Health and Society – Case Study

Background of Patient

From the case study, Poole is old and socially excluded. She is 74 years of age and lives alone in a rural town. Also, she is an introvert, since she does not often leave home. Her husband died half a year ago, her son lives far away in Western Australia, and her daughter has family commitments to her three children and husband. Lauren, Poole’s daughter, is the only family member who seems to support her since they talk over the phone every day. She lives near a city and has a reasonably appropriate physical environment. Poole is relatively active in her activities of daily life, but her medical history reveals a range of health issues related to old age, nutrition, and external factors. For instance, Erzen & Çikrikci (2018, p.5) reports that living alone, and social exclusion is directly linked to mild depression. Also, her report indicates that she has lost appetite, which is a risk factor to malnutrition and related health issues. Poole’s background prompts a reflection of the social determinants of health in her case study.

The Social Determinants of Health

According to WHO, “social determinants of health are the conditions in which people are born, grow, live, work and age” (“Social determinants of health,” n.d.). Social determinants of health are grouped into five themes that concern education, neighborhood and living standards, socioeconomic status, social support, and healthcare. They were identified by the WHO’s Commission of Social Determinants of Health after evidence that the health of an individual is influenced by both medical care and social factors (Braveman & Gottlieb, 2014, p.19). For instance, some of Poole’s health issues are hypothetically caused by social determinants. Precisely, her recorded mild depression may be an outcome of social exclusion, and grieving on the loss of her husband. Old age care services might have mitigated her malnutrition and loss of appetite, but that social support is not available. Besides, while she is fairly active, she has underlying health conditions such as diabetes, hypertension, and hypercholesteremia, which require critical health care. Some of the social determinants that arise from Poole’s case study are described below.

 Economic Stability

This socioeconomic metric concerns the economic status of an individual regarding their employment status, food security, housing stability, and poverty. According to WHO, employment status or the capacity to earn an income clarifies the occupational threats to an individual’s health (“Social determinants of health,” n.d.). From the case study, Poole is fairly economically stable. First, she does not have a caregiver at her home. Secondly, she attends to her garden, which is a risk factor to falls. Thirdly, she does not have a private means of transport and relies on public transport. Hence, Poole does not have access to critical safety and care facilities, which could mitigate her falls, depression, and poor eating habits.

Health and Healthcare

This determinant entails the healthy lifestyle patterns of individual such as access to food and nutrition, and access to primary health care (“Social determinants of health,” n.d.). Innovative healthcare integrates other social determinants and follows up on an individual to reduce readmission. For instance, Poole’s medical history reveals cases of bilateral knee replacement and osteoarthritis, which are a risk factor to falls. Hence, previous treatment sessions could have recommended a caregiver, and walking support to combat falls. Concerning food and nutrition, individuals’ access to a balanced diet and appropriate eating habits mitigate health issues. Nevertheless, Poole does not eat enough due to the loss of appetite.

 Community and Social Context

It entails social integration, community engagement, social support system, discrimination, and mental health. Social exclusion is the instance of inadequate social engagement of an individual in the community or social life (“Social determinants of health,” n.d.). It may lead to psychological health issues or harmful behaviors. From Poole’s case study, she is an introvert; hence she does not engage with other community members. She lives alone, and the only person actively connected to her is her daughter, through the phone. Thus, she faces risks of poor dietary habits, stress, and burnout due to lack of caregiver or helper.

Recommendations

Since social health determinants are critical to an individual’s health, they must be integrated with medical care to enhance the effectiveness of the treatment process. Notably, while only three determinants are listed above regarding Poole’s case study, there are other related determinates, which would as well influence her health outcomes.

Firstly, there is a need to improve the economic status of Poole.  Studies have shown that the health outcomes of an individual are directly related to their socioeconomic status (Wang & Geng, 2019, p.2). In Poole’s case, socioeconomic issues identified include lack of a private means of transport, and home help or caregiver. Given that she attends to all her daily life activities wither underlying health conditions, it appears that she cannot afford the home services. Therefore, it is imperative to consider the probable sources of income for Poole, accounting for her lack of details concerning sources of income in the case study. Firstly, she should be enrolled in the 2020 Aged Care Approvals Round (ACAR).

