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From 2019 to 2020, the average life expectancy of people in the U.S. dropped by 1.5 years. However, the reduction in life expectancy was not equally distributed across the entire population. While white people lost an average of 1.2 years of life expectancy, Black and Hispanic people lost — on average — three years, and Native American people lost 4.5. Many of the causes for this discrepancy can be attributed to social determinants of health (SDoH), ranging from access to health care, quality of education, economic stability and environment. As a nurse practitioner (NP), you play a vital role in increasing health equity and reducing the impact SDoH has on patients within your community.
Observed in April, National Minority Health Month highlights the importance of improving the health of racial and ethnic minority communities and reducing health disparities in the United States. The American Association of Nurse Practitioners® (AANP) is proud to stand by its partners in the health care field and would like to take this opportunity to share recommendations and resources for keeping health equity top of mind throughout the year.
What are SDoH, and how do they factor into the health equity conversation? According to the Centers for Disease Control and Prevention (CDC), SDoH are defined as the “conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.” These can fall into five key categories: quality and access to health care, access to quality education, social and community contexts, economic stability and one’s own neighborhood.
As noted by AANP Diversity, Equity and Inclusion (DEI) Committee member Dwayne Alleyne, DNP, APRN, ACNP-C, in a recent episode of AANP’s official podcast NP Pulse: The Voice of the Nurse Practitioner®, “If you live in a neighborhood where there’s a lack of stores — the nearest store with healthy food is 20 miles away and the closest store is a dollar store with nothing but junk food […] you’ll see a higher population with diabetes, kidney disease, heart disease. So [as an NP], you have to look at that and see how you can get this population specifically some better nutritional choices and ways to live a healthy lifestyle.”
While you may not be able to affect what kinds of foods are available in your patients’ communities, you can still empower your patients through improved education and health literacy. In a recent article from the Journal of Environmental Health Sciences, the authors conclude, “Interventions that improve health literacy may empower individuals and communities to take action on social and economic determinants of health at both the individual and community level. Improvements in health literacy are likely to result in improved utilization of preventive services, medical adherence and involvement in health decision-making.”
According to the U.S. Department of Health and Human Services Office of Minority Health (OMH), “When patients are provided with culturally and linguistically appropriate information, they are empowered to create healthier outcomes for themselves and their communities.” That’s why OMH has declared the theme of this year’s Minority Health Month “Better Health Through Better Understanding.”
As per a report on health literacy in the U.S., “At least 88 percent of adults living in the U.S. have health literacy inadequate to navigate the health care system and promote their well-being.” Health literacy is defined as the degree to which individuals can find, understand and use information and services to inform health-related decisions and actions for themselves and others. Take the time to explore the following resources on how you can improve health literacy for patients in your community and empower them to make better healthy choices.
When a patient interacts with a health care provider who they are comfortable talking to or can easily identify with, they are more likely to have a positive outcome. That’s why Dr. Alleyne pushes for diversity in nursing throughout his profession, his advocacy work and his discussions with the AANP DEI Committee. “The biggest thing about diversity in the workforce is communicating — understanding certain cultural traditions that you cannot necessarily read from a book.” Alleyne added, “I did not open up a book and look up how to talk to African American patients, I just knew certain trends and certain rhymes from being within that community.” Having a diverse workforce widens the net for patients to feel truly seen and proficiently treated with the person-centered care NPs provide.
Recruiting and retaining students from racial and ethnic minority populations to work in health care settings is critically important. In order to encourage the next generation of health care professionals, Alleyne reaches out to the community directly by speaking at high schools and using himself as an example of how representation within the NP workforce can make a huge difference. However, for those students who do pursue careers in health care, retention is a huge issue.
“There are minority students, especially in undergrad, who rarely come into my office hours,” states Alleyne. “The ones that do, I pull them aside and say ‘Hey, what’s going on? This is the first time you came, why haven’t you come before?’ A lot of them feel less than because they have to ask for help. They don’t feel good enough or embarrassed that they have to ask for help.” Alleyne’s response? “One of the things I try to do is empower them. […] I say it’s ok to fail, as long as you take the next step in order to improve.” By offering students positive encouragement, providing access to leadership programs and opening up mentorship programs, racial and ethnic minority students can overcome the initial hurdles of nursing programs to become successful health care professionals.
Hear more fresh perspectives on minority health issues from Alleyne and learn how greater representation within the health care workforce can help save lives on the latest episode of NP Pulse: The Voice of the Nurse Practitioner®. Be sure to subscribe to NP Pulse on your preferred podcast provider and stay tuned for an episode on LGBTQ+ health equity issues on April 19!
Are you looking for other ways to help promote health equity? Join the Health Equity, Diversity and Inclusion AANP Community to engage in vibrant conversations on this important topic with your NP colleagues, visit the AANP CE Center to enroll in a variety of diversity and inclusion courses from past AANP conferences and events and access the free Examining AANP’s Past, Present and Future Commitments to Diversity webinar series.