Jan 23, 2024

The critical role of nurses in addressing upstream social determinants of health


The Research problem

Our project will investigate how nurses, who make up 59% of the global health workforce can be empowered to effectively engage with, and take leadership regarding, the upstream social determinants of health (SDoH). The SDoH are non-medical factors, such as living and working conditions, that impact health outcomes. Upstream SDoH are those higher level socio-structural, -cultural, -economical and -political factors that influence health and health systems, and thereby exert positive or negative effects on health outcomes for populations ‘downstream’. The potential for nurses to have a positive impact on population health by influencing the upstream SDoH has been reported, however, the factors that support or limit nurses’ engagement in this arena are poorly understood. Nurses are the largest healthcare profession, with more than 27 million nurses employed worldwide. The majority of nurses deliver secondary and tertiary health services, with limited engagement with the upstream SDoH. Our project recognises the opportunity that nurses have to improve health outcomes at a population level, but there is a need to strengthen this capacity by harnessing international expertise to focus on the role of nurses in addressing the upstream social determinants of health.

Research Design
The key questions that our project seeks to answer include:

  1. In what ways can nurses engage upstream with the social determinants of health?
  2. What models or frameworks are available for such work?
  3. What is the existing evidence base on nurses’ engagement with the social determinants of health, including professional responsibilities and scope of practice?
  4. How would such an approach be authentically and effectively evaluated?
  5. What steps would be necessary to prepare the nursing profession for such work?

We will explore these questions by bringing together a diverse group of experts, including nursing and public health specialists, academics from WUN and non-WUN universities, and other health stakeholders, for a 3-day international symposium. The symposium will serve as a platform for in-depth discussions, collaboration, and the development of action plans, focused on the critical role of nurses in addressing the upstream social determinants of health and advancing equitable healthcare practices globally.

Project Objectives

The goal of this project is to equip nurses to address the root causes of poor health and prevent illness, where possible. This goal aligns with WUN Global Challenges by enabling nurses to realise their obligation to promote human rights and social justice, and address inequalities by elevating their scope of practice to incorporate action on the upstream SDoH. This project will build nurses’ capacity to work with community-identified priorities and codesign strategies to improve health. The WUN is supporting this project by providing a platform for sharing knowledge and resources, and creating international partnerships and networks, to improve health.