NRS 428 Topic 2 DQ 1 What are social determinants of health?

NRS 428 Topic 2 DQ 1 What are social determinants of health?


Social determinants of health are the circumstances or situation surrounding a person’s economic stability, education, environment, health, and social conditions (Healthy People 2030, n.d.). The social determinants of health affecting the public either improve their health or put them at risk for poor health outcomes. Individuals that are educated, have access to healthcare, have financial stability and have good family and community support are more likely to have better health than those that do not. A lack in any of these areas can affect an individual’s health. For example, a newly diagnosed individual with diabetes that has poor access to healthcare, lives in poverty, and limited resources, may have challenges managing their diabetes. It is likely that the diabetes will worsen and may cause other illnesses. Providing resources and e

NRS 428 Topic 2 DQ 1 What are social determinants of health
NRS 428 Topic 2 DQ 1 What are social determinants of health

ducation on treatment can improve the deterioration of disease for individuals.

The communicable disease chain represents the method of transmission of infectious disease that illustrate six links which represent the steps of disease in the transmission process (Van Seventer & Hochberg, 2016). The transmission of disease requires an infectious agent, a host (ex. human or animal), a portal of exit from the host such as through blood, respiratory droplets, or skin. The mode of transmission can be direct or indirect. The chain also requires a portal of re-entry of the host to a susceptible host.

Nurses can break any of the links in the transmission of disease by providing education to patients on how the infecting agent is transmitted, what measures to take to stop transmission, the importance of hand hygiene, wearing a mask, isolation, and on the treatment of disease. Educating the public on any of these measures can decrease the spread of infectious diseases.

Social Determinants of health can be political. Our political temperament and governmental structure play heavily into the healthcare resources that are available to the citizen. It was interesting to learn that healthcare for all, in the United States, was proposed as early as 1904, and was for a time pursued by Franklin D. Roosevelt’s administration. When the doctor’s association of the time protested he pulled back to pursue the Social Security Act. Post-WWII Europe embraced healthcare for all as a deterrent to communism, while the United States felt that “socialized” medicine promoted communism. The American Medical Association, comprised of MDs, has continued to lobby and exert political power against healthcare reform, including the ACA.

For years it was the pressure that they exerted on Medicare that prevented those in rural communities from being able to seek care from advanced practice nurses and NPs. While at the same time not being able to attract MDs to their rural communities to serve their people. To be more precise Advanced Practice RNs and NPs could provide care Medicare would just not pay them for it. The AMA’s pressure was to protect power and revenue for their constituency, disappointing. In most areas of inequity if you follow the money or the power the true nature of things will be revealed. Thankfully the Affordable Care Act addresses some of these past hurdles.


Green, Sue Z. (Ed). (2018). Community & Public Health: Epidemiology and Global Health. Retrieved from

Healthy People 2030 (n.d.) Social Determinants of Health. Retrieved from Social Determinants of Health – Healthy People 2030 |

Van Seventer, Jean M., & Hochberg, Natasha S., (2016). Principles of Infectious Diseases:  Transmission, Diagnosis, Prevention, and Control. International Encyclopedia of Public Health. Retrieved from Principles of Infectious Diseases: Transmission, Diagnosis, Prevention, and Control – PMC (

The social determinants of health include a person’s birth, childhood, adulthood, place of employment, and ageing. A person’s wealth, level of education, geographical surroundings and neighborhood, job, social support networks, and access to medical treatment all fall under this category. The many variables that form the concept of social determinants of health impact every aspect of society. They should not be confused with medical treatment or a person’s particular lifestyle choices. Social characteristics significantly affect health outcomes, especially for disadvantaged populations (Alcaraz et al., 2020).

