• Pamela Nelson, RN

Social Determinants Drive Change to Better Outcomes for Environmental Related Illness

This topic can easily go unattended and become more focused to the financial aspects of air quality from factories, emission controls and the environment. Asthma and the impact of our environment has been cited and placed on platforms for the past few decades with mixed reviews depending on the location. It takes awareness, action and persistence for change and sustainability. I remember the movie Erin Brockovich that publicized the efforts of business and financial gains without looking at the impact of health or the long-term effects. Researchers have increasingly published studies that support the social determinants that impact health and how changing policies on air quality and improving environmental protection laws can course correct the outcomes related to diseases associated with the environment such as asthma.

In a recent article, Jean Raphael and Jeffrey D. Colvin provides an explanation why social determinants need to be included in public policy making. As with most conditions, asthma can be expressed as the symptom of a deeper problem that is not resolved with an ER visit and an inhaler prescription (Raphael & Colvin, 2017). Public policy changes must address and get to the root cause of issues which in many cases of asthma can be linked to economic status. In order to improve the outcomes of asthma, nurses can be a part of the solution by making our patients and their families aware and educate on the multiple factors that can contribute development and exacerbate asthma in addition to being advocates for policy changes. Social determinants have been cited in numerous articles as the reason for ___________________ (you fill in the blank). Our zip code as a child should not be the predictor of our outcome as an adult. However, even in Biblical times, the public prejudiced their acceptance of Jesus Christ because of his childhood background being from Nazareth; Jesus identified, and preconceptions formed because of where he came from and not where he was going.


Raphael, J. and Colvin, J. (2017) More than Wheezing: Incorporating Social Determinants into Public Policy to Improve Asthma Outcomes in Children. Pediatric Research; New York Vo. 81 Issues, I-1, Jan 2017: Pages 2-3.

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