What are the characteristics of the individuals in this case study?
Carla is a middle-aged woman, 54 years old, living in a small, rural mining town. She currently lives alone on a single income, but has 2 children and an ex-husband that are some-what dependent on her. The Australian Bureau of Statistics (2012) indicates that the number of one-parent families is made up of 81% single-mother households. Her ex-husband has developed a mental disorder and her eldest daughter is pregnant, these life stressors are said to increase future prevalence of linked mental health problems as well as a decrease in physical and social health status if not intervened sufficiently (Schneiderman et al. 2008). Carla has very little income and is of a low socioeconomic status and has received little education throughout her life. Being of a low socioeconomic status shows a statistical secondary schooling completion rate of just over 60% (Polidano et al. 2013). Average income in later life for those with no post-secondary qualifications is 24% less than those whom completed tertiary education (Anon 2013). Her lifelong friends no longer reside in the town and social isolation is becoming prevalent. Her overall health is diminishing as her lifestyle stressors increase and her family situation becomes direr. Thus biopsychosocial elements of Carla’s life greatly influence her overall health and that of her families.
What are the social determinants of health that are evident in the case study?
Social determinants of health can be broadly defined as the factors that influence health such as social, economic and political resources (Baker et al. 2009). The conditions in which we live, work and grow significantly define our health outcomes. As an elderly woman living in rural/remote community Carla experiences significant burdens in relation to transport, social isolation, job security and employment and food security. These encumbrances place further stress on her placement upon the social gradient and her relative socioeconomic status. Carla previously worked in grocery and retail positions, in which, The Australian Bureau of Statistics (ABS, 2013) summarizes individuals that receive lower incomes portray significant impacts in their economic wellbeing and health status. Carla currently receives minimal income from cleaning services she supplies around the town. Carla’s education was insufficient in preparing her for qualified employment and neither of her children commenced greater levels of schooling. Completion of secondary schooling has been positively correlated with improved health on a physical and economic level in aforesaid individuals future, similarly, the education of immediate family and neighbors is alleged to support the completion of education by those in direct contact (Myhr et al. 2017). Living rurally a foremost concern is the access to primary health care and hospital care available to residents and transport to and from these services (Hartley 2004). Carla’s lack of education and augmented stressors throughout her early life, that is the stress of her parents’ death and therefore interrupted up-bringing, predispose her unbeknownst understanding of health and nutrition as well as her poor employment status and low socioeconomic standing (Emily B. Zimmerman, Steven H. Woolf 2015). Being of a lower socioeconomic status, chronic stress can apprehend a variety of social outcomes that are associated with poor health (Baum et al. 2007). Food security can relate to the affordability, accessibility and availability of healthy and nutritious food. P. Ward, et al. (2012) explains that the cost of food tends to be a major contributor to meal preparation amongst a low-income household, thus making healthy choices tenuous leading to greater health problems. The state of poor physical health can subsequently impact on mental and social health as life stressors are amplified by degradation of health status. Family dependency and mental health issues relating to her ex-husband, as well as her daughter’s pregnancy and social isolation are chronic stressors that Carla faces in her current situation. Social relationships provide a sense of connectedness and networks for support that are an integral factor of positive mental health (Australian Bureau of Statistics (ABS) 2009).
Select one of these social determinants and describe the best way(s) to address this issue in order to have an impact on the whole of population?
To improve health on a population level the education of individuals and communities must first be addressed. Education as a determinant that not only refers to the general standard achieved by an individual but also the acknowledgement of health literacy and community interventions to provide an understanding of available treatments and facilities. Education is an important social construct that can shape individual and community health outcomes in the future (Kelleher & Hagger 2007). The main strategy is to address the provision, accessibility and quality of education in rural areas to promote and support health literacy in adolescents and children, and to create an understanding in adults and parents about how these strategies can be implemented in everyday life. This can be approached in ways of supplying similar funding to rural schools that mirror that of urban populations (Barclay 2013) in regards to teaching staff and incorporation of health related learning in the broader curriculum. Strategies such as Health classes with aspects relating to how to maintain being healthy and nutritious eating can implant ideations into how adolescents and children view health. Health campaigns run by the government such as ‘Swap it don’t stop it’ are in place to promote small changes in people’s everyday lives to improve health and wellbeing, but targets whole communities, particularly adults, at any given time. These varieties of health promotion have a strong impact on education of large groups of people at once about how they can make a difference in their health and the importance of upholding these changes. Improving the access to health information and their capacity to use it effectively, is reasoned to improve health literacy which in turn empowers communities and individuals (Nutbeam 2006). Access to education in rural settings can sometimes involve traveling significant distances which in turn has its effect on individual learning capacity, thus improving transport options in the way of buses and public transport can assist in an advance in health literacy. Individual involvement in the community can be seen as a form of education, especially when health campaigns or fundraisers are involved that help raise awareness to major non-communicable lifestyle diseases and improve education on prevention of these matters. Improving the promotion of a healthy lifestyle and proper education through advertisement in supermarkets or at local community events will in response improve health outcomes of targeted individuals and communities (Kumar & Preetha 2012). The inescapable conclusion is that to address the determining factor of education, health inequalities must first be expunged.
What roles should health professionals play in addressing this issue?
Health care workers are major educators and promotors of health within the community. The social determinants of health have a significant impact on the health of people within communities, and also influence the sustainability and availability of health services. Thus it is integral that primary health care practitioners and health professionals recognize these impacts of factors like education on the health outcomes of those in a rural community and address issues relating (Anon 2013). A health professional has many options for care including patient care, person-centered care and community-based approaches. For a primary health system to be accessible it requires a dynamic program running on a number of research based approaches that address low levels of health literacy, also that the health care practitioners are aware of the widespread issues surrounding heath literacy which span all age levels and socioeconomic backgrounds (Kelleher & Hagger 2007). As a health professional the avocation, implementation and accessibility of health information and literacy should be upheld as a number one priority in their everyday occupations.