Why Do Social Factors Impact Health Outcomes?

"Based on a meta-analysis of nearly 50 studies, researchers found that social factors, including education, racial segregation, social supports, and poverty accounted for over a third of total deaths in the United States in a year."

The Kaiser Family Foundation

Social factors play a major role in affecting health outcomes, such as illness, difficulties with activities of daily living, and premature death. This is why optimal health care must address the social and environmental factors that contribute to inequality and impact the health of under resourced populations. Nursing@USC, the online Master of Science in Nursing from the USC Suzanne Dworak-Peck School of Social Work Department of Nursing, is at the forefront of this evolving conversation. The first program in the nation to have such a close collaboration between nursing and social work, Nursing@USC will prepare aspiring family nurse practitioners (FNPs) to provide effective prevention and treatment strategies to patients and communities through an advanced understanding of the biological, behavioral, and social factors that influence health and well-being.

According to Ellen Olshansky, Chair of the Department of Nursing, the program will have a particular focus on social determinants of health, which will help students understand the root causes of patient health. “I am excited about our new program and I believe it will contribute to an improved health care system, where health and illness are understood from a more holistic lens,” she said.

We feel that, in addition to improving clinical care, an important step toward actualizing this more well-rounded approach to health is to build a community and a discourse with you around these topics. Whether you're a seasoned clinical practitioner, a student, a patient, a social worker or an advocate from another field, your voice matters here. In this first post, we'll define what we mean by social determinants of health and lay the groundwork for working together to build a better health care system.

The Role of Social Determinants in Health Disparities

What are social determinants? According to Healthy People 2020, social determinants are conditions in one's environment—where people are born, live, work, learn, play and worship—that have a huge impact on how healthy certain individuals and communities are or are not. Socioeconomic status, quality of education, access to health care resources, and transportation options are just a few examples of factors that can make some people more susceptible to illness, injury or long-term health problems. “It is important to realize that one’s zip code has a tremendous influence on one’s health,” Dr. Olshansky emphasized.

Various social, economic and physical factors impact how individuals interact with their communities and influence overall security, health and well-being. For instance, children born to parents who haven't had the opportunity to complete high school are more likely to live in unsafe, unsanitary or deteriorating neighborhoods that do not accommodate healthy play and community learning opportunities. Resources that improve quality of life can have a major impact on health outcomes for entire populations, including:

  • Housing that is safe and affordable.
  • Access to education, healthy foods and local health services.
  • Environments free of toxins that could be life threatening.

In addition to the impact on health, these social conditions are expensive and counterproductive for the U.S. health care system as a whole. When a health care system tolerates disparities, it's not just patients who suffer. Trying to improve quality of care in these flawed systems results in unnecessary costs, loss of productivity and even premature death.

"It is important to realize that one's zip code has a tremendous influence on one's health." - Dr. Ellen Olshansky, Nursing@USC Chair

According to the Kaiser Family Foundation, recent estimates note that 30 percent of direct medical costs for African-Americans, Hispanics and Asian-Americans are excessive and related to health inequities. Furthermore, the KFF notes that the U.S. economy is estimated to lose approximately $309 billion annually due to the direct and indirect costs of disparities. If not addressed, the costs related to health disparities among minority populations will continue to rise as the population becomes more diverse.

Taking a New Approach to Health Care

America's nurse practitioners are on the front lines, and in a unique position to effect long-term, widespread change. These professionals and their colleagues across the health care spectrum already bear witness to the immense impact of social factors, disparities and inequity on a daily basis. The community we cultivate here at Nursing@USC can make a difference by educating future generations of nurses and by helping us all determine the best way to collaborate across sectors. There is a growing recognition of the importance of coordinating services across the care continuum. Social supports and services can be integrated into health care to address the broad range of social determinants that play such a key role in health and well-being.

Here on the Nursing@USC blog, we plan to cover themes related to the underlying social causes for poor health outcomes and better understand how currently siloed systems, sectors and teams across the health care spectrum can work together to combat disparities. In addition to these larger themes, the blog will feature spotlights on the Nursing@USC curriculum, faculty and students to provide insight on the program and our innovative approach to health care. We aim to build a community through content that accounts for the full weight of social factors in facilitating better health, for an individual person or for an entire population. "I look forward to interesting and meaningful discourse," said Dr. Olshansky.

We're building the Nursing@USC community to hear from you. Follow us on Facebook, Twitter, Instagram and LinkedIn and tell us what is most important to you when it comes to improving health care. With collaboration, we can create an awareness of the biological, behavioral and social factors that impact health outcomes and advocate for an equitable health care system.