Many health systems, community organizations, public health officials, and policymakers increasingly believe we can only achieve greater health and well-being by addressing the social determinants of health. These complex social and environmental factors—such as where we are born and live, the strength of our families and communities, the economic opportunities available to us, and our educational backgrounds—shape our health over our lifetimes.
Professional nursing is rooted in a fundamental concern for the social, emotional, and physical needs of the disadvantaged. But many nurse-led innovations have not been disseminated widely, owing to inadequate resources, misaligned incentives, and insufficient attention to racial and class inequities. Furthermore, few nurses sit at policymaking tables. Given nursing's history and its ranking as the most trusted profession, nurses have a historic opportunity to address social determinants of health in America.
That is why the Robert Wood Johnson Foundation (RWJF) is partnering with the National Academy of Medicine (NAM) on a new report assessing the nursing profession. The Future of Nursing 2020-2030, to be released at the end of 2020, will chart a course for nurses to improve the health and well-being of the U.S. population in the 21st century. This report follows the Institute of Medicine's 2010 report, The Future of Nursing: Leading Change, Advancing Health, which served as a blueprint for the profession to build capacity by strengthening education, expanding scope of practice, promoting leadership, and improving workforce diversity.
To inform the new report, the RWJF asked Patricia Pittman, PhD, a professor at George Washington University, to write a background paper, setting the context for what nurses are already doing to address the social determinants of health and, importantly, to point out what more nurses can and should be doing. (To read Pittman's summary of her paper for the RWJF, see this month's Special Feature.)
In her background paper, Pittman identifies several innovative, evidence-based, and nurse-led models showing evidence of impact. One example is a project where nurses at Chicago's Rush University Medical Center developed and implemented a social determinants screening tool to use in their daily nursing assessments. The assessments revealed food insecurities, transportation, and housing as patient priorities. In response, nurses worked with community partners to find solutions—for example, they designed an initiative that repackages unused food from hospitals and restaurants and delivers it to families in need. To date, nine hospitals and organizations across the country have adopted the model.
The RWJF also solicited more than 500 nurses’ views on how nurses might better address health inequities. Their perspectives reveal that nurses want to address the social determinants of health but need support and additional resources. Indeed, nurses alone cannot eradicate poverty, poor health, or health inequities, but they can—and should—work with social workers, community health workers, and physicians within their health institutions to do so.
This summer, nurses are invited to weigh in on the new NAM report. All nurses—whether they work in acute care settings, long-term care, or the community—must get involved. The NAM committee is hosting town hall meetings to gather nurses’ input. Nurses can attend in person or via webinar. The next meetings will be held on July 24 in Philadelphia and August 7 in Seattle. More information can be found at https://nam.edu/publications/the-future-of-nursing-2020-2030.
The nursing profession demands we respond to the root causes of health inequities. It is far more effective to improve community health now than to treat chronic disease later. The great public health nurse Lillian Wald wrote, “The call to the nurse is not only for the bedside care of the sick, but to help in seeking out the deep-lying basic causes of illness and misery.” Now is nursing's time to make it happen!