While administering treatment and care, it is critical to consider the patient’s environment, level of education, and current financial status. When resources to counteract unfavorable social determinants of health are made accessible, population health outcomes may change intensely. If there are insufficient amounts of these resources accessible, social concerns such as inequality and prejudice might produce unfavorable circumstances. The social injustice dynamics that lead to poor health outcomes and may have a generational effect are discussed as part of the impact of discrimination, which is referred to as “embodied inequality.”

According to the communicable illness model, a communicable disease involves an infectious agent, a host, and an environment that exists and propagates within a population (Baharom et al., 2021). The infectious agent is critical to the disease’s onset and development. Bacteria, viruses, and parasites are examples of infectious agents. Any vulnerable organism serves as the host. The infectious agent may infect plants, animals, or people, causing them to become hosts. Any extra variables that encourage or impede the spread of sickness are included in the environment.

A communicable illness may spread when an infectious agent and a vulnerable host coexist in an environment favorable to transmission. Hand washing regularly is the quickest and most effective technique for nurses to care for a patient with an infectious disease to prevent the spread of the sickness. The nurse may assist break the chain by cleaning surfaces with the appropriate cleaning agents, keeping the essential personal protective equipment (PPE) outside the patient’s room, and clustering care to avoid spending too much time in the patient’s room.


Alcaraz, K. I., Wiedt, T. L., Daniels, E. C., Yabroff, K. R., Guerra, C. E., & Wender, R. C. (2020). Understanding and addressing social determinants to advance cancer health equity in the United States: a blueprint for practice, research, and policy. CA: a cancer journal for clinicians70(1), 31-46.

Baharom, M., Ahmad, N., Hod, R., Arsad, F. S., & Tangang, F. (2021). The impact of meteorological factors on communicable disease incidence and its projection: a systematic review. International journal of environmental research and public health18(21), 11117.

NRS 428 Topic 2 DQ 1 What are social determinants of health?Replies 

There are various factors that affect the health of individuals and populations, and it is crucial to understand the factors for health promotion. Social determinants of health (SDH) are the non- medical factors including and not limited to economic, social and environmental factors that impact the health of individuals (WHO, 2019). The working and housing conditions of an individual, their salary, education level, level of social inclusion, food security, and access to quality health services are some of the social determinants of health. SDH affects health equity and individuals faced by unfavorable determinants often have poorer health outcomes thus causing and widening disparities in healthcare. For instance, an individual in an environment that has no access to clean water due to low income is more susceptible to cholera and other water-borne diseases.

The communicable disease model shows the impact of the environment in prohibiting or promoting the spread of disease since for diseases to spread, there must be a host, the infectious agent, and the environment needs to promote spread (Palmer et al., 2019). Steps that a nurses should take to break the link in the communicable disease chain model include health education. Providing individuals with information on the disease, its agent and how it infects a host, and how to minimize its transmission can help reduce prevalence of communicable diseases.

Health promotion should include methods to destroy the agent such as boiling drinking water, how to reduce interaction between the host and agent e.g., by only drinking boiled or treated water. Moreover, immunization is essential for infections that have a vaccine since it reduces the susceptibility of individuals to the disease. The nurse should also promote modifying the environment so that it inhibits instead of promotes the transmission of disease.


Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: future directions for health disparities research. American Journal of Public Health109(S1), S70-S71.

World Health Organization [WHO]. (2019, May 30). Social determinants of health.

Social determinants of health are conditions contributing or hindering a person’s well-being. These conditions include where people are born, grow, live, play, learn, worship, work, and age (, 2018a). They impact a wide range of health, functioning, and quality-of-life outcome.

The social determinant of health like education, socio-economic status, and healthcare can contribute to disease development. Poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. Lack of access, or limited access to health services greatly impacts on individual’s health status. For instance, when individuals have low income or do not have health insurance, they are less likely to participate in preventive care and more likely to delay medical treatment (Rockville, 2016). Health care professionals should understand SDOH and their impact on an individual’s health so that they can improve their health equity.

