Integrating a Social Determinants of Health Framework into Nursing Education

The purpose of this ground-breaking Textbook is to describe and illustrate, with pedagogical features, the process by which social determinants of health (SDOH) has been integrated throughout all courses in the Nell Hodgson Woodruff School of Nursing. Specifically, the authors describe initial steps to develop a comprehensive SDOH model for nursing education, followed by rigorously designed faculty educational materials, exemplars of SDOH instructional materials, and evaluation of this process from faculty and students. It describes a comprehensive framework that guides the development, implementation, and evaluation of SDOH across the pre-licensure and post-licensure curriculum and illustrate the process integrating SDOH throughout all aspects of didactic, simulation, and clinical education. 

Among the subjects addressed, the history of nursing and SDOH and the value of SDOH content in nursing courses to alleviate health disparities are described and mandates to integrate SDOH content into nursing curriculum by the leading nursing organizations are summarized. The authors also include a review of existing SDOH frameworks used in public health and medicine and present a comprehensive SDOH model for nursing education. A SDOH educational course content for faculty is detailed (Social Determinants of Health 101) and exemplars from faculty and students are provided along with an evaluation after the first year. The authors conclude with a discussion from faculty leadership; what they learned and their suggestions to other nursing programs.

Although there are books published, no books exist on this topic for nursing education and practicing nurses, yet SDOH is foundational to nursing curriculum and practice. The leading nursing organizations are all mandating that SDOH be integrated into nursing courses. Hence this textbook will be a key resource for Schools of Nursing in the US and globally. The intended audience of this book are leaders and faculty of nursing education programs, national professional nursing organizations, practicing nurses at hospitals and health systems, community and public health agencies, and ambulatory care.

Jill Hamilton, PhD, MRPL, RN, FAAN is Professor, tenured, and Senior Faculty Fellow of SDOH & Health Disparities at the Nell Hodgson Woodruff School of Nursing and Affiliate Professor at Candler School of Theology at Emory University in Atlanta, Georgia.  Dr. Hamilton earned her BSN, MSN, and PhD in nursing from the University of North Carolina at Chapel Hill, a Masters in Religion and Public Life from the Candler School of Theology, a BS in Accounting from North Carolina Central University, and postdoctoral training in the nursing care of older adults at the Oregon Health & Science University. She previously held faculty positions at Johns Hopkins University and the University of North Carolina at Chapel Hill where she was tenured Associate Professor.  Dr. Hamilton’s research interests include social determinants of health, health disparities, and the mental health promoting strategies used among older African American their families in response to life-threatening illness.  She has developed culturally-relevant measures of social support and spirituality and has conducted research to examine ways in which these social determinants influence health outcomes.  Dr. Hamilton is published on topics related to culture, social support, religiosity, spirituality, and quality of life among African Americans with life-threatening illness. She has done original research on the effects of Storytelling that incorporates religious songs and scripture on psychological distress among older and younger African Americans. The findings from this research are published in Cancer Nursing, the Journal of Religion and Health, the Gerontologist, and Nursing Research. She was a Georgia Cancer Coalition Distinguished Cancer Scholar from 2003-2007 and a member of the 2014 Class of the UNC Thorp Faculty Engaged Scholars. Dr. Hamilton is currently a Fellow in the American Academy of Nursing and a Faculty Scholar of the Center for Spirituality, Theology & Health at Duke University. She was the recipient of the 2019 Distinguished Alumni Award from the School of Nursing at the University of North Carolina and the 2011 OncologyvNursing Society (ONS) Publishing’s Division Award for Excellence in Writing Qualitative Research.  

Dr. Beth Ann Swan is Professor, Clinical Track, Associate Dean and Vice President for Academic Practice Partnerships, Executive Director for the Emory Nursing Learning Center at the Nell Hodgson Woodruff School of Nursing, and Co-Director of the Woodruff Health Sciences Center Interprofessional Education and Clinical Practice Office at Emory University. She previously served as Dean of the Jefferson College of Nursing, Thomas Jefferson University. Dr. Swan is a fellow of the American Academy of Nursing, past president of the American Academy of Ambulatory Care Nursing (AAACN), and a Robert Wood Johnson Executive Nurse Fellow. She is nationally and internationally known for her research in health care and nursing. She was an early leader in exploring the impact of changing health care delivery models on outcomes of care.  Throughout her career, Dr. Swan has been an advocate for engaging consumers in their health care, promoting quality care coordination and safe care transitions, and creating innovative evidence-based practices to improve care.   

As the principal investigator on extramural funded grants, Dr. Swan has provided leadership and mentorship on ground-breaking projects impacting both nursing practice and interprofessional education. With her entrepreneurial mindset and belief in consumer-centered care and engagement, her latest research is focused on leveraging technology and big data to optimize cross setting communications to improve care coordination and transitions of care. She is also working in the simulation and virtual reality space building an interprofessional collaborative education model that leverages virtual reality in support of achieving interprofessional and social determinants of health competencies during transitions of care. 

 Dr. Swan was a member of the Veterans Health Administration Choice Act Blue Ribbon Panel and was a member of the Josiah Macy Jr. Foundation Planning Committee for Preparing Registered Nurses for New Roles in Primary Care. Her numerous publications cover a wide range of topics focused on primary and ambulatory care, innovations for education and practice, and health care policy. Dr. Swan developed the major contribution to care coordination and transition management, the national curriculum known as CCTM.