food, safe housing, healthcare)
Poverty and financial instability contribute to chronic stress and poorer health outcomes
Employment provides income, benefits, and a sense of purpose, while unemployment is linked to adverse health effects
Lack of affordable housing and homelessness exacerbate health problems and limit access to care
Education access and quality
Higher levels of education are associated with better health outcomes and health literacy
Early childhood education and development lay the foundation for future academic success and health
Disparities in school funding, resources, and quality perpetuate health inequities
Nurses can promote health education and partner with schools to support student well-being
Health care access and quality
Availability, affordability, and accessibility of health services impact health outcomes
Lack of insurance coverage, high out-of-pocket costs, and limited provider networks create barriers to care
Cultural and linguistic barriers, discrimination, and mistrust of the healthcare system deter some populations from seeking care
Nurses play a crucial role in advocating for equitable access and providing culturally competent care
Neighborhood and built environment
Physical environment, including air and water quality, green spaces, and walkability, influences health
Exposure to environmental toxins, pollution, and lead contributes to health problems (asthma, developmental delays)
Food deserts and lack of access to healthy food options impact nutrition and chronic disease risk
Neighborhood safety, crime, and violence affect mental health and physical activity levels
Social and community context
Social networks, support systems, and community engagement impact health behaviors and outcomes
Discrimination, racism, and social exclusion contribute to chronic stress and health disparities
Cultural norms, values, and practices influence health beliefs, behaviors, and healthcare utilization
Nurses can foster trust, build relationships, and engage with communities to promote
Health disparities
Health disparities are preventable differences in health outcomes and determinants between population groups
Disparities are rooted in social, economic, and environmental disadvantages and inequities
Recognizing and addressing health disparities is essential for nurses to provide equitable care and advocate for
Definition of health disparities
Health disparities are differences in health status, outcomes, and determinants that are closely linked with social, economic, and/or environmental disadvantage
Disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on characteristics (race, ethnicity, socioeconomic status, gender, disability, geographic location)
Health disparities are avoidable, unfair, and unjust differences in health that result from social inequities
Measuring health disparities
Disparities can be measured by comparing health outcomes (life expectancy, disease prevalence) between population groups
Examining differences in access to care, quality of care, and social determinants of health helps identify root causes of disparities
Data collection and analysis by demographic factors (race, ethnicity, income) is essential for tracking and addressing disparities
Nurses can contribute to data collection, advocate for inclusive data practices, and use data to inform equitable care strategies
Racial and ethnic disparities
Racial and ethnic minorities experience disproportionately poorer health outcomes compared to non-Hispanic whites
Disparities persist across various health indicators (infant mortality, chronic diseases, life expectancy)
Structural racism, discrimination, and cultural barriers contribute to racial and ethnic health disparities
Nurses must provide culturally competent care, address implicit biases, and advocate for policies that promote racial health equity
Socioeconomic disparities
Socioeconomic status, including income, education, and occupation, is a strong predictor of health outcomes
People with lower socioeconomic status experience higher rates of chronic diseases, mental health problems, and premature mortality
Limited access to resources (healthy food, safe housing, healthcare) and chronic stress contribute to socioeconomic health disparities
Nurses can connect patients with social services, advocate for policies that address poverty, and promote health literacy
Geographic disparities
Health outcomes and access to care vary significantly by geographic location (urban vs. rural, zip code)
Rural populations face unique challenges (provider shortages, long distances to care, limited resources) that impact health
Neighborhood characteristics (walkability, safety, green spaces) influence health behaviors and outcomes
Nurses can partner with communities to address local health needs, promote telemedicine, and advocate for equitable resource allocation
Economic factors
Economic factors, such as income, wealth, poverty, employment, and housing, are key determinants of health
Understanding the impact of economic factors on health is crucial for nurses to provide holistic care and advocate for policies that promote economic stability and health equity
Income and wealth inequality
Income and wealth inequality have widened in recent decades, with significant health implications
Higher income and wealth are associated with better health outcomes, while poverty is linked to poorer health
Unequal distribution of resources contributes to health disparities and limits access to health-promoting goods and services
Nurses can advocate for policies that reduce inequality (progressive taxation, living wage) and connect patients with financial resources
Poverty and low-income status
Poverty is a major risk factor for poor health outcomes and health disparities
People living in poverty face multiple barriers to health (lack of insurance, limited access to care, food insecurity, unsafe housing)
Chronic stress associated with poverty contributes to mental health problems and chronic diseases
Nurses can screen for social needs, connect patients with resources (food banks, housing assistance), and advocate for anti-poverty policies
Employment and job security
Employment provides income, benefits, and a sense of purpose, all of which are important for health
Job insecurity and unemployment are associated with poorer physical and mental health outcomes
Lack of paid sick leave and other benefits can deter workers from seeking preventive care and managing chronic conditions
Nurses can support patients in navigating job-related health challenges and advocate for policies that promote fair labor practices and worker protections
Housing instability and homelessness
Housing instability and homelessness are significant barriers to health and healthcare access
People experiencing homelessness have higher rates of chronic diseases, mental health problems, and substance use disorders
Lack of stable housing makes it difficult to manage medications, maintain hygiene, and follow treatment plans
