Social Determinates of Health (SDOH) on Family’s Health Status
Introduction
The World Health Organization (WHO) defines social determinants of health (SDOH) as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels” (WHO, 2020). This SDOH entails the specific economic and social surroundings that considerably affects the health status of an individual or group. A Family Health Assessment depicts different acts taking into account a precise family as a client who is evaluated to ascertain the family’s ability to resolve, prevent and control issues/causes for ailment and health problems among the family members. The paper assesses the impact of SDOH on family health status identified in the previous assessment and debates on the social-ecological model with its relevance in health promotion strategies for this family.
SDOH effect on family health status.
The conditions in the residences where individuals reside, learn, work, and play impacts on their health risk exposures and outcomes. SDOH necessitates promoting the living and working conditions that affect these individuals’ exposure to diseases or vulnerability to injury or infections as a way of promoting health. The SDOH points out the environmental factors that shape the resources, power, and money distribution, at certain societal levels (Garg, Boynton-Jarrett, & Dworkin, 2016). These factors include socioeconomic status, neighborhood and physical environment, education, social support networks, employment, and access to health care (see Figure 1). These determinants primarily surround a person right from birth through his/her bring up. The economic and social policies, as well as education, may for instance influence the ability of the family to access medical care and health screening. For example, the assessed family have access to school and are thus elite who have limited time to spare for exercise because of their tight school and work schedule. This might hamper their health condition if they neglect physical health.
Besides, having access to housing facilities and critical services might give the Mrs. Jean sleepless nights and stress as the household is a demanding aspect in terms of access to foods to support her family’s healthy eating patterns. Irrespective, the choices and access to healthy food are critical in a moderately healthy family. Mr. Jean is a prostate cancer survivor he is in remission for five years now. As the head of the household, he might be experiencing stress because of his occupational status as a school bus driver an aspect that might be related to his elevated cholesterol levels. As a church-going and community membership family, social support and coping skills are critical in family health. The family generally exhibit healthy behavior.
Recommendations for age-appropriate screenings each family member
Health screening is primarily evaluated five core social needs correlated to health. According to Hawk & Evans (2013), asking valid screening questions about social needs like utilities, food, transportation, housing, and personal safety are important in healthcare practice. In this context, screening tools such as SDOH Patient Action Plan, SDOH Short-form, and SDOH Long-form screening tools are applicable and implemented in screening procedures. For both the son and daughter of Mr. and Mrs. Jean, performing a cancer screening would be recommended in their age of 20 – 45 given their fathers and family health care history on cancer. For women in the daughter’s age, their normal cholesterol levels do not need to have the test repeated for 5 years. Generally, at the age of 20 – 40, a routine cholesterol check should be completed in their twenties, and annually once they turn 35. Mrs. Jean, aged 57 who is under the age of 40 – 65 needs to be screened for blood pressure, cholesterol levels, diabetes, and cancer as this age is characterized by many health complications for women (Medline Plus, 2020). At the age of 60, Mr. Jean falls under the high-risk population who require bone density study every two years. Additional screening may be necessary if the assessment is based on his personal and family medical/health history. For instance, recommending a CT lung cancer screening on him is crucial. All the questions in the screening procedure need to evaluate the educational background, personal safety to help to administer any assistance to the family members in this case. Assessing the parents about their occupations, housing, and foods should be included as they compose the background to health access.
Bronfenbrenner’s ecological model and its applicability
Bronfenbrenner’s ecological model is widely known theoretical frameworks in human development which contemplates the undercurrents of the environmental and personal dynamics interrelations. The model esteems the psychological and biological make-up of an individual with reliance on the genetic and personal developmental history (Vélez-Agosto, Soto-Crespo, Oppenheimer, Molina, & Coll, 2017). The social and physical environment has a significant influence on the development of an individual and the family’s health status in general. The model is effective for the family in this case as it would help in the social and psychological development of the children, as well as help Mr. and Mrs. Jean to conform to the recognized pattern in the model. Based on figure 2, the model deliberate on various patterns or environments including the microsystem, mesosystem, exosystem, macrosystem, and chronosystem. The microsystem influences them as well as their son and daughter’s life. For example, their son and daughter’s school life, peers, and friends make up their microsystem while for Mr. Jean and Mrs. Jean it is their workplace, neighborhood, and religious beliefs.
The steps for family-centered health promotion and health communication strategies.
Promoting the health of Mr. Jean’s family is centrally based on the ability of the family to incorporate routine family outdoor exercise or activities amid their tight schedules. Creating a schedule alongside either schooling or work or family time might enhance their physical activity as a family and better their longtime health status. The second step might have to do with reducing the stress that Mr. and Mrs. Jean experiences at their old age by increasing their interaction with their family and community. As mentioned in the case, after surviving cancer, Mr. Jean struggles with elevated cholesterol levels that could have a further complication in the case stress kicks in. As mentioned early, reducing stress in a family especially for the adults will benefit at the workplace or household chores
The communication strategies to be included in this case could be understanding the conventional conceptions correlated to the settings and culture prevalent to Mr. Jean’s family. Secondly, it is wise to consider cultural competence and the health literacy of this type of target group. Most families require a vast education to understand their hereditary genetic health matters therefore educational platforms such as educational seminars for the children and using billboards, social networks, and prints can help educate adults.
Figure 1 SDOH
Figure 2: Bronfenbrenner’s ecological model
References
Garg, A., Boynton-Jarrett, R., & Dworkin, P. H. (2016). Avoiding the unintended consequences of screening for social determinants of health. JAMA, 316(8), 813. doi:10.1001/jama.2016.9282
Hawk, C., & Evans, W. (2013). Health promotion and wellness: An evidence-based guide to clinical preventive services. Lippincott Williams & Wilkins.
Medline Plus. (2020). Health screenings for women ages 40 to 64: Medline Plus medical encyclopedia. Retrieved from https://medlineplus.gov/ency/article/007467.htm
Vélez-Agosto, N. M., Soto-Crespo, J. G., Oppenheimer, M. V., Molina, S. V., & Coll, C. G. (2017). Bronfenbrenner’s Bioecological theory revision: Moving culture from the macro into the micro. Perspectives on Psychological Science, 12(5), 900-910. doi:10.1177/1745691617704397
WHO. (2020). About social determinants of health. Retrieved from https://www.who.int/social_determinants/sdh_definition/en/