UCSF

Abstract:Background: The impacts of social determinants of health (SDOH) have been found to adversely affect the current and long-term health status of people. In fact, all people are affected in some way by SDOH but the degree in which these determinants become barriers differs depending on the individual situation. This impact has yet to be assessed in how these barriers affect the ability of nursing students in their successful completion of nursing school. Those studies that have been analyzed in the literature with regards to health and college students are mostly assessing the impact of lifestyle choices such as binge drinking or smoking on health status. Purpose: The focus and purpose of this study is to assess the challenges presented by SDOH in nursing students and the effect they have on a student nurses’ perception of their overall health status. Design: This study used data from the 2019 California Newly Licensed RN Employment survey conducted by Health Impact California and disseminated from the California Board of Registered Nursing. The survey gathered data from 12,249 newly licensed nurses in the state of California. The response rate was 24.3% and 162 nurses did not meet inclusion criteria, resulting in a sample of 2,873 nurses. Methods: The dependent variable used in this study was the perceived overall health status as rated by the respondents. This variable was created as an ordinal variable in a Likert-like scale and was measured as: poor, quite poor, fair, quite good and very good. The independent variables used were also created Likert-like in design to capture a range of answers. The independent variables used were housing security, food security, trouble with clothing, utilities, child care, adult dependent care, medicine/healthcare, transportation, depression, stress, family economic status, and bias/discrimination. Descriptive analyses were conduct by the Health Impact team. Multivariate Ordinal logistic regressions were conducted using STATA 16.1 to find which SDOH had affected the nurse’s perceptions of overall health. Analyses were completed on overall health status initially with only the independent variables and then again with race/ethnicity as a moderating variable. Using race/ethnicity as a moderating variable was done in order to find out what, if any race/ethnicity, faced challenges with social determinants that are more pronounced. Results: It was found that of those who were accepted into the survey, 721 out of 2,873 of these nurses reported having some challenges related to SDOH (25.09%). The most common problem observed was the impact of depression on nurses perceived overall health. Depression was significant on every level of overall health, with and without race/ethnicity as a moderating variable. Other findings in the survey included the impacts of housing security, bias, and who was mostly affected based on race/ethnicity. Conclusion: While SDOH occur in everyone’s life, not all experience them in the same way. The effects of social determinants of health such as unstable housing, family socio-economic status and mental health barriers, have shown through this analysis to affect an individual’s perception of their overall health status. With all of the information gathered, it is imperative to remember that these are successful nurses in California and further research must be conducted to better understand the challenges nursing students face outside of the classroom