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Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Office of Disease Prevention and Health Promotion, 2019)”. The types of conditions may be in social, economic, and physical environment. Social determinants examples are; availability of resources to meet daily needs, educational and job opportunities and access, health care services access, patient safety, social support, social norms, exposure to crime, socioeconomic conditions, residential segregation, literacy or language, mass media access, and culture. The physical determinants examples are; green space or natural environment, built environment, recreational, work sites, schools, exposure to toxic substance, physical barriers, and aesthetic elements. Settings could be pertaining to school, church, workplace, and neighborhood, any type of setting that can be considered their “place”. Healthy People 2020 established five key areas of social determinants; economic stability, education, social and community context, health and health care, neighborhood and build environment. “
“Social determinants of health are economic and social conditions that influence the health of people and communities (Centers for Disease Control and Prevention, 2014)”. The social determinants of health contribute to the development of disease. The factors may be social in nature, biological, psychosocial, behavioral, and socioeconomic. For example, genes and biology such as sex and age, health behaviors such as EtOH abuse, social environment – discrimination, income, physical environment; where a person lives and type of condition, and health services – access to health care or not having insurance. “Each person’s health is affected by the person’s behavior, which, in turn, is associated with his or her social or economic status (e.g., income, education, and marital status) and the corresponding environmental conditions (e.g., the proportion of people in a neighborhood who live below the federal poverty level [FPL] or who do not have a high school education) (Ruiguang Song, 2011)”.
The fundamental idea of what the communicable disease chain model represents is composed of three elements; infectious agent, host and environment. The infectious agent must be present for the disease to occur or developed. Examples of infectious agents are bacteria, viruses, and parasites. The host can be any susceptible organism. Examples of hosts are plants, animals, and humans. The environment are all other possible factors that promote or prohibit the disease transmission.
Examples of steps a nurse may take to break the link within communicable disease chain is by simply disrupting or interrupting the chain at any link. Examples are; correctly washing hands often, vaccinations, staying at home when ill, abiding by regulations for standard and contact isolation, implementing personal protective equipment appropriately, cleaning and disinfecting the area, sterilizing medical equipment, following safe practices, utilizing antibiotics appropriately in order to prevent antibiotic resistance.

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