Integrating Social Determinants of Health into Nursing Practice: A Framework-Based Review
Christiana Adeyemi, Opeoluwa Oluwanifemi Ajayi, Irene Sagay, Sandra Oparah
Abstract
This presents a framework-based review of strategies for integrating social determinants of health (SDOH) into nursing practice to advance health equity and improve population health outcomes. Recognizing that factors such as economic stability, education, healthcare access, neighborhood environment, and social context profoundly influence individual and community health, this review examines evidence-based approaches guided by established nursing and public health frameworks. The review explores how nursing practice can operationalize SDOH interventions within clinical and community settings through targeted assessment, care planning, and resource linkage. Drawing upon frameworks such as the WHO Health Equity Framework and the National Academies’ “Culture of Health” model, the review identifies key nursing interventions across five core SDOH domains. In the domain of economic stability, strategies include screening for financial strain, food insecurity, and housing instability, alongside nurse-led resource navigation and referral programs. In education access and quality, nurses assess health literacy, provide tailored education, and collaborate with community literacy initiatives. For healthcare access and quality, interventions involve addressing insurance barriers, enhancing care coordination, and promoting culturally competent communication. Environmental health efforts include assessing neighborhood safety and advocating for policy changes to improve living conditions, while strategies addressing social and community context focus on screening for social isolation and promoting trauma-informed, community-centered care. The review also highlights organizational and policy-level approaches for embedding SDOH into nursing workflows, including the use of electronic health record (EHR) tools for SDOH documentation, interdisciplinary collaboration, and community partnerships. Additionally, it underscores the need for education and workforce development to enhance nurses’ competencies in SDOH screening, advocacy, and care integration. The findings reaffirm the critical role of nurses in addressing upstream determinants of health and provide a structured foundation for expanding SDOH-focused nursing practice to reduce health disparities and promote holistic, equitable care.