Social Determinant of Health
The quality of health is determined by an individual’s environment and access to various opportunities. Typically, people upholds their health by eating healthy and being physically active. Furthermore, access to quality healthcare plays an instrumental role in upholding the quality of life of an individual. In essence, various factors bar people from accessing quality healthcare. The factors are denoted as social determinants. Most social determinant of health factors are linked to an individual’s academic back ground, home environment, neighborhood, workplace safety, and the cleanliness of the food, water and air (Center for Disease Control and Prevention, 2018). The social determinants differentiate the disparity in health among people in the community. It is prudent for health personnel to identify the social determinants of their patients to establish any barriers to effective care for the patients. Furthermore, doing so will aid the health personnel to know the ideal intervention and treatment to accord a patient.
Nurses can use various strategies to determine their patients’ social determinants. One of the best data collection methods is an open-ended questionnaire. According to O’Cathain and Thomas (2004), use of open ended questions in questionnaires plays a significant role in seeking clarifications and disclose hidden information the researcher did not know about a patient. Notably, it aids the health personnel make informed decision the best treatment to accord the patient. I formulated five questions to assess the patient’s social determinants of health. The questions are
1. What is your highest level of education and job specialization?
I have a Bachelor Degree and working as University Staff.
2. Do you have insurance or access to quality healthcare?
I have medical insurance provided by my employer. I risk losing it now that am nearing retirement.
3. What kind of society or neighborhood do you live in?
My neighborhood comprises of many single-family houses and has sidewalks. Most social amenities are close to the place I live especially the grocery store and gas stations. Moreover, I drive myself most of the time thus accessing the social amenities is not a challenge.
4. What is your home environment like (is it supportive or stressful, do you have children, a wife or a person you live with)?
I am married and got one child. My home environment is supportive.
5. What are your interest and hobbies?
I like cooking and artistic works. Most of the times am indoors either drawing or surfing the internet for the latest development in technology. I like doing research. I also like going out with friends to have drinks at our favorite joint.
Another ideal assessment strategy to apply on the patient is the patient teach back method. The technique entails confirming the patient has understood health education passed to them by a health professional by asking the patient strategic questions (Agency for Health Care Research and Quality, 2015). In essence, the techniques helps a health professional to identify the points the patient did not understand for further clarification. After filling the questionnaire, I asked the patient oral questions associated with the questions he had filled to confirm whether the information he had provided was correct. He responded effectively thus assuring me that the information he had filled was correct. The patient confirmed that his lifestyle had contributed to his health condition since his neighbor did not promote physical activities considering social amenities were near. Moreover, his interests were indoor activities. I also had a one on one interview with the patient where he opened up about his health condition and its association with his lifestyle.
Impact of Patient’s Social Economic Ability on Health
Assessment of the patient’s social economic ability shows that the individual has the potential to afford quality healthcare but lacks awareness of upholding quality healthcare. The patient has medical insurance thus can access quality healthcare. Moreover, the patient works in a renowned institution; consequently, he can afford quality healthcare in an instance where the health insurance cover is limited. The patient has been in employment for a long time and is due to retire in a few years. The socioeconomic ability of the patient will dwindle upon retiring and is likely to lead to a crisis in the family. He is likely to lose his medical insurance cover upon retiring, and with his reduced income, he might find it challenging to afford quality healthcare. In light of the above, the patient’s future economic stability has a significant impact on his health considering he is suffering from a cardiovascular complication.
Education is an important social determinant of health. According to Shankar, Khalema, Couture, Tan, Zulla and Lam (2013), higher education plays a significant role in shaping an individual employment opportunity. Higher education achievement opens an individual to lucrative employment opportunities and improves an individual decision making ability on health issues. The patients is a bachelor’s degree holder, which has earned him a well-paying job at the university. Zulla and Lam assert that education enables an individual to secure a job that allows him to provide for his family (2013). The patient is well paid as he can afford a luxurious lifestyle. He lives in an upscale neighborhood. The man is enlightened considering he knows the latest development in the technology. Access to the internet allows the individual to conduct vast research on topics of interest. The patient shows he has vast ability to make informed decisions about his health. Unfortunately, the patient lacks awareness of the impact of his lifestyle on his health.
Literacy is the capability of an individual to read and write. The patient is highly literate considering his academic qualifications. Health literacy, on the other hand, is the ability of an individual to access and process health information and health services thus enabling him or her to make an informed decision (Office of Disease Prevention and Health). Factors such as an individual’s culture lay and professional knowledge of health topics determine the health literacy of a patient. The patient has a Bachelor’s degree thus can make informed health decisions. Moreover, the patient has an excellent opportunity to obtain health information since he has access to the internet. For this, the patient is likely to make an informed decision and take charge of his health. However, in this instance, the patient is ignorant of the effects of his lifestyle on his health; he chooses to live an unhealthy lifestyle at the expense of his health. For this, it is ideal to conclude that he has contributed partially to his health predicament.
The patient’s education level creates numerous health opportunities and limited barriers for the patients. The patient can surf the internet for the latest health information about his condition and the strategies he can apply to improve the quality of his health (Office of Disease Prevention and Health). His education has secured him medical insurance through his job. His education has given considerable purchasing power that he can afford a luxurious life. Poor social interaction is a major hindrance to upholding quality health for the patient since he is alcoholic thus is likely to interact with alcoholics. Associating with people who practice a certain habit encourages an individual to uphold the behavior (Shankar et al., 2013).
