Changing Health Outcomes of Vulnerable Populations Through Nursing's Influence on Neighborhood Built Environment: A Framework for Nursing Research

Abstract

PURPOSE: The purpose of this article is to present a framework for nurses to study the impact of built environment on health, particularly in vulnerable populations. ORGANIZING CONSTRUCT: The framework is adapted from Social Determinants of Health and Environmental Health Promotion, a framework describing how physical and social environments interact to influence individual and population health and health disparities via macro, community-level, and interpersonal factors. METHODS: The original framework was modified for public health nursing using nursing research evaluating built environment and health, and supplemented with Nightingale's theory of nursing and health. FINDINGS: The built environment affects health through regional-, neighborhood-, and individual-level factors. Nursing can affect the health of patients by evaluating the neighborhood built environment where patients reside, and by advocating for changes to the built environment. CONCLUSIONS: Through development of built environment research, nurses can provide valuable insight into the pathways linking built environment to health of vulnerable populations, providing evidence for public health nurses to advocate for these changes on a neighborhood, state, and federal level. CLINICAL RELEVANCE: This framework can be used by public health clinicians to understand the pathways by which the built environment may be affecting the health of their patients, and by researchers to investigate the pathways, and to design and test community interventions.

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