The Nell Hodgson Woodruff School of Nursing is committed to integrating social determinants of health (SDOH) into the curriculum at all levels. As examples of health inequalities increase, so should the capabilities and understanding of nurses.
The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.
Framework
Social Conditions
Social Conditions are defined as those that occur due to systemic racism, economic disparities, education gaps, and/or occupations that influence wellness. Specifically, we consider:
Access to education, financial resources, job opportunities
Social Support
Language and Health Literacy
Access to health care (use of preventative health services, primary care
Cultural Conditions
Customary beliefs, social norms, attitudes, values, practices shared by a group of people (community or society) in a place and time can affect health outcomes. In particular, cultural conditions that can influence SDOH include:
Religion/spirituality
Societal values
Nursing values
Interpersonal Racism/Discrimination
Customs/behaviors
Identity (ethnicity, gender, sexual orientation)
Environmental Conditions
Physical & social environments have an outsized impact on individual and population health. In the Emory Nursing SDOH Framework, we consider:
Natural Environment: Green spaces, bike lanes, sidewalks
Exposure to toxic substances
Access to healthy foods
Climate, water quality, air pollution
Spaces for social interactions/connections
Familial relationships & social capital
Social settings can also influence wellness via:
Faith-based institutions
Quality of schools, worksites, recreational settings
Affordable housing and transportation
Policy Conditions
Guidelines, principles, legislation and activities that affect the living conditions conducive to the welfare of individuals', communities', and societies' quality of life make up the Policy pillar. This pillar considers:
Affordable/universal healthcare
Child protection
Abortion
Guns
Sex workers
LGBTQ issues (including same sex marriage)
Education/housing policies
Recreational drugs
APRN restriction on prescriptions, radiology, dispensing, etc.
Publications
Integrating a Social Determinants of Health Framework into Nursing Education
Jill B. Hamilton, Beth Ann Swan, Linda McCauley
Springer Nature, Feb 10, 2023 - Medical - 216 pages
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.
Transforming Social Determinants to Promote Global Health: Achieving Health Equity through Lived Experience (Forthcoming)
JB Hamilton & CE Moore (Eds.)
Cham: Springer International Publishing. Forthcoming 2024.
The purpose of this book is to highlight global community-based programs that have been implemented in marginalized and/or low resource global communities. The community programs that incorporate SDOH in this book represent communities from rural, urban-inner city, southern, northeastern, and western geographical regions as well as global communities from Malawi, Kenya, Tanzania, Ethiopia, Botswana, the Grenadines, Nigeria, and Peru. Moreover, the SDOH conditions emphasize a diversity of influences on health and well-being of the individuals in those communities. For ease of reading, we have further classified these SDOH conditions according to a 4 pillar SDOH framework of social, cultural, physical environment, social environment, and policy conditions.
News
School of Nursing Receives R25 Grant for Pioneering Advanced Research Training in Social Determinants of Health
September 17, 2024
Nell Hodgson Woodruff School of Nursing Professor Jill Hamilton, PhD, MRPL, RN, along with co-Multi Principal Investigators (MPIs) Professor Drenna Waldrop and Emory University President Emerita and Charles Howard Candler Professor Claire E. Sterk, have been awarded a R25 grant from the National Institute of Nursing Research (NINR). This grant supports a groundbreaking initiative to advance research training focused on Soc
This project will fund the development of the Advanced Research Training in SDOH (ART) program, designed to enhance the capabilities of both early-career and mid-career researchers. The ART program's primary objective is to prepare a new generation of nurse scientists and allied researchers to effectively study and address how social determinants influence health outcomes at individual, family, and community levels.
Building upon a successful four-year initiative at the Nell Hodgson Woodruff School of Nursing, the
program will focus on training researchers in various SDOH-related areas, such as cancer, cardiovascular disease, aging, cognition, climate change, and behavioral health. By exposing trainees to new methodologies and providing robust research training, the ART program will create a cadre of experts who will lead the way in SDOH research and contribute to reducing health inequities.
Faculty Involvement
The following are faculty members engaged in the work/mission of SDOH.
