
Social Determinants of Health in Nursing Education: Integrating Into Curriculum and Practice
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Dawn M. Bowker, Iowa State University
Karla S. Kerkove, Iowa State University
Copyright Year:
Publisher: Iowa State University Digital Press
Language: English
Formats Available
Conditions of Use
Attribution-NonCommercial
CC BY-NC
Reviews
Reviewed by Trayanna Whiting, Director of Education for Data Analytics & Informatics, Adjunct Nursing Instructor, Radford University on 1/21/26
The book provides a clear and well organized overview of social determinants of health that is appropriate for nursing education and clinical practice. It covers essential concepts such as health equity, structural influences, and cultural... read more
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Reviewed by Trayanna Whiting, Director of Education for Data Analytics & Informatics, Adjunct Nursing Instructor, Radford University on 1/21/26
Comprehensiveness
The book provides a clear and well organized overview of social determinants of health that is appropriate for nursing education and clinical practice. It covers essential concepts such as health equity, structural influences, and cultural awareness without overwhelming the reader. While it is not meant to be exhaustive, the balance of foundational content and practical examples supports meaningful learning and makes it suitable for curriculum integration across different levels of nursing education.
Content Accuracy
The content in this book is accurate, current, and well aligned with established nursing and public health principles related to social determinants of health. Key concepts are clearly defined and consistently applied throughout the chapters. The information presented reflects accepted evidence and professional standards, supporting its use as a reliable educational resource for nursing students and healthcare professionals.
Relevance/Longevity
This book is highly relevant to nursing education and clinical practice, as social determinants of health directly influence patient outcomes and care delivery. The content connects foundational concepts to real world scenarios nurses encounter across settings, making it easy for learners to see practical application. Its focus on integrating these concepts into curriculum and practice supports current priorities in nursing education and healthcare delivery.
Clarity
The book is written in a clear and accessible manner that supports learners at varying levels of experience. Concepts are presented logically, with concise explanations that are easy to follow. The use of graphics and tables helps reinforce key points and makes complex ideas more understandable without oversimplifying the content.
Consistency
The resource stays consistent throughout its chapters with clear structure and uniform formatting that help guide learners logically from one topic to the next. Each section uses similar language and visual patterns so students do not feel a sudden shift in tone or depth as they progress. This steady organization makes it easier to focus on the content without getting lost in changing layouts or uneven explanations.
Modularity
The resource is well modularized with distinct sections that stand on their own while building toward a larger understanding of social determinants of health. Each module covers a focused topic with defined objectives so learners can absorb one concept before moving to the next. This modular design makes it easy to integrate individual units into a curriculum or to use the material for targeted learning sessions without needing to work through the entire text at once.
Organization/Structure/Flow
The organization of the resource supports learning by grouping related concepts in a logical sequence that mirrors how instructors might teach the material. Introductory ideas are presented first, followed by deeper explorations and practical examples. Headings and subheadings are used effectively to break content into manageable sections, making it easier to navigate and review key points. This clear organizing structure helps learners build understanding step by step.
Interface
The interface is clean and user friendly with visual elements that support rather than distract from the content. Colorful graphics and tables are placed thoughtfully to highlight important ideas and make complex information easier to digest. Navigation feels intuitive so learners can move between sections without confusion, and the layout helps keep attention on the material rather than on figuring out where to go next.
Grammatical Errors
The resource demonstrates strong grammatical quality with clear, professional language that is appropriate for healthcare education. Sentences are well constructed and easy to read, with minimal errors that might distract learners. The consistent grammar and writing style support credibility and help ensure the focus remains on understanding the content rather than interpreting the text.
Cultural Relevance
The resource reflects cultural awareness by acknowledging the diverse social, economic, and environmental factors that influence health outcomes. Examples and discussions are presented in a way that respects different populations and lived experiences without relying on stereotypes. This inclusive approach supports culturally responsive education and encourages learners to consider equity and context when applying concepts in practice.
CommentsOverall, this resource is a strong open educational tool for nursing and healthcare learners. It balances concise content with meaningful depth and uses visuals, tables, and activities to reinforce learning. From an informatics and educational design perspective, it is easy to adapt, integrate into coursework, and apply in practice, making it a valuable addition to nursing education focused on social determinants of health.
