In all countries, it is well-established that poorer people have substantially shorter life expectancies and more illnesses than the rich — inequalities that cannot be explained by differences in health care or by personal health behaviours. Studies have shown that these disparities are associated with structural differences, such as income, employment and working conditions, housing, education, food security, social inclusion and the environment — what we now consider the social determinants of health.
The World Health Organization, in its final report by the Commission on Social Determinants of Health, points to the burdens of illness and premature loss of life that stem from “the conditions in which people are born, grow, live, work, and age.” Such social determinants of health have a significant impact on the predisposition of individuals and groups to illness, as well as on the way they experience and recover from illness. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which themselves are influenced by policy choices.
It is critical for nurses to understand the impact these factors have on the individuals and groups they work with and to include these factors in their assessments. This information may affect the choice of intervention and the need for other community resources. At a broader level, nurses need to know how the health of their patients can be improved by advancing progressive policies that address the social determinants of health.