Upstream nurse-community partnership strategies to improve social determinants of health: A scoping review.

BACKGROUND

Nurses are vital in improving the social determinants of health (SDOH) through community partnerships. While individual-level SDOH interventions are well studied, less is known about nursing strategies that support systemic, community-based change.

PURPOSE: To examine the scope, characteristics, and gaps in the literature on nurse-community partnership strategies to address SDOH.

METHODS

A scoping review was conducted using PubMed, CINAHL, Scopus, Academic Search Premier, and SocINDEX. The search identified 20 records describing nursing strategies implemented with community partners to address SDOH in community or population health practice settings.

DISCUSSION: Nurse-community partnership strategies addressed multiple, intersecting SDOH domains, including economic stability, education, healthcare access, social and community context, neighborhood and built environment, and planetary conditions. Strategies included community-level services, co-design, shared governance, coalition-building, culturally responsive health promotion, systems redesign, and policy advocacy. Nurses leveraged trust-building, relational practice, multisector collaboration, and community-defined priorities to strengthen SDOH-related efforts. However, the literature primarily documented short-term or intermediate outcomes, with limited empirical evaluation of long-term, structural, or sustained impacts. Findings underscore the need to integrate partnership-building, policy advocacy, systems thinking, and upstream practice competencies into nursing education and role expectations, and to expand organizational and policy support for nurse-led, community-engaged SDOH initiatives.

CONCLUSION

Nurse-community partnerships are a promising strategy for advancing health equity by addressing both immediate community needs and upstream social determinants of health. Future research should evaluate the structural impact, durability, sustainability, and enabling organizational conditions of these partnerships over time.