When we discuss health care, we often think of physicians, hospitals and medications. However, my day-to-day work as a nurse and professor of nursing teaching health policy and advocacy to nurse practitioner students makes it clear that our community and environment have so much more to do with health outcomes than what happens in a health care provider’s office. It’s time to fully acknowledge this reality and address the health disparities and inequities in our communities.

Social determinants of health (SDOH) refers to how a community’s living conditions impact their overall health and quality of life. Factors such as economic stability, access to education, food security, built environment, pollution levels and access to health care all influence our immediate and long-term health outcomes.

If we want to get serious about tackling high rates of chronic illness, especially in vulnerable, underserved communities, we need to start considering SDOH in our long-term community planning.

Virginia leaders are beginning to recognize the importance of community and environmental health. In the 2025 session, the General Assembly passed HB 1827, a permissive bill with bipartisan support that would have allowed local governments to consider SDOH in their comprehensive planning process. The bill simply gave local leaders the option to use this data; it was not a mandate.

To my colleagues and me, this was a no-brainer. Localities already participate in a comprehensive planning process every five years and, by incorporating readily available SDOH data in their planning process, they can improve health outcomes for their residents and address the serious quality-of-life issues plaguing Virginians.

I was hopeful Gov. Glenn Youngkin would sign this legislation into law, considering his mother, Dr. Ellis Youngkin, was a fellow health care professional and educator who was well respected by those of us who knew her work. In part, this bill could have helped address the high rates of maternal and infant mortality by encouraging localities to consider access to health care in their planning. Dr. Youngkin dedicated her life to women’s health care and was a longtime obstetrics and gynecology nurse practitioner.

However, the governor vetoed this legislation and prevented local leaders from having a new tool in their toolbox that could aid them as they respond to the growing disparities in health care and environmental threats to our quality of life. The governor even acknowledged the disparities nurse practitioners work to mitigate in a 2024 proclamation honoring nurse practitioners, making his veto even more troublesome.

People should be put first in our long-term community planning, not polluting industries and big developers who pose an existential threat to our health and well-being. This bill was a nonpartisan way to encourage local leaders to use the SDOH data that we already have to improve the health of all Virginia residents. Living in a community with clean air and water, access to health care and food security is a right, not an amenity for those who can afford it. Physicians and medical providers believe this, as well as a bipartisan majority of the General Assembly, and it is disheartening to see that the governor disagrees.

This legislation would have saved lives and improved the quality of life for residents in rural, suburban and urban areas.

Until we make a conscious effort to incorporate SDOH factors in our community planning, we will continue to see higher rates of chronic illness in communities burdened by pollution, scarce access to health care and food insecurity.

Community leaders have to be able to identify the needs of the community before they can even begin to address them.

The writer is the vice chair for Virginia Clinicians for Climate Action.