Health starts in our workplaces, schools, homes, communities and neighborhoods. Resources available in our environment and homes as well as accessibility to economic and social opportunities has significance in our health.
Social determinants of health are economic and social factors that affect people’s health. They are apparent conditions and settings in the environment in which people are born, live, play, worship, learn, heath system, quality of life and risks. Furthermore, sense of security and patterns of social engagement and wellbeing are determined by the place where people stay or live. Resources such as public safety, access to education, affordable housing, health services and availability of health foods are significant determinants in population health.
In this report writing, I am focusing on Eileen’s Poole case study to identifying any issues related to the social determinants of health that may impact patient’s treatment and recovery.
Mrs. Eileen Poole is a 74 years old widow who lives alone since her husband died about six months ago. Since the death of her husband, Eileen mostly stays at home because she does not drive and therefore she relies on public transport. At home she does fairly well in gardening and management of house chores. Eileen was born in Scotland but moved to Australia with her parents while still a young girl. She later moved to a rural town known as Miami when she got married to her husband of 51 years old. Eileen has two children, Laureen and Jason. Jason is 32 years old and lives in Western Australia while Laureen is 35 years and lives with her husband and their three children 5 kilometers away from Western Australia. Laureen and Eileen are so close and they speak on phone every day.
Eileen has hypertension, type II diabetes, osteoarthritis and hypercholesteremic. She was recently diagnosed with mild depression and she is now on antidepressants. Five years ago, Mrs. Poole had a bilateral knee replacement and with the help of physiotherapist she was under rehabilitation and recovered well. Mrs. Poole manages her daily activities and she is very mobile but does not use any mobility aids. However, she uses glasses while reading.
Mrs. Poole was admitted overnight to the ward via operating theatre following closed reduction and application of backslap. Mrs. Poole right wrist is impaired, has some bruising on the right fingers, her pupils are equal and reactive to light, her left upper limb has normal strength and sensation and other limb observation are within normal limits. Blood Glucose level is 7.2mmol and Fluid Balance Chart indicates positive balance of 300ml while her skin integrity is fair and no wounds noted. Mrs. Poole is on a light diabetic diet. She is having 73kg weight and has been ordered to light diabetic diet. However, she needs cannot feed herself with her left hand and therefore she needs assistance.
Social determinants of health are nonmedical features that can affect a person’s health outcomes and overall health. Someone place of birth and social conditions in that place has significant influence in his or her life expectancy. The impact of social issues is seen in numerous individual health outcome. For instance, lack of social support and social exclusion are associated with poor health care self-management and reduced primary health care.
Social and environmental factors such as limited access health care, lack of social support and exclusion and poor functional status, difficulties with housing and transportation are major determinants in health care system.
Social determinants of health (SDH) are defined as “the conditions in which people are born, grow, learn, work, live, worship and various set of systems and forces shaping daily life”. SDH have significant influence on health outcomes and they include factors like socioeconomic status, neighborhood, physical environment, social exclusion or inclusion, health food availability, education, social support, access to healthcare and employment. In this case study I am focusing on the relevance of social exclusion, transportation options and housing in patient treatment, management and recovery.
Social exclusion is one of the social determinants of health. According to World Health Organization(WHO) report on social exclusion and poverty stated that poverty and social exclusion are driving factors of health iniquities for large populations. Groups that are generally vulnerable or at risk of social exclusion in health care include people who are homeless, people with disabilities, people with mental health problems, women and children, single parent families and adults.
Social exclusion has direct and indirect influence in health. Primary healthcare providers need to understand and find solutions to exclusionary processes being experienced by their patients to ensure healthcare management and treatment despite with real medical issues.
Social support is significant to health and quality of life. Social support simply means having other people, friends and family turning up to you during time of need. Health care providers in hospital and community practice settings are well trained to identify the social factors that might affect the patient’s treatment and management as well as general health outcomes. They can analyze and come up with solution based on the situation. For example, during consultation a patient may depict physical symptoms which root cause maybe due to social needs.
Most health care providers including nurses and general health practitioners recognize the importance of social determinants in primary care provision. They understand that patients’ social needs are equally important as their medical needs in treatment. Clinical physicians need to understand the root cause of an illness and factors that influence treatment and management. Addressing social determinants of health is key in achieving equality in health sector.
From the case study report, Eileen is old and she now lives alone since the death of her husband. She has hypertension, type II diabetes, osteoarthritis and hypercholesteremic. She was recently diagnosed with mild depression and she is currently on antidepressants. Her health problems are more due social determinants of health such has lack of social support, social exclusion and inclusion. She has no one to stay with and she might be suffering from stress especially that she recently lost her husband. She rarely goes out instead she spends more time at home which. Risk factors such as physical inactivity, sedentary behavior and unhealthy eating.
Physical activity helps in controlling body weight and in combating various health conditions and diseases such as hypertension, depression, anxiety, stroke, and cardiovascular diseases. When an individual engages in regular exercise or physical activity ensures smooth blood flow, thus a decrease in cardiovascular diseases, one burns calories and therefore help in management of diabetes and hypertension. Unhealthy eating habits can lead to health problems, including obesity and related diseases. Overweight is known to increase the risk of heart disease, diabetes, and stroke, among various other conditions
Eileen’s health conditions need extensive understanding of her social determinants in primary care management. She needs a regular physical activity, someone to help her in daily home duties, someone to stay with. She also needs to manage lifestyle.
Maness, S. B., Buhi, E. R., Daley, E. M., Baldwin, J. A., & Kromrey, J. D. (2016). Social determinants of health and adolescent pregnancy: An analysis from the National Longitudinal Study of Adolescent to Adult Health. Journal of Adolescent Health, 58(6), 636-643.
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2017). Health literacy and the social determinants of health: a qualitative model from adult learners. Health promotion international, 32(1), 130-138.
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