The case study is talking about the family of a 54years old woman named Carla. Carla married John when she was just a teenager and got two children named Robbie and Annie. Annie lives with her boyfriend Josh of which they are expecting to have a baby soon. From the case, Carla did not do well at school as her guardian aunt was uneducated indicating that she probably drop out of school. However, from the case, Carla can be described as a very hard working person. She was worked in groceries and currently despite her age she still working at the post office. She is also committed, caring as she remained with both her children despite the separating with the husband. She still also tries to take care of her husband who is currently having depression.
John, on the other hand, is also a hardworking man but lack responsibilities. She left her wife and children and only provided for a short period. He is also non-educated as most of the time he depended on casual labor. Robbie seems to be the most educated person in the family as he archived to finish Grade 12. Annie, on the other hand, is a school dropout and currently, she seems to be depending on her boyfriend Josh. Their household is one room apartment indicating they might have a problem when their child will be born. Looking by the type of work all members of the family work, they must be earning very little. Carla even feeds on bread in order to save money for public transport. All members live in small apartments and they are all with no or low levels of education. However, Josh is currently working but planning to quit to reasons such as low earning, and he will be having difficulties when the baby comes so he needs to work more.
The major social determinants of health in the case study include education, employment, income and possibly early marriages. Education equips people with enough knowledge and skills for better health and success throughout life(Smylie and Firestone, 2016). Education allows one to have stable employment with good and enough income to sustain one’s life (aihw.gov.au, 2019). From the case study, Carla did not have a good education to sustain better jobs. Annie also was a school dropout and thus good not secure a better job to support her coming child and live in a better house. If John could have also been having enough education, he could have been able to secure jobs easily, pay for hospital bills after head injury and support his family. All their problems were primarily due to lack of enough education to sustain good jobs with better incomes.
Lack of employment is also a major social determinant of health in this case study. The evidence from the close association established between working and living conditions and the health outcomes have elaborated that human health is sensitive and is effected easily due to social environment. When people lose jobs or unable to secure jobs, they are prone to health problems such as psychological problems, lack of enough basic need and family separations (World Health Organization, 2019). John could not find jobs easily with made him separate from his wife, have depression and finally become dependent. If he could have a more secure job, his children could have attained enough education to support themselves, as proper education provides a stable employment and secure income. Carla also had a problem in looking for jobs as most baseness keeps closing and people moving out. If she could have better employment, she could have been able to at least afford a better house for her unborn daughter.
Income and wealth are among the key determinant of social economic position a person and his or her family has(Marmot, 2005). Higher income allows a person to attain better health status as compared to those with low incomes(Marmot and Allen, 2014). From the case study, Annie has gestational diabetes and often have other related problems like being tired all day. If her boyfriend Josh could have been able to attain higher income, she could not need her mother to take care of her since she could have higher a home-based nurse and a personal doctor. Other than that, John could have been treated head injury without worrying if he was being paid better.
Early marriages affect people since it does not allow a person to have enough time to collect resources that can support his or her children (aihw.gov.au, 2019). Other than that, it prevents people not to gain enough mental, physical and personal skills that could allow a person to take care of his or her family (Duppen et al., 2019). If Carla could have waited a little longer to attain an age of marriage, she could have earned enough with little responsibilities of which later should have been able to support her family through her savings or from personal business.
According to the World Health Organisation (WHO), low levels of education are associated with poor income, unemployment, low incomes, more stress and lack of enough confidence (who.int, 2019). In addition to that, people with low levels of education are usually associated with health illiteracy. According to the Australian Institute of Health and Welfare, only about 40% of people have enough health literacy to do what is needed by medical professional and to deal with every life(Marmot, 2011). In order to combat this problem, certain strategies need to be put into place. These include government support to basic primary and secondary education to all, educating people the need for education and health literacy, and increasing access to health facilities to all Australians. Such strategies if implemented can greatly help to reduce illiteracy in the country and thus helping to improve the overall health problems(Adams et al., 2009). For instances, if the Carla and his family were having enough education, they could have attained good jobs and thus earn better incomes which in turn could have led to proper housing, good health and high economic status(Adams et al., 2009). The development of community-based education strategy, where few professional members will actively participate in the community and help the uneducated people to learn and educate themselves as much as they can. The above strategies can greatly work due to various reasons such as need towards education for a better life and physical stability. One is due to the fact that they address a problem that exists nationally and hence can be targeted as a national strategy helping the people all over the world to utilizes and implementing those strategies to help the sufferers. Once people are educated, they can easily deal with most of the other social determinants of health.
Other than just providing individual care and treatment, health care providers can have a greater impact to reduce and eradicate the negative effects of the social determinant of health. One of the major roles is in advocating the patients and larger communities so that they can overcome the negative effect of social determinant (Johnson, 2015). This means that health care providers talk on behalf of individuals who cannot pay the hospital bill, patients with chronic infections and the disabled and can communicate their perspective to the higher authority so that they can help them to overcome such factors. Other than that, health care professional can also involve themselves in policy-making in order to lead for a change, as the policy will have few updated and required criteria, which must be fulfilled by the government to overcome the issue (Johnson, 2014). These include things like involving themselves in national and local planning in matters like healthcare financing for people with low economic status (Hoover, 2019). In addition, health care providers can also contribute in other health promotion strategies, which will educate them about the factors leading to such issues like taking up health campaigns and health programs. These strategies will enlighten people regarding the importance of disease preventions and patient literacy identifying governmental needs that has to be addressed certifying issues affecting the country such as poverty, employment, and chronic infections.
References
Adams, R. J. et al. (2009) ‘Risks associated with low functional health literacy in an Australian population’, Medical Journal of Australia.
aihw.gov.au (2019). Australia’s health 2016, Chapter 4 Determinants of health – Australian Institute of Health and Welfare. [online] Australian Institute of Health and Welfare. Available at: https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/determinants [Accessed 26 Mar. 2019].
Duppen, D., Van der Elst, M. C., Dury, S., Lambotte, D., De Donder, L., & D-SCOPE. (2019). The social environment’s relationship with frailty: Evidence from existing studies. Journal of Applied Gerontology, 38(1), 3-26. https://doi.org/10.1177/0733464816688310
Hoover, A. G. (2019). Defining Environmental Health Literacy. In Environmental Health Literacy (pp. 3-18). Springer, Cham. https://doi.org/10.1007/978-3-319-94108-0_1
Johnson, A. (2014) ‘Health literacy, does it make a difference?’, Australian Journal of Advanced Nursing.
Johnson, A. (2015) ‘Health literacy: How nurses can make a difference’, Australian Journal of Advanced Nursing.
Marmot, M. (2005) ‘Social determinants of health inequalities’, Lancet. doi: 10.1016/S0140-6736(05)71146-6.
Marmot, M. (2011) ‘Social determinants and the health of indigenous Australians’, Medical Journal of Australia.
Marmot, M. and Allen, J. J. (2014) ‘Social Determinants of Health Equity’, American Journal of Public Health. doi: 10.2105/ajph.2014.302200.
Smylie, J. and Firestone, M. (2016) ‘The Health of Indigenous Peoples’, in Social Determinants of Health: The Canadian Perspective. doi: 10.1016/B978-012288145-9/50048-6.
who.int (2019). WHO recommendations on health promotion interventions for maternal and newborn health 2015. [online] World Health Organization. Available at: https://www.who.int/maternal_child_adolescent/documents/health-promotion-interventions/en/ [Accessed 26 Mar. 2019].
World Health Organization. (2019). Social determinants of health. Retrieved from https://www.who.int/social_determinants/en/
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