Connecting the Social Determinants of Health to Health Outcomes
The following three patients with different health concerns and issues come from different geographical areas and from different social circumstances. Determine which social determinants of health (SDOH) may be directly contributing to each patient’s current state of health. Take into consideration all information provided about each patient when determining which SDOH is applicable to each patient’s circumstances. Each patient will have more than 1 SDOH contributing to their current state of health. Provide an explanation justifying why your selected SDOH would impact the patient’s current health outcomes.
Consider SDOH from all 5 domains:
• Economic stability
• Education access and quality
• Health care access and quality
• Neighborhood and built environment.
• Social and community context
Patient # 1
Samuel T, a 7-year-old Black male who lives in West Garfield Park on the southside of Chicago.
Family
Samuel has 2 siblings (an older sister and older brother). His parents are divorced, and he is residing with his mom who is single. His mother works 2 jobs, 1 full-time and 1 part-time, to make ends meet. He does stay with his father on weekends occasionally, who lives in Englewood.
Social
Samuel’s mother reports that he doesn’t seem to have many friends. She says that he used to be very social and eager to go play outside with the neighborhood kids. About a year ago he stopped wanting to go play outside and has preferred to stay indoors at home.
Physical
Samuel is underweighted for his age (nutritional deficiency) and was recently diagnosed with asthma.
Mental
Samuel’s mother reports that he has been having problems with insomnia, acting aggressive and irritable, and his grades have recently dropped in every subject.
Patient # 2
Crystal P., a 32-year-old White female who lives in southeast Oklahoma in a small rural town (population 6,487) in McCurtain County.
Family
Crystal is single but has 4 children all under the age of 10. Two of the children have the same father and the other 2 both have different fathers. Crystal has never been married and has a history of intimate partner violence.
Social
Crystal is on a fixed income due to her chronic back pain disability. She does not own a car and must depend on others for rides to buy groceries, do laundry, etc.
She does have insurance due to her disability.
Physical
Crystal was recently admitted to the ER for complications due to not taking diabetes medication as prescribed. Crystal also suffers from chronic back pain. The doctor advised her to lose weight.
Mental
Crystal has a history of bipolar disorder, currently untreated.
Patient # 3:
Marcos Y., a 54-year-old Native American male. He is homeless, jobless, and living on the streets of Phoenix, Arizona.
Family
Marcos has no immediate family living in the area.
Social
Marcos has no transportation nor a mailing address. He tends to stay to himself and has been arrested many times for public intoxication.
Physical
Marcos was recently hospitalized after he was found unconscious due to severe dehydration and heat stroke.
Mental
Marcos has schizophrenia and a long history of alcohol and substance use disorder. He has had difficulty concentrating and focusing on anything. He exhibits depressive behaviors. He lacks motivation to work or even practice self-care.
After reading the 3 patient profiles, determine which social determinants of health (SDOH) may have played a role in each patient’s current state of health. Use the tables below to provide your answers. In the first column list the SDOH that you believe had an impact on the patient’s health. In the second column, provide your justification for choosing the SDOH by explaining how the SDOH could be connected to the patient’s current state of health. Provide citations for your evidence supporting your rationale. Each patient will have multiple SDOH that have impacted their current state of health. Add additional rows as needed. An example is provided in the first row of the Patient 1 table.
Patient 1
Social Determinant of Health How the SDOH was a factor in determining current state of health
Ex. No health insurance People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need. This may be a reason why a patient has not been compliant in taking their prescribed medications.
Patient 2
Social Determinant of Health How the SDOH was a factor in determining current state of health
Patient 3
Social Determinant of Health How the SDOH was a factor in determining current state of health