The communicable disease chain model explains the spread of a communicable disease from one host (or person) to another. The basic idea represented in the chain of infection is that individuals can break the chain (reduce the risk) at any point, thus the spread of the disease can be stopped. The nurse can break the chain of infection through executing hand washing, wearing of personal protective equipment, proper patient placement, careful handling and cleaning of patient care equipment and environment.

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References (2018). Social determinants of health. Retrieved from

Rockville, M. D. (2016). Agency for Healthcare Research and Quality; 2001. AHRQ publication1, E058.

Social determinants of health refer to the conditions individuals are born in or reside in and this often has an impact on their health and how diseases can be managed when they are affected by it (Kelley, 2020). Social determinants affect individuals’ health behaviors and can impact how diseases develop, for instance, studies have shown that individuals with a low education level are prone to engage in risky behaviors affecting their health due to their ignorance. For instance, they might end up engaging in unsafe sexual practices which exposes them to the risk of contracting HIV.

Education level of a population is one of the crucial determinants of health because it affects health promotion behaviors. Education equips individuals with the requisite knowledge and supports safe practices, for instance, individuals are able to appreciate the importance of hygiene and consuming clean water which in turn ends up reducing chances of an outbreak of water borne diseases. Further, through education, individuals are taught different healthy habits they can take.

For instance, education has played a key role in the management of chronic diseases like diabetes and cancer where individuals at risk have been educated on the need to live healthy and take part in screening exercises. Another key social determinant is socioeconomic factors which refer to a person’s surroundings and their economic wellbeing. For example, individuals that live in poor neighborhoods have an increased chance of becoming sick due to the risks they are exposed to like increased pollution.

A chain of infection model outlines the spread of diseases across different hosts and it is studied with the view of identifying the weakest link in the chain which then helps stop the spread of disease (OER, 2020). For instance, when dealing with diseases like COVID-19, understating the infection model has helped break the transmission chain by requiring social distancing.


Kelley, A. (2020). Public Health Evaluation and the Social Determinants of Health. Taylor & Francis.

OER. (2020). The Chain of Infection Model. Retrieved from OER Services Contemporary Health Issues:

Social determinants of health are defined by the areas in which people reside, work, learn, grow, attend religious functions/organizations, and play (Green, 2018). Social determinants of health play a major role in one’s health or lack thereof. Factors such as environment, transportation, housing, access to businesses, and access to quality healthcare facilities are all variables that weigh heavily on the ability to attain or maintain good health. Lower socioeconomic status has been proven to contribute to poor health, increased levels of disease, and the higher incidence of illness.

Poor living conditions, lack of proper education, poor sanitation, and lack of clean water increase the risk of illness and increase the presence of disease. For instance, many people who lack access to quality healthcare are at an increased risk for developing preventable diseases such as obesity, diabetes, and cardiovascular disease. Lower socioeconomic status can lead to an increase in purchasing less expensive foods that are typically higher in nitrates, nitrites, sugars, and processed foods. Healthier foods tend to cost more and for some are unattainable.

The communicable disease chain model is designed to represent how microorganisms travel, infect, and cause harm to its hosts. It demonstrates how to break the chain or stop the spread of infection as well. The communicable disease chain model reveals each step in the process of transmission. There are six chains or links that when broken can stop the spread or break the cycle. The six chains in the communicable disease chain are as follows:

1-   the microorganism or infectious agent

2-   the reservoir

3-   the portal of exit

4-   the mode of transmission

5-   the portal of entry or re-entry

6-   infection of the susceptible host

The greater number of breaks in the chain, the greater the chance of decreasing or stopping the transmission of the infectious agent. The host’s response to the infectious agent is dependent upon several factors including but not limited to the amount and length of exposure, immunity, and defense mechanisms (van Seventer & Hochberg, 2017).

