Navigating health inequities in aging: The impact of social determinants on health and homecare nursing for older people

The term "social determinants of health" (SDoH) describes conditions contributing to health inequities. While extensively studied in the working-age population, research on their impact among older people is limited. This study investigates how SDoH influence older people's health and homecare nursing. Using an interpretive phenomenological approach, data were generated through participant observations, situational interviews, and small group interviews with twelve homecare nurses from two municipalities. Data analysis included paradigm cases, exemplars, thematic analysis, and collaborative data analysis to incorporate perspectives from older people and civil society stakeholders. Findings identified digitalization, social networks, transport, financial insecurity, and healthcare access as impactful SDoH. The complexity of the healthcare system and its demands on patients, juxtaposed with the functional decline of aging populations, significantly affect older people's health and homecare nursing. SDoH profoundly impact older people's health, necessitating additional support from homecare nurses and highlighting the need for equitable access and a holistic nursing approach.