Autherine
Abiri
DNP, FNP-C, ENP-C
Assistant Professor
Dr. Autherine Abiri is an Assistant Professor at Nell Hodgson Woodruff School of Nursing. She is a certified family & emergency nurse practitioner and has dedicated her clinical career working in the emergency department. She obtained her Bachelor of Science in Nursing from the University of Wisconsin Madison in 2009 and her Master of Science in Nursing as a family nurse practitioner from Graceland University in 2015. Dr. Abiri graduated with her Doctor of Nursing Practice from Emory University in 2020 where she was recognized with the Nell Hodgson Woodruff School of Nursing Social Responsibility Award for breaking down barriers and creating an environment for diversity, equity and inclusion. Additionally, Dr. Abiri serves as a national committee member of the American Academy of Emergency Nurse Practitioner’s Diversity Equity and Inclusion Committee. She takes a special interest in research that centers on the impact of social determinants of health on patient outcomes and health disparities. Dr. Abiri is passionate about providing patient-centered care and implementing processes that promote health equity.
Jinbing
Bai
RN, MSN, PhD, FAAN
Assistant Professor
Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University Member, Winship Cancer Institute
Dr. Bai is an Assistant Professor from School of Nursing and a member of Winship Cancer Institute, Emory University. His expertise includes treatment toxicities, patient-reported outcomes, and biological mechanisms of symptoms in pediatric oncology. He is one of the national Champions for the environmental health in pediatric cancer under the first cohort of Pediatric Oncology Clinician Education Supplement (POCES) training. Dr. Bai has intensive research experience in understanding the role of multilevel social determinants of health in children’s care outcomes, including neighborhood socioeconomic deprivation, ambient air quality, and green spaces. As a pediatric cancer researcher, Dr. Bai is very passionate to discover new knowledge and disseminate new evidences to promote children’s health.
Glenna
Brewster
PhD, RN, FNP-BC
Assistant Professor, tenure track | PhD, RN, FNP-BC
Dr. Glenna Brewster is an Assistant Professor, tenure track, at the Nell Hodgson Woodruff School of Nursing at Emory University and a Family Nurse Practitioner in the Integrated Memory Care Clinic. She graduated from the University of South Florida with a Bachelor and Masters of Science in Nursing, a Masters of Arts in Gerontology, and a Ph.D. in Nursing Science. She completed a postdoctoral fellowship at the University of Pennsylvania, School of Medicine in the Center for Sleep and Circadian Neurobiology. Her program of research aims to understand sleep disturbance experienced by persons living with cognitive impairment and their caregivers, develop behavioral interventions to address the identified sleep disturbance, and examine the impact of these sleep interventions on psychological, cognitive, and physiological outcomes.
Dr. Brewster has been funded by the National Hartford Center of Gerontological Nursing Excellence, the National Institute on Aging, and the National Institute of Nursing Research. She is currently funded by the Goizueta Alzheimer’s Disease Research Center at Emory, the Alzheimer’s Association and the National Heart, Lunch and Blood Institute through her participation in the Programs to Increase Diversity in Behavioral and Sleep Medicine Research.
Dr. Brewster recently served on the Board of Directors for the National Hartford Center of Gerontological Nursing Excellence and as a co-convener for the Nursing Care of Older Adults research interest group for the Gerontological Society of America. She has published her research in many multidisciplinary journals including the Journal of Aging and Health, and Geriatric Nursing. Dr. Brewster has also given numerous presentations about her work at local, regional, and international conferences including the Alzheimer’s Association International Conference, Southern Nursing Research Society, SLEEP, and Gerontological Society of America.
Roxana Chicas, PhD, RN is an Assistant Professor, Tenure Track, in the Nell Hodgson Woodruff School of Nursing and a Bridges to the Baccalaureate scholar. She earned an ASN from Georgia Perimeter College in 2015, a BSN from Nell Hodgson Woodruff School of Nursing in 2016, and a PhD from Emory University Laney Graduate School in 2020. Dr. Chicas completed a one-year postdoctoral training in the Renal Division of the School of Medicine at Emory University.
Dr. Chicas’ research experience in occupational and environmental health, and nephrology, along with being a bilingual bicultural investigator equip her with a unique set of strengths and skills as a nurse scientist. Dr. Chicas conducted the first field-based intervention study of methods to reduce core body temperature using real-time biomonitoring equipment among farmworkers in the United States.
Dr. Chicas is a sought-after scientist with features in Bloomberg News, NPR, and The World. She has collaborated with the Center for American Progress and the Alliance of Nurses for Healthy Environment to advocate for climate change policy solutions. She is also an advocate for immigrants and workers’ rights. Dr. Chicas is a host on the Nurses Station webcast.
