Still swimming against the tide? A follow-up study to explore Ontario-based social determinants of health public health nurses’ experiences in role enactment
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Follow-up research on the role of the social determinants of health public health nurse
This resource summarizes the findings of a new research study that follows up on the 2016 case study entitled “Swimming against the tide: A Canadian qualitative study examining the implementation of a province-wide public health initiative to address health equity.”
The recent research project was undertaken to explore the enactment of the social determinants of health public health nurse (SDH-PHN) role in Ontario since 2015. Experiences of and reflections on role enactment were collected from 30 nurses and chief nursing officers through focus groups and an online survey.
The role of the SDH-PHN
The research explored various areas of the SDH-PHN role, including:
- What activities and strategies have SDH-PHNs been engaged in?
- What supports and challenges affect the enactment of the SDH-PHN role?
- How does leadership, organizational culture and context influence the role?
- How do structurally embedded workplace inequities impact health equity priorities and role enactment?
- How do the activities of SDH-PHNs influence organizational capacity to take health equity action?
- How did the COVID-19 pandemic affect the work of the SDH-PHN?
Key takeaways
- The findings of this study have far-reaching application. Key takeaways include:
- While SDH-PHNs emphasized the value and impact of their work, they described a constant challenge to working upstream. As in 2015, they are still swimming against the tide and continuing to experience role precarity.
- More organizational and leadership support for the role is needed to enable SDH-PHNs to work to their full scope of practice according to the 2019 Canadian Community Health Nursing Standards of Practice to meaningfully address the structural and social determinants of health and advance health equity.
- The creative expertise and leadership described in this research amplifies and validates the capacity of public health and public health nursing to effect upstream and structural change associated with advancing health equity.
- The health of individuals, families, communities and populations is the work of Canada’s public health nurses and best addressed through an applied structural and social determinants of health lens.
The report concludes with several important recommendations and an important message from those who participated in the research: “This role represents a compelling opportunity for public health units across Canada to enable public health nurses to live our scope of practice according to our standards — to witness, advocate, capacity build, [and] effect change.”
Use this resource to
- Deepen understanding of the role of SDH-PHNs in Ontario and of public health nurses across Canada
- Facilitate discussion about opportunities to address the structural and social determinants of health, and the work of public health to address the root causes of inequity and advance health equity
- Consider how you and your organization can remove barriers to and support public health practitioners’ scope of practice to include meaningful community engagement to advance health equity
Related resources:
Let’s Talk: Determinants of health
See more resources on organizational capacity to advance health equity.
Reference
National Collaborating Centre for Determinants of Health. (2024). Still swimming against the tide? A follow-up study to explore Ontario-based social determinants of health public health nurses’ experiences in role enactment. Antigonish, NS: NCCDH, St. Francis Xavier University.
Tags: Competencies & organizational standards, Leadership & capacity building, Modify and orient interventions, Document, Report / Document, Learning from Practice