Health and HealthCare Status
The patient is living an unhealthy lifestyle that is likely to aggravate his health condition. According to the National Institute on Alcohol Abuse and Alcoholism, heavy drinking is likely to lead to blood clots, which makes an individual prone to heart attacks or strokes. In essence, alcoholism makes the patient vulnerable to getting anemia since heavy drinking destroys red blood cells, which carry oxygen throughout the body (National Institute on Alcohol Abuse and Alcoholism). The patient’s inactivity might make him gain weight uncontrollably making him obese. In return, the patient is likely to get high blood pressure and diabetes because of increased sugar levels in his body. In light of the above, the patient’s lifestyle reduces his quality of life gradually. Unless the patient takes the necessary precautionary measures, he is likely to suffer significantly in his old age.
The patient is living in a high-income area. The patient has an effective means of transport to access healthcare facility for he own a car. Moreover, people living in high-income areas have a high purchasing power attracting all sort of businesspersons. For this, licensed healthcare personnel are likely to establish healthcare clinics in the regions ensuring access to quality care for the individuals. He has access to healthy foods considering there is a grocery in the neighborhood where he can source fresh fruits and vegetables. Notably, patients living in up-scale areas are likely to suffer from various lifestyle conditions such as obesity, diabetes and cardiovascular complications because of their unhealthy lifestyles and poor eating habits.
Persons living in upscale areas have the ability to afford quality healthcare considering most of them have effective means of transport to access healthcare facilities. Moreover, most of them have financial power to afford quality healthcare since most of them can afford to pay for medical insurance. The situation is different in low-income areas where healthcare clinics are limited and crowded. It makes access to quality healthcare challenging because the individuals have limited purchasing power. Furthermore, the quality of healthcare in the regions is limited considering most patients cannot afford specialized care. Patients living in low scale areas have limited chances of suffering from lifestyle conditions such as obesity, diabetes and cardiovascular complications since they have limited purchasing power to afford foods and drinks that can contribute to lifestyle diseases (Bissonnete et al., 2012). Moreover, they engage in various physical activities in their jobs.
Notably, patients living in rural areas face challenges accessing healthcare facilities considering the region’s infrastructure is poor especially transport system (Sherwood & Barnsteiner, 2017). The healthcare facilities in rural areas are underequipped because of limited infrastructure such as electricity and most lack qualified personnel (Bissonnette et al., 2012). Furthermore some hospitals lack essential vaccines to be offered to patients since they lack the necessary equipment to preserve them. The quality of healthcare in the urban centers on the other hand is advanced considering most healthcare facilities are well equipped and have qualified personnel to accord patients quality healthcare (Office of Disease Prevention and Health). Moreover, the hospitals have sufficient medicine stock since they have the facilities to preserve most medicine especially vaccines. The hospitals are linked to crucial infrastructure such as electricity and water. Patients in urban centers can access healthcare facilities easily compared to those living in rural areas. the only similarity between rural and urban healthcare facilities is that they both have the capability to offer basic healthcare services. the quality of health in urban centers is advanced compared to rural areas.
Addressing social determinants
Social determinants determine the quality of health of a patient. The major social determinants that need addressing are health literacy, access to health, and access to technology. The three social determinants are reducing the quality of life of the patient and aggravating the health condition of the patient.
Health Care Plan
The medical records of the patient show that the patient might be suffering from a cardiovascular complication thus I will refer him to a cardiologist for a thorough diagnosis. I will then advise him on the health complications of alcoholism on the patients since his alcoholism puts him at a significant risk of suffering major cardiovascular complications that can lead to death if not attended to efficiently (National Institute on Alcohol Abuse and Alcoholism). I will advise to seek help in a rehabilitation center in case he finds quitting the habit challenging. I will request a physiotherapist to help me develop simple works for the elderly patient to exercise regularly to reduce his inactivity. According to Booth, Roberts and Laye (2014), I will encourage him to be taking long walks and limit driving often to increase his physical activity. The barrier am likely to experience is lack of co-operation from the patient considering is old age. I will monitor the patient’s progress by making him visit the healthcare facility one bi-weekly.
Conclusively, the patient lifestyle and limited health literacy have contributed to his healthcare condition. However, with the right intervention, the patient is guaranteed of maximum recovery. The patient is fortunate he has limited social determinants that are easily addressable.
Agency for Healthcare Research and Quality. (2015). Health Literacy Universal Precautions Toolkit, 2nd Edition. Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html
Bissonnette, L., Wilson, K., Bell, S. & Shah, T. (2012). Neighbourhoods and potential access to health care: The role of spatial and aspatial factors. Health & Place. 18(4). 841-853
Booth, F. W., Roberts, C. & Laye, M. (2014). Lack of exercise is a major cause of chronic diseases. Comr Physiol. 2(2). Pp.1143-1211
Center for Disease Control and Prevention. (2018). Featured Resources Addressing Social Determinants of Health. Retrieved from https://www.cdc.gov/socialdeterminants/
National Institute on Alcohol Abuse and Alcoholism. (n.d). Alcohol's Effects on the Body. Retrieved from https://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body
O’Cathain. A & Thomas, K. (2004). "Any other comments?" Open questions on questionnaires – a bane or a bonus to research?. BMC Med Res Methodol. 4(25)
Office of Disease Prevention and Health. (n.d). Social Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Shankar, J., Ip, E, Khalema, E, Couture, J., Tan, S, Zulla, R., & Lam, G. (2013). Education as a Social Determinant of Health: Issues Facing Indigenous and Visible Minority Students in Postsecondary Education in Western Canada. Int J Environ Res Public Health. 10(9). 3908-3929.
Sherwood, G. & Barnsteiner, J. (2017). Quality and safety in nursing : a competency approach to improving outcomes. Hoboken, New Jersey: Wiley Blackwell.