Professor, tenured, Director of Center for Data Science
Dr. Hertzberg is a Professor, tenured, and is an internationally-recognized expert on "big data" and its impact on health care. She is widely known for her work measuring the social contacts in emergency departments and disease transmission on airplanes. Her research has been funded by the National Library of Medicine, National Institute of Neurological Disorders and Stroke, the National Institute of Environmental Health, and the National Institute of Allergy and Infectious Disease. Her work has been published in high-impact journals, including the Proceedings of the National Academy of Science, New England Journal of Medicine, PLOS One, and Pediatrics.
Irene Yang is an Assistant Professor, tenure track, and received her MSN in Nursing Education and PhD in Nursing Research from the University of Louisville in 2014. She continued her research training with a T32 postdoctoral fellowship at Emory's Nell Hodgson Woodruff School of Nursing and was privileged to join the faculty in 2016.
Nicole S. Carlson, PhD, CNM, FACNM, FAAN is an Associate Professor, Tenured, at Emory University’s School of Nursing. At Emory, Dr. Carlson conducts research on the biologic mechanisms of labor and strategies for achieving optimal perinatal outcomes and decreasing racial disparities in women with different levels of obesity. She has received support for her research from the National Institutes of Health, the March of Dimes, and The American College of Nurse-Midwives. She is currently PI of an R01 investigation, “The Weight of It All: Balancing the Scales for Pregnancy & Birth in Black Women” (WOIA), a 5-year prospective observational study to better understand how the social determinants of health, structural racism, the midwifery model of care, and pregnancy lifestyle affect prenatal metabolic health and labor/birth outcomes. This work is made possible by the amazing group of community members, students, midwives, nurses, faculty, and staff who are the WOIA team.
Associate Professor, Assistant Director for Global Research
Dr. Kariuki is an Associate Professor and the Assistant Director for Research at the Lillian Carter Center for Global Health and Social Responsibility. Most recently, he served as an Assistant Professor at the University of Pittsburgh School of Nursing where he also coordinated the Adult-Gerontology Primary Care Nurse Practitioner Program. His BSN is from the University of Eastern Africa, Baraton; His MSN, Post-master’s Certificate (AGNP) and PhD are from the University of Massachusetts Boston.
Dr. Kariuki’s program of research focuses on prevention of cardiometabolic diseases in high risk and underserved communities. His doctoral research focused on making cardiovascular risk assessment more accessible in underserved communities by validating and demonstrating the cost-effectiveness of a resource efficient screening algorithm. Currently, he is working on projects in the US and Africa focusing on helping insufficiently active individuals overcome common and atypical barriers to physical activity. His research team has developed a web-based physical activity intervention designed to help diverse individuals with obesity increase their physical activity. The intervention is intentionally designed to make physical activity enjoyable and convenient and can be used in any home environment irrespective of neighborhood walkability score or safety. The National Heart, Lung, and Blood Institute, awarded $792,307 in 2023 to fund a pilot efficacy trial of this intervention in a grant titled, Efficacy of a novel web-based physical activity intervention designed to promote adherence to physical activity guidelines in adults with obesity.
He has extensive teaching and curriculum development experience in areas of gerontology, preventive health, and intervention development. During his faculty practice hours, he works as a per diem Nurse Practitioner with Signify Health. His service contributions include: Senior Associate Editor at Behavioral Medicine, member of the American Heart Association (AHA) Lifestyle Physical Activity Committee, member at Large of the AHA Council on Cardiovascular and Stroke Nursing, and member of the AHA Early Career Committee of the Council on Lifestyle and Cardiometabolic Health. Dr. Kariuki is also a manuscript reviewer for various journals including the Lancet Public Health, Annals of Medicine, Behavioral Medicine, Journal of Medical Internet Research, Journal of the American Heart Association (JAHA), Journal of Cardiovascular Medicine, Geriatric Nursing Journal, and npj Digital Medicine.