Nurses can connect patients with housing resources, provide trauma-informed care, and advocate for affordable housing policies
Social factors
Social factors, such as discrimination, social isolation, adverse childhood experiences, and stress, have a profound impact on health
Understanding the role of social factors in shaping health outcomes is essential for nurses to provide patient-centered care and promote health equity
Discrimination and racism
Discrimination and racism, at both individual and structural levels, contribute to health disparities
Experiences of discrimination and racism are associated with chronic stress, mental health problems, and poorer physical health outcomes
Racial and ethnic minorities face barriers to accessing quality healthcare due to discrimination, bias, and cultural insensitivity
Nurses must recognize and address their own biases, provide culturally competent care, and advocate for policies that promote racial equity
Social isolation and loneliness
Social isolation and loneliness are risk factors for poor mental and physical health outcomes
Lack of social support and connectedness is associated with higher rates of depression, anxiety, and cognitive decline
Social isolation can impact health behaviors (decreased physical activity, poor nutrition) and limit access to resources
Nurses can assess for social isolation, promote social engagement, and connect patients with community resources (senior centers, support groups)
Adverse childhood experiences
Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, have lifelong impacts on health
ACEs are associated with increased risk of chronic diseases, mental health problems, and substance use disorders in adulthood
Toxic stress from ACEs can alter brain development and immune function, leading to long-term health consequences
Nurses can provide trauma-informed care, screen for ACEs, and connect patients with mental health resources and support services
Stress and allostatic load
Chronic stress, particularly from social and economic disadvantage, contributes to health disparities
Allostatic load, the cumulative burden of chronic stress on the body, leads to physiological dysregulation and increased disease risk
Stress and allostatic load are linked to cardiovascular disease, diabetes, mental health problems, and premature aging
Nurses can teach stress management techniques, promote resilience, and advocate for policies that address social and economic stressors
Intersection of social and economic factors
Social and economic factors do not operate in isolation but intersect and interact to shape health outcomes
Understanding the cumulative impact and cyclical nature of social and economic disadvantage is crucial for nurses to provide holistic care and advocate for systemic change
Cumulative impact on health
The combination of multiple social and economic disadvantages has a cumulative impact on health
Individuals experiencing multiple forms of marginalization (low-income, racial/ethnic minority, limited education) face compounded health risks
Cumulative disadvantage across the life course contributes to widening health disparities over time
Nurses must consider the intersectionality of patients' identities and experiences when assessing health needs and developing care plans
Cycle of poverty and poor health
Poverty and poor health are interconnected and can create a self-perpetuating cycle
Poverty limits access to health-promoting resources and increases exposure to health risks, leading to poorer health outcomes
Poor health, in turn, can limit educational and employment opportunities, further entrenching poverty
Nurses can work to break this cycle by connecting patients with resources, advocating for policies that address poverty, and promoting health education
Intergenerational transmission of disparities
Health disparities can be transmitted across generations through social, economic, and biological pathways
Children born into disadvantaged families are more likely to experience poverty, limited educational opportunities, and adverse health outcomes
Maternal health and prenatal exposures can have long-term impacts on child health and development
Nurses can provide prenatal and early childhood interventions, support parenting skills, and advocate for policies that promote equal opportunities for all children
Addressing health disparities
Addressing health disparities requires a multi-faceted approach that includes improving access to care, enhancing social and economic policies, and promoting health equity
Nurses play a crucial role in reducing disparities through patient care, advocacy, and community engagement
Improving access to healthcare
Expanding insurance coverage and reducing financial barriers to care can help improve access and reduce disparities
Increasing the diversity and cultural competence of the healthcare workforce can enhance trust and engagement with underserved populations
Implementing community health worker programs and mobile health services can bring care to hard-to-reach populations
Nurses can advocate for policies that expand access, provide culturally competent care, and partner with community organizations to reach underserved groups
Enhancing social and economic policies
Addressing social and economic determinants of health through policy change is essential for reducing disparities
Policies that promote income stability (minimum wage, earned income tax credit), affordable housing, and access to education can improve health outcomes
Investing in early childhood programs and parental support can help break the cycle of poverty and promote health equity
Nurses can advocate for policies that address social and economic inequities, educate policymakers on the health impacts of these issues, and mobilize communities for change
Promoting health equity
Health equity means that everyone has a fair and just opportunity to be as healthy as possible
Promoting health equity requires removing obstacles to health, such as poverty, discrimination, and lack of access to good jobs, education, and housing
Addressing implicit bias, cultural insensitivity, and structural racism within the healthcare system is crucial for promoting equity
Nurses can champion health equity by providing equitable care, advocating for inclusive policies, and partnering with diverse communities
Role of nurses in reducing disparities
Nurses are well-positioned to address health disparities through their roles as caregivers, educators, advocates, and leaders
Providing patient-centered, culturally competent care that addresses social and economic barriers to health is essential
Educating patients, families, and communities about health promotion, disease prevention, and navigating the healthcare system can empower them to take control of their health
Advocating for policies that address social determinants of health and partnering with community organizations can help drive systemic change
Nurses must continue to develop their cultural competence, engage in lifelong learning about health equity, and use their voices to champion social justice in healthcare