Six months ago, our view about healthcare and community in this country was very different. Nurses recognized the importance of addressing the social determinants of health as part of the admission process and we would dutifully ask questions about occupation, marital status, where they lived, who they lived with, if they had steps to navigate, if they had a primary care provider, and if they felt safe in their current arrangement. Sometimes nurses would ask about the patient’s ability to afford food and medications. Hospitals were beginning to realize the importance of caring for the community as well as individual patients because addressing chronic conditions in primary care or clinics was much more economical then addressing them as part of an acute care admission; keeping acute care for emergencies and for elective procedures, which were revenue drivers.
Fast forward to May 2020; we are in the middle of a COVID-19 pandemic. Many people have been furloughed or completely lost their jobs. With their jobs went their health insurance if they were lucky to have it in the first place. Lack of childcare is preventing people from working and social distancing adds to this dilemma, and now parents have to be teachers to their children as well. Basic food and supplies are at a premium in many areas and the costs have been inflated due to the supply/demand chain. While the restrictions are necessary to limit viral spread, the impact to the community cannot be underestimated.
Community is defined as a group of people who share something in common, have a purpose and work together to plan and build for the future. Healthcare organizations are key contributors to successful communities and history has shown that when healthcare organizations and jobs leave a community, the community will no longer thrive. COVID-19 has changed the landscape of our communities.
Healthcare systems are integral in community engagement. We need to ask our patients about economic, food, housing, and neighborhood security as well as healthcare access. Healthcare systems have been on the frontline screening patients for COVID and we must continue screening for other conditions as well. Assisting the community with the establishment of food banks, healthcare and mental health clinics will be paramount to getting communities back on firm footing.
For many years, nurses have been the most trusted profession; our ability to gain trust is because we earn it. Nurses are the one’s venturing out into the community to assess needs. We need to take a more in-depth look at the social determinants of health and assist our healthcare institutions with defining where they can make the most difference.