Dr. Kalisha Bonds Johnson is an Assistant Professor, Tenure track at Emory University’s Nell Hodgson Woodruff School of Nursing in Atlanta, Georgia. She graduated from The University of Tennessee at Martin with a Bachelor of Science in Nursing in 2007. She graduated with a Master of Science in Nursing in 2012 from Vanderbilt University, specializing as a Family Psychiatric Mental Health Nurse Practitioner. Most recently, Dr. Bonds Johnson graduated with a PhD from Oregon Health & Science University in 2019. During her PhD program, she was funded through several mechanisms, including the SAMHSA at American Nurses Association Minority Fellowship Program and the Jonas Foundation as a Veterans Healthcare Scholar. In her PhD studies, Dr. Bonds Johnson focused on how the caregiving experiences of African American dementia dyads (i.e., African American persons living with dementia and their African American family caregivers) were associated with their quality of life. Specifically, Dr. Bonds Johnson focused on interpersonal factors such as decision making and the relationship quality. In her postdoctoral fellowship, she advanced this line of inquiry to focus on the decision-making processes regarding healthcare services for African American persons living with dementia and how these decision-making processes affect the quality of life of African American persons living with dementia and their families. Dr. Bonds Johnson hopes to improve health outcomes from African American persons living with dementia and their families through the development of culturally tailored clinical interventions.
Jill Hamilton, PhD, MRPL, RN is a 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 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 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 2003-2007and 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 Oncology Nursing Society (ONS) Publishing’s Division Award for Excellence in Writing Qualitative Research and the 2023 ONS Award for Excellence in Cancer Nursing Education. Dr. Hamilton’s work on religious songs was featured in the November 2012 Thanksgiving edition of Good Housekeeping magazine.
Dr. Telisa Spikes is a Tenure-track Assistant Professor in the Nell Hodgson Woodruff School of Nursing at Emory University. Dr. Spikes’ research interest focuses on the chronic stressors derived from the social environment and the impact of their embodiment related to accelerated biological aging and cardiovascular disease risk in early midlife adult African American women ages30-44 years old, a group that has seen a dramatic increase in cardiovascular disease (CVD) morbidity and stagnating declines in CVD mortality.
She has publications related to psychosocial stressors, hypertension medication adherence, and blood pressure reactivity in Black women as well as socioeconomic status and arterial stiffness in Black adults using community-based cohorts and a large epidemiological cohort, Atherosclerosis Risk in Communities (ARIC) study published in high-impact clinical journals. She has been most recently awarded a K23 early career training grant from the National Institutes of Nursing Research (NINR).
Dr. Spikes has been invited to present her work to national audiences for notable organizations such as the American Heart Association (AHA), American Heart Association Epidemiology Lifestyle Sessions, Sigma Theta Tau International, and the Southern Nursing Research Society (SNRS).
After completing her PhD at the Emory University Nell Hodgson Woodruff School of Nursing, Dr. Spikes completed a2-year postdoctoral fellowship focused on research methodologies to eliminate cardiovascular health inequalities in vulnerable populations at the Rollins School of Public Health in the division of cardiovascular/social epidemiology at Emory University.
Dr. Spikes earned her Masters degree in nursing at Kennesaw State University, and a bachelor's degree in nursing from Georgia Baptist College of Nursing at Mercer University.
Quyen Phan, DNP, APRN, FNP-BC, is an Associate Clinical Professor at Emory University's Nursing school. With nursing background in both Canada and the United States., Dr. Phan’s areas of expertise include public health, primary care, academic-practice partnership, and nursing education.
Dr. Phan is the primary investigator/project director of two HRSA-funded grants totaling $8 million dollars, focusing on expanding healthcare to underserved and rural populations and preparing nursing students through nurse-led mobile health programs, and improving the nursing workforce in eight states in the Southeastern region of the United States through the training of clinical faculty and preceptors in underserved and rural areas of the region. She is the co-investigator on two other HRSA grants, totaling $4 million dollars to train nursing students in assessing and addressing social determinants of health, and to train Community Health Workers to better serve their community's health needs.
Foster Osei Baah, PhD, RN is a cardiovascular nurse scientist with a program of research focused on the social determinants of cardiovascular health behavior, self-care, cardiometabolic disease and cardiovascular health disparities in marginalized groups. The fundamental goal of this research program is to inform, design, and test interventions that enhance health behavior, improve health outcomes, and promote equity across diverse population groups. Prior to joining the Nell Hodgson Woodruff School of Nursing as a Tenure Track Assistant Professor, he completed a PhD in Nursing Science at the University of Pennsylvania and postdoctoral fellowship at the Social Determinants of Obesity and Cardiovascular Risk Laboratory at the National Heart, Lung, and Blood Institute (NHLBI) with a focus on intervention design to address obesity and cardiovascular health disparities in resource limited neighborhoods.
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