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We are a product of our environment.   Everything in our environments affect us, this is called social determinants of health.     We have all seen the disparities in populations and how poverty affects access to healthy foods, safe neighborhoods, and good education.   By applying what we know about social determinants of health we can improve individual health and advance health equity.   By looking at the root cause of illness, we are likely able to influence community health (Centers for Disease Control and Prevention website, 2016) .      Despite spending far more on health care than any other nation, the U.S. ranks near the bottom on key health indicators.   This is due to underinvestment in addressing social and behavioral determinants of health.   These are problems that are either caused by behavioral risks or social conditions.   For example, smoking increases incidents of lung cancer, respiratory disease, diabetes, heart disease, and stroke.   An interesting side note; many of the social and behavioral variables linked to disease are involved in the stress response.   Stress experiences produce change in the brain and body that promote illness and disease.   This release of cortisol ( the stress hormone) when stressed can lay the foundation for chronic illness (Adler & Prather, 2015) .  

The communicable disease chain begins with the chain of infection.   An infection is an overgrowth of bad bacteria.   There are 6 elements to this chain.  

1.     Infectious agent :   an organism with the ability to cause disease.

2.     Reservoir :   a place where that organism can grow, thrive, and reproduce.   This is also inanimate objects like water, doorknobs, and tabletops.  

3.     Portal of exit :   an exit way for the organism to leave the reservoir.

4.     Mode of transmission :   method of transfer of organism from one place to another.

5.     Portal of entry :   an opening allowing the organism to enter the host.

6.     Host :   a person who cannot resist the organism entering the body, multiplying, and resulting in infection.

The infection will only develop if the chain is unbroken.   This is where the nurse plays a big part, we know how to break the chain.   Hand hygiene is a good place to begin.   Standard precautions are tools a nurse learns, knows, and lives.   Nurses can break the links in the chain.   An organism in a wound can spread to the IV site when doing improper dressing site changes.   A cut in the nurse’s skin can also invite the organism into their system.   Hospitals harbor many organisms; the nurse is the front-line weapon in breaking the links in the chain of infection (Olin, 2012) .


Adler, N. E., & Prather, A. A. (2015). Determinants of health and longevity. Retrieved from

Centers for Disease Control and Prevention website. (2016).

Olin, J. (2012). Nursing plays a major role in infection control. Retrieved from

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