Social Determinants Of Health And Their Impact On Nursing And Social Service Interventions: An Umbrella Review Of Systematic Evidence

Abstract

Background: Social determinants of health (SDOH) — the conditions where people are born, grow, live, work, and age — drive much of health inequity and influence the effectiveness of clinical and social service interventions. Nurses have a vital role in addressing social and health inequities to promote quality healthcare for all.

The aim of this study: To synthesize high-level systematic review evidence on how SDOH influence health outcomes and to identify effective nursing and social-service interventions that mitigate SDOH-related harms.

Methods: We conducted an umbrella review (synthesis of systematic reviews) focusing on SDOH-related interventions implemented or evaluated by nursing and social service programs. We searched PubMed/Medline, CINAHL, Scopus, Web of Science, and gray literature (WHO, national health agencies) for systematic reviews and meta-analyses up to 2023.

Results: Five thematic intervention areas emerged across reviews: (1) routine SDOH screening and referral, (2) care coordination/case management and resource navigation, (3) community partnerships and multi-sectoral programs, (4) nurse-led public health and outreach interventions, and (5) policy/advocacy and organizational change to address structural determinants. Evidence suggests that multi-component, multi-sectoral approaches — often led or coordinated by nursing teams — improve linkage to services and can enhance some health outcomes, although the effects on hard endpoints (mortality, long-term disease progression) are mixed and influenced by context.

Conclusion: Nursing and social service interventions that explicitly incorporate SDOH assessment, proactive linkage, and community partnerships show promise. Future research should emphasize rigorous evaluation (RCTs where feasible), equity-focused metrics, and implementation studies in low-resource and diverse settings.