Reviewed by Jennifer Riggs, Professional Specialist, Saint Mary's College on 12/19/25
The authors note that their goal for this project was to create a resource that could offer knowledge and support for integrating Social Determinants of Health (SDOH) in both undergraduate and graduate nursing programs. They call the resource a... read more
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Reviewed by Jennifer Riggs, Professional Specialist, Saint Mary's College on 12/19/25
Comprehensiveness
The authors note that their goal for this project was to create a resource that could offer knowledge and support for integrating Social Determinants of Health (SDOH) in both undergraduate and graduate nursing programs. They call the resource a “workbook” which leads me to believe that their intention was to create an activity-based resource rather than comprehensive text. Still, the first sections of the workbook offer an effective introduction to the topic of SDOH that includes important definitions, a discussion on cultural aptitude, and practical and creative suggestions for how to integrate both into nursing curriculum in a variety of settings (classroom, lab, clinical, simulation, interprofessional education, etc.). Suggestions target student learning of SDOH as well as how programs can improve modeling of cultural aptitude via faculty diversity and development. The second half of the workbook contains detailed case studies that are based on the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Model and that incorporate NextGen NCLEX -type comprehension questions.
Content Accuracy
The list of references used is found at the end of Section 3 and includes only current, reputable sources. The authors frequently cite the World Health Organization’s guidelines as well as the U.S. Department of Health and Human Services’ Healthy People 2030 objectives for monitoring SDOH and considering them in patient care.
Relevance/Longevity
Authors strategically aligned their work with the NCSBN’s Clinical Judgment Model and the four spheres of care supported by the current American Association of Colleges of Nursing (AACN) Essentials. The AACN guidelines place a significant emphasis on the nurse educator role of helping nursing students to understand how structural and cultural influences impact health outcomes and nursing practice. The workbook provides specific recommendations for how to integrate these concepts into nursing curriculum. Additionally, each case study provides a focused approach within one of the spheres of care and addresses multiple SDOH domains.
Clarity
The text is clear, concise, and easy to understand. It is appropriate for an undergraduate nursing student.
Consistency
Each section is formatted in the same way and is easy to navigate.
Modularity
The amount of information in each section is appropriate. I believe that students (and faculty!) will appreciate the conciseness and simplicity of the layout.
Organization/Structure/Flow
The workbook includes 5 short sections and makes good use of tables and images.
Interface
I have not experienced any interface issues with this book. There is no online book option, however. The workbook must be downloaded as a PDF.
Grammatical Errors
Grammar is correct. Language is appropriate for an undergraduate student.
Cultural Relevance
The concept of cultural awareness is inherent to the discussion of SDOH and is emphasized throughout the entire workbook. The second section is dedicated to explaining cultural aptitude and describes the differences between cultural competence, cultural humility, and cultural safety. The authors set the tone for the book by acknowledging that there is a need to address and incorporate SDOH into nursing curricula because they are interrelated with the concepts of diversity, equity, inclusion, and health policy. The case studies include patients who vary by gender, age, race, ethnicity, background, experience, diagnosis, and care setting. Thus, each scenario challenges students to consider different SDOH. Additionally, the authors reference Leininger’s Transcultural Nursing Theory and encourage nurse educators to promote cultural aptitude at local, domestic, and international levels.
Reviewed by Marie Beechy, Assistant Professor of Nursing, Marian University on 11/4/25
This text is less of a book on the SDOH details and more of a support to be used in a class or clinical setting to help students put the concepts into practice in the form of case studies. The majority of the text is a series of detailed case... read more
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Reviewed by Marie Beechy, Assistant Professor of Nursing, Marian University on 11/4/25
Comprehensiveness
This text is less of a book on the SDOH details and more of a support to be used in a class or clinical setting to help students put the concepts into practice in the form of case studies. The majority of the text is a series of detailed case studies that goes over SDOH in the case study. A review of the case studies shows them to be very comprehensive and beneficial resource.
Content Accuracy
The text provides a brief, but accurate overview of SDOH. No errors were noted in the text.
Relevance/Longevity
The format of this text will need updates to maintain its relevance over time. Several specific charts and facts will require regular revision to ensure the information remains current. Additionally, some content linked to external sources, such as the CDC, will help support its ongoing relevance.
Clarity
The text is a clear, concise resource to use when educating students on SDOH.
Consistency
There was no indication of inconsistency within the text. The case studies were presented in a clear and uniform manner, making the resource particularly useful for students.
Modularity
The textbook has a clear and logical layout that makes navigation very easy for the user. Its well-organized structure helps students easily find and understand key concepts.
Organization/Structure/Flow
The textbook has a clear and logical layout. It is well-organized.
Interface
There is no evidence of issues in the interface of the text.
