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Equality and inequality in health is the fundamental attribute of interpersonal relationships in healthcare. Interpersonal power is proposed, multidimensional, and complex that includes interdependence theory, communication theory, and social exchange theory. In the healthcare system, it operates “under the surface” as communication choices are affected even the conflict is not overt (Montesanti & Thurston, 2015). The example could be a nursing professional who disagrees with the medicine prescribed by the doctor. The power here is relevant in all types of conflicts even though the nurse does not say anything at all, share opinions, communicate behavior to enact, and conform the expectations of others. Numerous constructs have been found in the healthcare system and need clarity to eliminate confusion and differentiate from one another (Hatzenbuehler & Pachankis, 2016). Interpersonal power has the relationship between the process behavior and outcomes of how they reach to a patient. It is related to a variety of factors such as environmental and sociodemographic factors beyond their control in providing quality care to adopt specific behaviors and attitudes. This can lead to an increase in knowledge and positive behavior change in professionals of healthcare institutions (Sharma, Pinto & Kumagai, 2018). In the healthcare system, low interpersonal power that is low decision-making power is related to the low morale of patients and loss of control on the bodies. This creates an imbalance between the partners, which is undesirable for both the parties. This gives rise to interpersonal interdependence that is the behavior that gives rise to other persons’ motives, beliefs, preferences, and outcomes (Montesanti & Thurston, 2015).
Social determinants have a great impact on the health conditions of people. These include economic stability, food, neighborhood, and physical environment, community and social context, and the healthcare system. These are the factors that are outside the health system but shape the policies and practices of the health sector in promoting health and health equity (Alderwick & Gottlieb, 2019). Social determinants give rise to relevant contributing factors such as health behaviors, smoking, diet, exercise, and social and economic status in which a person lives. A growing number of initiatives are taken by the government to address the focus on non-health sectors, while others have a great focus on environmental and social health. The availability and accessibility of transportation services affect healthcare, affordable foods, employment, and other important drivers (Alcalá, Sharif & Samari, 2017). Nutritional programs are essential for supporting low-income communities, school programs, and community programs that support the consumption and production of healthy foods. The multi-layer federal and state initiatives in the healthcare system focus on addressing and identifying the non-medical and social needs of patients. Hence, the main challenges to health like social determinants of health have to be managed by enforcing work requirements associated with public programs and reducing funding for public health and prevention (Martinez, Artze-Vega & Wells et al., 2015).
Alcalá, H. E., Sharif, M. Z., & Samari, G. (2017). Social determinants of health, violent radicalization, and terrorism: A public health perspective. Health Equity, 1(1), 87-95. https://doi.org/10.1089/heq.2016.0016
Alderwick, H., & Gottlieb, L. M. (2019). Meanings and misunderstandings: Social determinants of health lexicon for health care systems. The Milbank Quarterly, 97(2), 407. https://dx.doi.org/10.1111%2F1468-0009.12390
Hatzenbuehler, M. L., & Pachankis, J. E. (2016). Stigma and minority stress as social determinants of health among lesbian, gay, bisexual, and transgender youth: Research evidence and clinical implications. Pediatric Clinics, 63(6), 985-997. https://doi.org/10.1016/j.pcl.2016.07.003
Martinez, I. L., Artze-Vega, I., Wells, A. L., Mora, J. C., & Gillis, M. (2015). Twelve tips for teaching social determinants of health in medicine. Medical Teacher, 37(7), 647-652. https://doi.org/10.3109/0142159X.2014.975191
Montesanti, S. R., & Thurston, W. E. (2015). Mapping the role of structural and interpersonal violence in the lives of women: Implications for public health interventions and policy. BMC Women's Health, 15(1), 1-13. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0256-4
Sharma, M., Pinto, A. D., & Kumagai, A. K. (2018). Teaching the social determinants of health: A path to equity or a road to nowhere?. Academic Medicine, 93(1), 25-30. https://doi.org/10.1097/ACM.0000000000001689
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