Poverty and health inequalities: Perceptions of social work students and nursing students

Abstract

This study describes student perceptions on health inequalities and causes of poverty. Background: As frontline providers, social workers and nurses are expected to engage with patients from socioeconomically diverse backgrounds. Methods: In this cross-sectional study, a socio-demographic questionnaire, a questionnaire on health inequalities and the Perceived Causes of Poverty Scale were administered using a convenience sample of 155 students in social work and 266 students in nursing undergraduate programmes at a state university in Turkey. Mann-Whitney U test and Spearman correlation coefficient were used in the analysis of the data. Findings: Social work students were more likely to attribute the cause of poverty to social injustice and a lack of opportunities, whereas nursing students had more fatalistic explanations or beliefs, maintaining that outcomes are pre-determined and therefore cannot be changed. In both groups, those who agreed that there were problems and deficiencies in health service provision and that there was ill-health among poor groups were more likely to associate poverty with social injustice and lack of opportunities. Those without a systemic understanding of poverty and health inequalities showed a tendency to hold more individualistic/fate-related perspectives. Conclusion and implications for nursing and education policy:The nursing students, as compared to the social work students, tended to explain poverty more on the basis of individual responsibility and fatalism and were less likely to link poverty with health inequalities and to advocate for policies to end health inequalities. The students' perceptions on the causes of poverty affected their views on health inequalities. These findings suggest the need to develop curricula that equip nursing students with an understanding of poverty as a systemic cause of health inequality. Health inequality and poverty need to be positioned at the centre of training curricula by professional accreditation bodies. Interdisciplinary collaboration is recommended to foster advocacy skills in students. Furthermore, transformative changes are needed in nursing and social work education to prepare students to adequately address the Social Determinants of Health. Curricula should incorporate leadership and political activism within courses to facilitate structural change. K E Y WO R D Shealth inequalities, nursing education, nursing students, perceptions of causes of poverty, social work students 

The Impact of COVID-19 Pandemic on Health Inequities: A Photovoice Study With Nursing Students

“…Education in social determinants of health, social justice, and sociocultural competence should be an essential element integrated throughout the degree programs. These points are insufficiently taught in nursing programs (Alemany-Arrebola et al, 2021; Demirtas et al, 2021; Habibzadeh et al, 2021). Moreover, no research has been found in which students reflected about how the virus influences those at a higher risk of suffering its wider consequences (specifically in ethnic minorities and socioeconomically vulnerable groups).…”

“…Future nurses must recognize one’s cultural values, beliefs, and practices about vulnerable populations and eradicate avoidable inequalities related to ethnicity, gender, race, or socioeconomic position, among others (International Council of Nurses, 2021). However, the literature suggests that aspects related to social determinants of health and social justice are insufficiently taught in undergraduate health and social education, specifically in nursing programs (Demirtas et al, 2021; Habibzadeh et al, 2021). This pandemic presents a learning opportunity to promote nursing students’ critical thinking (Riegel et al, 2021) and help them become more aware of the consequences of social inequalities of health (World Health Organization, 2021b).…”

Engaging Leadership Competencies Through Population Health Policy Advocacy: A Review of the Evidence

“…Traditionally, baccalaureate nursing programs have taught advocacy utilizing the lower cognitive processes of knowledge recall and understanding of social health policy and politics; however, the use of higher cognitive processes including application and analysis of policy has not been explored in a meaningful way (Benton et al, 2017;Turale & Kunaviktikul, 2019). A more comprehensive nursing policy and advocacy curriculum which requires higher cognitive processes is warranted to develop leadership competencies that will impact health policy and political activism (Demirtas et al, 2022;Staebler et al, 2017). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (NASEM, 2021) report expands upon the original Future of Nursing's (2011) recommendations regarding nursing's role in advocacy for patients via health policy (IOM (Institute of Medicine), 2011).…”

“…Nurse educators are nurse leaders to the student body they prepare for nursing practice. As such, nursing faculty can serve as influencers and role models to the student body through competent and active policy engagement, interdisciplinary collaboration, and ongoing continuing education in the policy arena (Demirtas et al, 2022;Ellenbecker et al, 2017;Persaud, 2018). As active advocates, nurse educators can shape student growth in policy advocacy and activism through the creation of partnerships with community stakeholders that provide experiences that intentionally expose students to the upstream drivers of the social determinants of health (Jordan et al, 2021; National League for Nursing, 2019)…”

“…Policy content has been a regular feature of prelicensure nursing education since the 1980’s, with general recognition that nursing students need to be educated and socialized to nursing leadership competencies that include political acumen, advocacy in the health policy process, and an understanding of how to be influencers of policy (Demirtas et al, 2022; Ellenbecker et al, 2017). The 2008 AACN Baccalaureate Essentials included a dozen health policy competencies meant to prepare students to have a basic level of understanding in order to participate in the policy process at the local, state, and national level.…”