Grammatical Errors
I was unable to see any grammatical errors in the text.
Cultural Relevance
The case studies do have some evidence of cultural inclusiveness but I do see room for improvement in this area. Three case studies are done on men and two are done on females. The female cases are more culturally diverse and culture is included in some of the SDOH.
CommentsThis is an excellent resource for those who are looking for comprehensive cases studies to include in their teaching strategies.
Reviewed by Kira Harkonen, Instructor, Radford University on 8/22/24
Brief introduction to social determinants of health in the beginning of the textbook and thorough case studies. Each case study incorporates social determinants of health and how they impact the care of the patient. read more
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Reviewed by Kira Harkonen, Instructor, Radford University on 8/22/24
Comprehensiveness
Brief introduction to social determinants of health in the beginning of the textbook and thorough case studies. Each case study incorporates social determinants of health and how they impact the care of the patient.
Content Accuracy
The textbook presents accurate information with no obvious errors. The information presented is unbiased.
Relevance/Longevity
Social determinants of health that are described in this textbook are relevant to current and future care. Necessary updates would be minimal and easy to make in regard to medications etc.
Clarity
Easy to follow and terminology used is relevant to the profession.
Consistency
The framework of the textbook follows a clear pattern. The social determinants of health are explained and then case studies follow with applicable scenarios.
Modularity
The text is easily divided into sections that can be assigned to students. Case studies are separated by patient diagnosis and can be used when appropriate to the course content.
Organization/Structure/Flow
The topics in the case studies are divided but not into clear sections. They are easily located but are not in any sort of order or grouping of diagnosis.
Interface
In the section where a word choice is to be selected the text is misaligned but all other images and charts are free of significant issues.
Grammatical Errors
The text is free of grammatical errors.
Cultural Relevance
The text is inclusive of a diverse populations including races, ethnicities, religions, and backgrounds.
CommentsThe book provides case studies that can be utilized in a variety of nursing courses. It would be a nice additional resource when covering the social determinants of health portions in Foundations courses.
Table of Contents
- Social Determinants of Health
- What is Cultural Aptitude?
- Incorporating into Nursing Curriculum
- Case Studies
- Facilitator Guide
- Photo Credits
- About the Authors
About the Book
This workbook was established with nurse educators and nursing students in mind to provide knowledge, guidance, and support for integrating SDOH across the nursing education spectrum. Contents from this workbook are applicable to pre-licensure baccalaureate nursing programs, RN-to-BSN programs, and graduate education. A strategic approach for this workbook was purposefully designed to meet the structure of the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measure Model® with a combined focus on the four spheres of care supported by the American Association of Colleges of Nursing (AACN®). Our goal with this workbook is to lead educators and students on a directed path of discovering how SDOH is an integral part of nursing practice and how nurses can implement effective interventions to positively impact the health outcomes of individuals, families, communities, and aggregates.
About the Contributors
Authors
Dr. Dawn M. Bowker is a nurse practitioner, educator, and researcher with over 40 years of nursing experience. Dr. Bowker is the Director of Nursing Education and Clinical Associate Professor of Nursing at Iowa State University. Dr. Bowker obtained a PhD in Nursing Science from New Mexico State University, a master’s degree in Transcultural Nursing and Community from Augsburg University in Minneapolis, and a Women’s Health Nurse Practitioner with clinical experience in private and community sectors. Dr. Bowker serves as a transcultural clinician and consultant on cultural discordance issues in the delivery of healthcare and is passionate about population health, public policy, advocacy, and increasing awareness of the impact social determinants of health have on health outcomes. Dr. Bowker is a visionary leader in nursing education with expertise in curriculum development, innovative educational strategies, and integrating social determinants of health and meaningful population-based clinical experiences in nursing curricula.
Karla S. Kerkove is an experienced educator with a background teaching in associate and baccalaureate degree nursing programs. Karla is a Clinical Assistant Professor at Iowa State University. She received her master’s in nursing education and holds two national certifications as a Certified Nurse Educator and Critical Care Nurse. Karla has over 10 years of nursing experience, including intensive care, clinical education, and academic nursing education. She has served as a change agent, developing multiple educational opportunities and leading initiatives to foster the development of both nurses and student nurses. Karla’s primary interest in nursing education includes innovative educational approaches, including e-learning, flipped classroom, classroom facilitation, coaching, and enhancing technology in the classroom. Additionally, her passion supports the socialization and development of nursing faculty to support an evolving and diverse future of nursing.