Social Determinants of Health

The subject of health is very basic in every community. As such, healthcare providers in each setting need to understand determinants of health on a social and economic perspective, and the contribution of such factors to disease development. With this kind of understanding, healthcare providers and policymakers can develop mechanisms to break or control the pertinent chains of infection. This paper will look at the different social determinants of health, their contribution to disease development, and the chain of infections. The post will also evaluate how the nursing fraternity can break the chain of infection.

Social Determinants of Health

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According to Clark (2015), Pacquiao (2016), and the World Health Organization (2018), social determinants of health are the health conditions that people are born into, grow, live, worship, work, and their age. These conditions often determine a wide range of health, functioning, and quality of life outcomes, as well as, distribution of health risk. The social determinants of health encompass the conditions of survival (social, economic, and physical) the settings, for instance, schools, churches, markets, and neighborhoods, and material attributes of the place factor. It is the social factors that determine resource availability, social engagement patterns, and security. Resources in this regard, include housing, economic opportunities, education, food, and health facilities to mention a few. WHO (2018) acknowledges that social determinants of health interact to support different changes in communal and individual behaviors. When social determinants of health are improved and sustained over time, the health of populations is likely to improve.

The Chain of Infection

Clark (2015) reckons that the chain of infection is the sequence of events followed by disease-causing pathogens, until they cause infections in persons. According to the Center for Disease Control (2012), the chain starts with the reservoir, the portal of exit, mode of transmission, portal of entry, and a susceptible host. The reservoir is the natural habitat of the agent – it is where it grows and multiplies. Reservoirs, as Clark elaborates, include humans, animals, and the environment. The CDC explains that the portal of exit is the path followed by the pathogens as they leave their reservoir. For instance, the tuberculosis pathogens exit the respiratory tract and malaria exits through blood-sucking arthropods. The mode of transmission is the different ways the agent/pathogen is moved, such as contact, airborne, or vector-borne.  The portal of entry is described as the manner in which pathogens enter a susceptible host. It provides with access to tissues where the pathogen can multiply or the toxins can act (CDC, 2012). The last link in the chain is the susceptible host. The susceptibility of a host is determined by the genetic combination, specific immunity, nonspecific factors, and social determinants.

Nurses can often break the chain of infections in a variety of ways through interfering with any of the mentioned steps/links in the chain. First, nurses can direct their efforts in the control or elimination of pathogens at their habitat. For instance, a patient with a communicable disease can be treated using the right medication by the nurse to reduce the risk of spreading. With an asymptomatic infection, a patient can be treated to heal the infection and reduce the risk of transmission. In home care, a nurse can cut the chain by advising patients and their caregivers along the Nightingale principles such as maintenance of cleanliness. A nurse can use advocacy to cut the links in a chain of infection. For instance, he/she can counsel persons on basic hygiene, promoting handwashing, and control of vector population, such as mosquitoes. 

In conclusion, the health of a population or an individual is determined by different social factors. The interaction of elements such as economics, housing, and education play a critical role in health outcomes. The nursing fraternity can actively be involved in breaking the chain of infection, which has been shown to have different stages.


Center for Disease Control. (2012). Principles of Epidemiology in Public Health Practice, Third Edition. Retrieved from

World Health Organization. (2018). Social determinants of health. Retrieved from:

Clark, M. (2015). Population and community health nursing (6th ed.), Hoboken, New Jersey: Pearson Education Inc.

Pacquiao, D. F. (2016). Social Determinants of Health. Global Health Care: Issues and Policies, 159.

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