Nurses are able to break the chain by simply washing their hands appropriately with soap and water. The effective use of soap and water for hand hygiene is a proven method of evidence base practice (EBP). Nurses utilize EBP to teach individuals and communities how to incorporate disease prevention and health promotion practices into their everyday lives. Hand hygiene is the number one way to break the cycle of passing microorganisms from one person to another and/or from one area of contamination to another. Nurses provide invaluable education to the public on the necessity of proper hand hygiene to prevent the spread of infectious agents/microorganisms. Providing public education related to proper hand hygiene with the use of demonstrations benefits the entire community.


Green, S. (2018). Epidemiology and global health. In Grand Canyon University (Ed.). Community & public health: The future of health care. (1st ed.).

van Seventer, J. M., & Hochberg, N. S. (2017). Principles of infectious diseases: Transmission, diagnosis, prevention, and control. International Encyclopedia of Public Health, 22–39.

Social determinants of health (SDOH) significantly impact one’s livelihood. They affect one’s health, function capabilities, and quality of life. Other SDOH examples include safe housing, adequate transportation, decent neighborhoods, racism, discrimination, violence, education or occupation advancement, income, access to nutritious meals, physical activity resources, clean air, purified water, and literacy skills. (Healthy People 2030, 2022). When people do not obtain the appropriate resources to promote their health, other medical problems arise. Health inequities and SDOH can hinder development in children, increase or decrease education barriers, occupational opportunities, food security related to finances, impact living conditions, culture development, health services, and access to technology and resources to obtain information.

Nurses, health professionals, and organizations must address SDOH to achieve health equity in their communities. SDOH can result in disease development and increase infection rates. These changes are seen on a chain of infection model used by professionals to determine how an infection spreads from one living mammal to another. The most common infections are communicable diseases. The examples provided are some common illnesses seen in the United States. Anyone can interrupt the chain of infection model by implementing a prevention activity. Education on preventing illnesses is crucial for nurses and patients to understand to promote health effectively. Disease will never stop due to SDOH factors in society. Educating others on disease transmission and prevention will decrease infection rates, resulting in community health promotion.


Healthy People 2030. (2022). Social Determinants of Health. U.S. Department of Health and Human Services.

Social Determinants of Health

Social determinants of health are social and economic factors or conditions which influence group or individual disparities on health status. They are factors that determine how health professionals can promote health across specific groups or individuals (Taylor et al., 2016).

Social health determinants have a significant impact on the development of a disease. In most cases, these factors can influence access to healthcare services. When they hinder individuals from access to care, their health conditions worsen. For instance, failure to get education and literacy is a major problem for accessing healthcare. Most illiterate people do not understand concepts such as early treatment. Besides, employment and the working environment can affect how people experience disease development. When they work in environment exposed to dangerous materials such as lead, most workers gradually experience chronic problems such as cancer.

The fundamental idea of the communicable disease chain model is that diseases spread through a chain process with well-defined steps. In the chain model, the disease spreads through human reservoir, portal of exit, transmission, portal of entry, and disease in new host. For instance, the coronavirus spread through this means. The virus was probably in the environment before it got into a person (reservoir), and then the infected person sneezed and did not appropriately use a handkerchief. This portal of exit causes transmission to surfaces, where the virus reside and taken by another person (new host) through contact. These processes can be altered by handling the human reservoir (Van Seventer & Hochberg, 2017).

Nurses can take various steps to break the link within the communicable disease chain at the hospital. The first step involves treatment, where nurses treat the human reservoir and isolating them to prevent the spread at the portal of exit. The second step is observing basic hygiene when handling patients. Hygiene breaks the link between disease and human reservoir and between transmission and portal of entry.


Taylor, L. A., Tan, A. X., Coyle, C. E., Ndumele, C., Rogan, E., Canavan, M., … & Bradley, E. H. (2016). Leveraging the social determinants of health: what works?. PloS one11(8), e0160217.

Van Seventer, J. M., & Hochberg, N. S. (2017). Principles of infectious diseases: transmission, diagnosis, prevention, and control. International encyclopedia of public health, 22.