Not every condition can be solved by medicine alone. As NPs work to provide holistic care for their patients, some cases may have several factors at play, including the patient’s current living situation. In fact, social determinants of health have shown across studies to “account for between 30–55%” of patients’ health statuses—a fact that the World Health Organization also notes on their list of factors that influence healthy equity.
The list includes income, education, food insecurity, housing, and several other factors. Patients who experience social determinants of health that negatively influence their well-being will likely have a more difficult time overcoming health complications.
As NPs who seek to provide holistic care, it is critical to account for these social determinants and provide extra assistance to these patients wherever possible.
Identifying Patient Needs Beyond Symptoms
To assist patients with the social determinants affecting their health, NPs must first be able to identify their social and economic needs. This can be done by asking open-ended questions about how they are currently able to care for their health in their daily life. Questions such as “Do you ever face obstacles accessing your medication?” or “Do you have a reliable source of transportation to attend treatments?” can lead to answers that provide a window into the patient’s situation.
There are also standardized screening tools NPs can use to help the process along. Here are two to start with:
- PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences): This widely used toolkit has been translated into over 25 languages, and it provides strategies for both gathering data and responding to social determinants.
- The Health Leads Screening Toolkit: This guide is offered in both English and Spanish, and it also includes questions on mental health and social isolation.
Addressing Food Insecurity
For patients struggling with food insecurity, it is essential for NPs to promote nutrition as a part of holistic care. By enhancing a patient’s food security, NPs will notice an improvement in the patient’s mental and physical health. Poor diets can lead to dangerous complications, such as cardiovascular disease and osteoporosis, so addressing patient nutrition early on is likely to keep these risks at bay.
To address food insecurity, NPs can provide their patients with these resources:
- Budget-Friendly Nutrition Tips: The USDA provides resources for how to save money when grocery shopping alongside nutritious recipes.
- Supplemental Nutrition Assistance Program (SNAP): If patients are unaware of the eligibility requirements, provide them with resources from the USDA alongside the application process.
- Women, Infants, and Children (WIC) Program: This program is also available for pregnant and postpartum women as well as children under 5 years old. NPs can refer to the WIC PreScreening Tool to help patients determine their eligibility.
- Meals on Wheels: Senior citizens and homebound patients may also struggle to access food. Try connecting these patients with Meals on Wheels, which operates over 5,000 community-based programs across the country.
Opening Doors to Housing Stability
A lack of safe and affordable housing is another factor that commonly affects health and well-being. Without a reliable place to stay, patients can struggle to manage physical health conditions. As an added concern, these situations take a toll on mental health as well.
For NPs who encounter patients with housing insecurity, here are some ways to offer assistance:
- Partnering with Community Organizations: NPs can partner with shelter health programs that strive to provide shelter and healthcare for residents. The National Health Care for the Homeless Council offers a toolkit that healthcare providers can reference for assistance.
- Housing Choice Voucher Program (Section 8): Information on this program may not be readily accessible to patients with housing insecurity. Provide printed resources on the Housing Choice Voucher Program along with assistance in determining eligibility.
- Continuum of Care (CoC) Programs: NPs can provide additional resources within CoC programs as they strive to help patients transition to permanent and supportive housing arrangements.
- Low-Income Home Energy Assistance Program (LIHEAP): Some patients may also be eligible for LIHEAP, which focuses on assisting with energy costs and home repairs. Not only will this help patients save money, but it also helps to provide heating and cooling situations that promote health and safety.
Advancing Holistic Health
Factors such as food insecurity, housing instability, and limited access to resources significantly impact health outcomes, and NPs play a critical role in identifying and mitigating these challenges. Through proactive and compassionate care, NPs can make a profound difference in addressing the root causes of health disparities.
