Give an example that illustrates how the social determinants of health from your community health clinical or other practicum

Purple Group – SG Hospital

COLLAPSE DT

Give an example that illustrates how the social determinants of health from your community health clinical or other practicum ( e.g, 429) influences health outcomes.

Describe the reasons for the health care disparities.

What interventions could reduce the health disparities/health inequalities in your population? 

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         During my practicum sessions, social determinants of health affect those babies as much as it does adults. Babies in the NICU have longer recovery times and poorer outcomes based on social factors that are embedded in their families lives. I have seen babies on c-paps improve quickly when their parents were there almost everyday and invovled in necessary duties. I have noticed that parents who have lower resources, education level, money, and power can not be with their babies as often as they would like to. Parents, especially mothers, can not spend time with their babies in the NICU if other social factors are impacting them. This in turn affects the outcome of the neonate. Parents are essential in the recovery of their children.

        According to an article titled,  "Social determinants of health and the neonate in the neonatal intensive care", "Social determinants affecting the neonate include socioeconomic inequalities, parental education level, parental addictive behaviors, breast feeding rates and parental mental health; each of these determinants are interlinked and overlap" (Adappa & Barr, 2023). In the same article it states, "Socioeconomic inequalities affect neonatal and infant mortality in all countris, including developing and developed countries" (Adappa & Barr, 2023). During my shifts, there was babies in the NICU for long periods, and their parents have not been able to visit them in a couple weeks, and in turn, the babies stay even longer. Also in article titled "Study of Social Determinats of Health in NICU Settings" from the Children Health Equity Center, "Adverse social determinants…can have detrimental consequences to health and well being both in the short and long term" and "Because infants who require extended stays in the NICU represent a uniquely vunerable population, it is vital that NICU families are actively screened for adverse social determinants of health and referred to appropiate resources" (Li & LeBlanc, 2022). According to a cohort study "The Association of Social Factors and Time Spent in the NICU for Mothers of Very Preterm Infants, "our cohort demonstrated decreased maternal time in the NICU throughout birth hospitalization, highlighting the likely several competing interests a mother faces during this time, including potential return to the workplace. These issues highlight the impact of social determinants of health (SDOHs), the environmental and economic conditions in which individuals are born and live, on both the hospitalized preterm infant and the family unit. SDOHs broadly contirbute to health inequities, such as preterm birth, with known disparities by factors including maternal race and/or ethnicity, education, and marital status" (Bourque et al., 2023).

       In conclusion, every day I work in the NICU for my practicum, I am deeply saddened by babies who are long timers. It is not their fault though because the conditions they are born into, essentially the "conditions of their environment" their parents are in does directly affect them. The determinants of their parents are the determinants for them and in their recovery and health. Stated above screenings can somehow support the neonate and their family by opening the gate to available resources, but the question is, is that enough. This is a systemic issue that needs to be addressed not by the individual or group level. Social determinants is a very intricate subject, but babies and children deserve a fair shot. 

References

Adappa, R., & Barr, S. (2023). Social determinants of health and the neonate in the neonatal intensive care.  Paediatrics & Child Health,  33(6), 154–157.  https://doi-org.proxy-hs.researchport.umd.edu/10.1016/j.paed.2023.03.002

Bourque, S. L., Weikel, B. W., Palau, M. A., Greenfield, J. C., Hall, A., Klawetter, S., Neu, M., Scott, J., Shah, P., Roybal, K. L., & Hwang, S. S. (2021). The association of social factors and time spent in the NICU for mothers of very preterm infants.  Hospital pediatrics,  11(9), 988–996.  https://doi.org/10.1542/hpeds.2021-005861

Li, J., & LeBlanc, A. (2022, May 27).  Addressing social determinants of health in the Neonatal Intensive Care Unit. Child Health Equity Center. https://childhealthequitycenter.org/addressing-sdoh-nicu/

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DISCUSSION 2

Social Determinants of Health: Orange Group

COLLAPSE ZV

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Social determinants of health (SDOH). 

Name the 5 domains of Healthy People 2030. What is the objective of Healthy People?

Select 1-2 overarching goals and describe the impact on health, well-being and quality of life.

Describe the current status of the overarching goals you selected.

Since Social determinants of Health (SDOH) have a major impact on people’s health and their well-being, they are the focus of Healthy People 2030. SDOH are the conditions in the environments that affect people’s health, functioning, quality of life, well-being, outcomes, and risks (Healthy People 2030, n.d.-a).

Five domains of Healthy People 2030 are Economic Stability, Education Access and Quality, Health Care access and Quality, Neighborhood and Built Environment, Social and Community Context (Healthy People 2030, n.d.-a).  

The objective of Healthy People is to guide national health promotion and disease prevention efforts to improve health of all people in the United States; it is released by the U.S. Department of Human Services (HHS) every ten years and it addresses the most critical public health priorities (CDC, 2020).

One of the overarching goals of Economic Stability is to help people earn steady incomes that allow them to meet their health needs (Healthy People 2030, n.d.-b). According to Healthy People 2030 (n.d.-b) one in ten people in the United States lives in poverty which means they cannot afford to buy healthy food, health insurance or adequate housing. Many of them live in unhealthy conditions such as not having access to clean water or live in houses polluted with lead. In addition, they cannot afford membership of a gym. All this impacts their health, well-being, and quality of life. To reach this goal Healthy People 2030 focuses on employment programs, career counseling, and high-quality childcare opportunities which can help to find or maintain employment. Additionally, developing policies to help people pay for housing, food or health insurance can decrease poverty and allow healthier lifestyle (Healthy People 2030, n.d.-b).

The status of this goal is following:

· Improving in reducing household food insecurity and hunger, reducing work-related injuries resulting in missed workdays.

· Little or no detectable change in reducing the proportion of people living poverty, increasing employment in working-age people, increasing the proportion of children living with at least one parent who works full-time, reducing the proportion of families that spend more than 30 percent of their income on housing, eliminating very low food security in children (Healthy People 2030, n.d.-b).

 

 

 

References

Centers for Disease Control and Prevention (CDC). (2020, August 18).  About – healthy people 2030. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/about/factsheets/factsheet-hp2030.htm

Healthy People 2030. (n.d.-a).  Social Determinants of Health. https://health.gov/healthypeople/priority-areas/social-determinants-health

Healthy People 2030. (n.d.-b).  Economic stability.  https://health.gov/healthypeople/objectives-and-data/browse-objectives/economic-stability

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