Changing Nursing Graduate Students’ Understanding of

Social Determinants of Health

Costa Rica

Nicaragua

Panama

Honduras

El Salvador

Dr. April FolgertConcordia University Wisconsin

Colombia

ObjectivesIdentify trends and approaches to reduce health disparities across populations.

• Identify two curricular strategies to enhance students’ knowledge of social injustice.

• Explain two lessons students learned about the social determinants of health.

• Explain one or more challenges and strategies for organizing a short-term study abroad course designed to teach students about the social determinants of health.

Nurse Practitioners

Images source: https://commons.Wikimedia.org

Within the Context of Culture

Image adapted from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

Neighborhoodand Built

Environment

Health and Health Care

Social and Community

ContextEducation

EconomicStability

SDOH

• Experiences Learning

• Resources

• Norms

• Language

Challenges

Strategies• Google

• Scouting Trip

• Tour Guide

• Learn Basics & Google Translate

Pre-Travel Assignments

• Readings Textbook Literature

• Online discussions

• Cultural Self-Assessment

CIMA Hospital

Hospital Nacional de Niños

La Guaria de Sarapiqui

Equipos Basicos de Atencion Ingegral en Salud

Journaling in Vade Mecum

Observations

Reactions

Feelings

Insight Gained

• Analyze the health care system

• Analyze levels of health care access implications for health

• Develop plan to promote health

Written Assignment

• Health Care

• Culture

• Social Inequality

• Role for Nurse Practitioners

Image adapted from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

% rated perceptions mostly or significantly increased

50556065707580859095

100

Arrival Hospital andCaja

EBAIS andIndg Cult

EBAIS &Indig Culture

Free Time

Cult Comp

Soc Injustice

Healthcare

“I found it surprising to take 8 hours to

receive care…”

“Immersing ourselves in another culture is an important aspect of

learning to deliver culturally congruent care to the patients

we serve.”

“As an NP, I need to advocate for a better system.”

“It was nice to hear the perspectives of those who use the system.”

Nicaragua

Honduras

El Salvador

Studying Abroad Enhances

Understanding of SDH

ReferencesDavis, S. L., & Chapa, D. W. (2015). Social determinants of health: Knowledge to effective action for

change. Journal for Nurse Practitioners, 11(4), 424-429. Retrieved from www.npjournal.org

Carryer, J., Halcomb, E., & Davidson, P. M. (2015). Nursing: The answer to the primary health care

dilemma. Collegian, 22(2), 151-152. doi: 10.1016/j.colegn.2015.05.001

Carryer, J., & Yarwood, J. (2015). The nurse practitioner role: Solution or servant in improving primary

health care service delivery. Collegian, 22(2), 169-174. doi: 10.1016/j.colegn.2015.02.004

Kidder, R. M. (2009). Overview: The ethics of right versus might. In R. M. Kidder (Ed.), How good people

make touch choices: Resolving the dilemmas of ethical living (pp. 12-29). Camden, MA: Institute for

Global Ethics.

Lanthrop, B. (2013). Nursing leadership in addressing the social determinants of health. Policy, Politics,

and Nursing Practice, 14(1), 41-47. doi: 10.1177/1527154413489887

Riner, M. E., Bai, J., & Larimer, S. (2015). Intercultural global health assessment and reflection framework

for teaching study abroad courses. Journal of Nursing Education and Practice, 5(5), 65-72.

doi:10.5430/jnep.v5n5p65

U. S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion.

(2011). Social determinants of health. Healthy People 2020. Washington, DC. Retrieved from World

Health Organization. (2012a). Social determinants of health. Retrieved from http://www.who.int/

social_determinants/thecommission/finalreport/key_concepts/ en/index.html