Given that she lives near Sidney, she has the eligibility of living near a large metropolitan region (ACAR, 2020). The ACAR fund may help in hiring a caregiver or uncovered healthcare services such as therapies. Secondly, her family, mainly Lauren and Jason, ought to support their mother economically. They may facilitate the hiring of a caregiver to help her in household activities and take care of her health. Besides, a private transport system may be appropriate for Poole to ensure appropriate management for her health conditions. Hence, her family ought to facilitate the procurement and management of Poole’s private transport system. Overall, Poole’s may rely on government funds or charity groups and family to enhance her capacity to afford a caregiver, uncovered health issues, and private transport.

Secondly, there is a need to re-evaluate the heal and healthcare management of Poole. Some health issues identified in her case include underlying health conditions and poor eating habits. Each of these issues is critical in that they influence the quality of a healthy lifestyle Poole lives. For instance, a diabetes type 2 patient may experience loss of appetite, which causes malnutrition, hence poor support or mobility and deteriorates their health conditions. In connection with the caregiver recommendation, eating with someone might motivate her to overcome the loss of appetite, and eat a balanced diet. Secondly, she ought to consult a nutritionist to advise the best eating frequency for her. Studies have found that management of health such as dietary patterns and frequency influences appetite, hence is manageable (Leidy & Campbell, 2010). Besides, her underlying health conditions like has type II diabetes, hypertension, osteoarthritis, and hypercholesteremia, and mild depression require medical attention. It is part of the philosophies of comprehensive healthcare, to ensure that a patient’s holistic healthcare needs are addressed. That way, it is possible to combat health risk factors such as impaired vision or bilateral knee replacement and osteoarthritis, which is prone to causing falls. Also, there is a need for management of Poole’s health care through follow up programs to ensure that she completes her medication to reduce the chances of readmission. Therefore, management of underlying health conditions and the risk factors that may deteriorate Poole’s health outcomes are critical for her treatment.

Lastly, there is an opportunity to improve social integration, community engagement, social support system, and Poole’s mental health. Firstly, Poole does not often leave her home. Therefore, she has socially self-excluded herself from the community. To mitigate the risk factors of social exclusion, she ought to join community groups or forums. That way, she will have a purpose to move out and participate in community programs. Secondly, she needs a social support system. Study shows that people who have reliable social support systems are less likely to suffer illnesses (Braveman & Gottlieb, 2014). The potential social support for Poole includes a caregiver, frequent visits by her children, and active involvement in per groups. Besides, the quality of caregiving and social inclusion is paramount. Studies have shown that through inclusion, older adults can reflect on their lived experiences and gain a deeper understanding of their experiences (Knight & Mellor, 2007). Hence, inclusion in poorly managed community forums may lead to regrets and, in severe cases, mental health issues. At old age, like Poole, people are vulnerable to health issues and require support for their activities of daily living. Such social systems and social inclusions are critical strategies to mitigate mental health issues for older adults. That is, external help to accomplishing tasks or financial and psychological help helps in coping with environmental stress. Therefore, Poole requires an appropriate social support system in her old age development stage.

References

“Social determinants of health”. About social determinants of health. Retrieved 29 May 2020, from https://www.who.int/social_determinants/sdh_definition/en/

ACAR. (2020). Aged Care Approvals Round (ACAR). Retrieved 29 May 2020, from https://www.health.gov.au/health-topics/aged-care/providing-aged-care-services/funding-for-aged-care-service-providers/aged-care-approvals-round-acar

Braveman, P., & Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Reports, 129(1_suppl2), 19-31. doi: 10.1177/00333549141291s206

Erzen, E., & Çikrikci, Ö. (2018). The effect of loneliness on depression: A meta-analysis. International Journal Of Social Psychiatry, 64(5), 427-435. doi: 10.1177/0020764018776349

Knight, T., & Mellor, D. (2007). Social inclusion of older adults in care: Is it just a question of providing activities?. International Journal Of Qualitative Studies On Health And Well-Being, 2(2), 76-85. doi: 10.1080/17482620701320802