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Nursing Science: Poverty Leads in Social Determinants of Health

Updated: Jan 5, 2023

The official poverty rate in 2020 was 11.4 percent, and data shows that more than 37 million people in America lived at or below the federal poverty line. Poverty is one of the largest constructs of the social determinants of health (SDOH) and reminds us daily of the social disadvantages in America. The SDOH include a range of factors that include poverty, health insurance, access to care, education, housing, employment. Poverty leads on a global scale in health disparities.

Nursing plays a significant role in the influence of SDOH in our communities. The practice of prevention, education and promotion are invaluable to the outcomes of health, the importance of public health nursing can not be ignored.

Science has documented well that poverty has a dramatic effect on the livliehood and economic equality of those affected. We must be diligent in our strategies and implementation as we empower our most vulnerable populations.

Health Inequities

The connection between socioeconomic status and health has been well documented. Data supports that the higher your socioeconomic status the better your health outcomes and vice versa. Behind the data are the personal experiences and stories of those affected, often termed vulnerable populations. Although many factors can contribute to inequitable access, in this VLOG I discuss poverty, a leading cause of health inequities that affects nearly 40 million households in America, and why nursing science, an untapped strategy is key to helping bridge the gap. In 2020, there were 37.2 million people in poverty, approximately 3.3 million more than in 2019. African Americans had the highest poverty rate at 19.5 percent, compared to Hispanics at 17 percent and whites at 8.2 percent. The Tuskegee Study of Untreated Syphilis in the Negro Male was conducted by the United States Public Health Service in 1932. The goal was to “observe the natural history of untreated syphilis” in Black populations. The participants, most of whom were low income, were unaware of this and were simply told they were receiving treatment for bad blood. In reality, they received no treatment at all. This study remains central to healthcare decisions by members of the African-American community to this day.

Social Determinants of Health

Social determinants of health, such as poverty, racism, access, education and income are the driving force behind health disparities and inequalities. If health inequities refer to systemic differences in the health status of different populations leading to unfair health outcomes, poverty, clearly, is a root cause that continues to affect generation after generation. Traditionally medical professionals work on the premise that they have no individual role in the battle on health inequities. These beliefs reflect policy decisions and social norms that sustain misinformation and cultural incompetence. If science is a part of breaking down the walls of ignorance about health inequities, it will be our ability as clinicians to seek understanding about a patient’s inability to gain access, and follow through with acknowledgment and positive action that changes the narrative that poverty as written. Nursing science is the untapped patient access task workforce.

Nursing Science

As technological advances secure change in how we deliver care, innovative approaches in prevention and education are needed to empower vulnerable populations. Nursing science is uniquely positioned to make impactful change by addressing the needs of those most affected. Knowledge gaps are a key proponent of health inequities. Nursing is a respected driver of community education, a proven pathway to reaching those impacted by discrimination such as the LGBTQ community, the elderly, mentally ill, and homeless. If implemented in policy change, an effective tool in bridging the gap of health disparities, nursing science is indispensable in closing the disparity gap.


Strong evidence supports that those who live in poverty experience more health problems and ultimately health inequities. Nursing science is a necessary tool to promote healthy initiatives that are significant to equitable health outcomes in our patients, their families and communities. Health equity is a movement and as always, nurses are on the frontlines.

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