NUR134 Health And Healthcare Assignment

1. Introduction

Understanding the multifaceted factors influencing health is crucial in the pursuit of health equity, as represented in Andrew’s case. The Social Determinants of Health (SDOH) are essential components that mold an individual's health and quality of life (Hill-Briggs et al., 2021). They encompass various aspects including economic stability, social and community context, health and healthcare, and neighborhood and built environment. In the case of Andrew, a 64-year-old man dealing with the consequences of an acquired brain injury (ABI), evaluating these determinants sheds light on the myriad ways his health and wellbeing are influenced. By examining Andrew's scenario, this essay will seek to explore relevant social determinants and their roles as enablers or barriers to his health equity, critically engaging with their implications on his health outcomes and applying appropriate strategies from the Ottawa Charter for Health Promotion to propose possible interventions.

2. Discussion

2.1.Social Determinants of Health in Andrew’s Case

SDOH are the conditions in the environments where individuals are born, live, learn, work, play, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Friedman, 2021). Understanding these conditions is critical in examining their impacts on an individual's health status. Andrew's case portrays a distinctive interaction of these determinants affecting his health and wellbeing. One significant determinant is economic stability. Post his early retirement due to an ABI, Andrew’s sole source of income is his superannuation funds. Limited financial resources can lead to compromised health due to the inability to afford necessities and health care services.

Furthermore, the health and healthcare determinant are starkly visible in Andrew’s case. His ABI impacts his overall well-being, contributing to his memory troubles and limiting his ability to maintain social interactions due to his challenges in conversing and expressing himself. Such cognitive limitations often lead to deteriorated mental health and wellbeing. With the same, his geographical location, residing 25 km away from the local regional center, implies potential barriers in accessing healthcare, goods, and services. A deprived neighborhood and built environment often correlate with a higher likelihood of poor health outcomes (Billings, Hale & Johnson, 2020). This is because of the lack of access to quality health services, goods, and opportunities.

It is also to note that the role of social and community context is notably predominant. Andrew lives alone, with minimal social interactions, primarily with his friend Jim and during the monthly music sessions. Such limited social connections can potentially lead to social isolation, impacting mental health adversely (Elmer, Mepham & Stadtfeld, 2020). This social determinant is accentuated by Andrew’s solitary lifestyle and minimal social engagements, which might predispose him to feelings of loneliness and related mental health complications. It is to mention that Andrew’s lifestyle and choices reflect his experiences with the determinant of education and access to information. His routine, marked by a structured grocery list, occasional indulgence in alcohol, and reluctance in meal preparations, point to possible gaps in nutritional knowledge and awareness about balanced lifestyle choices.

2.2.Examining Social Determinants as Enablers or Barriers to Health Equity

Health equity is predicated on the ideal that every individual should have a fair and just opportunity to attain their highest level of health, irrespective of social, economic, demographic, or geographical differences (Alhassan et al., 2021). It is vital in ensuring the optimal well-being of individuals and communities. The various social determinants identified within Andrew’s scenario act as a mixed bag of enablers and barriers toward achieving health equity. It is to mention that economic stability, a crucial determinant in Andrew’s scenario, surfaces as a significant barrier to health equity. His reliance on superannuation funds post-retirement constrains his financial abilities, affecting his ability to afford essentials and quality healthcare, which are pivotal for maintaining health and preventing disease (Jilani et al., 2021). This economic instability could inadvertently lead to poorer health outcomes, underscoring the imperative role finances play in equitable health access and outcomes.Access to health and healthcare is another determinant that stands out as a barrier in Andrew’s case. His ABI not only impacts his cognitive function but also restricts his social interactions due to communication difficulties. Having limited access to necessary health services and social support could potentially escalate the risks of deteriorating mental and physical health (Hearn, Rohn & Monden, 2022). Conversely, Andrew’s social and community context can act as both an enabler and a barrier. His interaction with Jim and his music friends represents a social support system, which is a critical enabler for mental well-being. However, his limited social interactions and resultant isolation act as barriers, leading to potential mental health issues due to lack of adequate social stimulation and support. The neighborhood and built environment, characterized by Andrew’s remote residence, is another prominent barrier. It limits his access to essential services and goods, restricting his ability to maintain a healthy lifestyle and manage his health optimally.

2.3.Function of the Ottawa Charter for Health Promotion

The Ottawa Charter for Health Promotion, developed by the WHO in 1986, acts as a guiding document for action in health promotion, aiming to achieve Health for All by the year 2000 and beyond. Its primary function is to foster conducive conditions that enable individuals and communities to take control over their health, emphasizing the development of personal skills, community action, and health-friendly public policy. It is to note that the Ottawa Charter introduces five strategies or action areas crucial for health promotion (Haugan & Eriksson, 2021). Firstly, "Build Healthy Public Policy" involves forming policies that foster equity and are conducive to health, addressing both legislative and societal aspects. Policies structured around promoting healthy practices and environments are critical in fostering community well-being.

The second action area, "Create Supportive Environments," emphasizes the influence of environmental and societal conditions on individual well-being. It underlines the importance of creating surroundings that are supportive of health, ensuring access to resources, and fostering community cohesion to facilitate optimal health outcomes (Michael, Barnes & Wilkins, 2023). "Strengthen Community Action" is the third action area. It focuses on empowering communities to take initiatives and make decisions that impact their health (Nutbeam & Muscat, 2021). Community engagement and collective action are pivotal in addressing and acting upon health concerns and issues from a grassroots level. The fourth action area, "Develop Personal Skills," is about enhancing individuals’ abilities to make healthy life choices. This involves educating and empowering individuals with the knowledge and skills needed to act on their health needs, make informed decisions, and cope with different life situations. Lastly, "Reorient Health Services" promotes a shift from a system focused primarily on curing illnesses to one emphasizing health promotion and prevention. This calls for the incorporation of health promotion practices at every level of healthcare, advocating for holistic well-being, and preventive care.

Even today, the Ottawa Charter remains relevant, providing a comprehensive framework for health promotion activities globally. Health practitioners and promoters utilize the charter's principles to guide their interventions and programs, focusing on enabling environments, community empowerment, policy development, and reoriented health services to address the prevailing health inequities and to ensure a holistic approach to health and well-being.

2.4.Proposed Intervention and Strategy

From the Ottawa Charter’s strategies, “Develop Personal Skills” is a potent area that can be leveraged to mitigate the negative impact of social determinants identified in Andrew’s scenario, particularly focusing on his economic instability. An intervention can be formulated to empower Andrew with financial management and literacy skills, enabling him to better manage his limited financial resources, thus promoting health equity. A health promotion activity can involve conducting regular workshops and offering resources aimed at imparting knowledge on budget management, savings, and investment. Such an intervention can help Andrew make informed financial decisions, optimize the utilization of his funds, and potentially improve his living conditions and access to healthcare services.

Enhanced financial literacy and management skills can act as enablers, empowering Andrew to allocate his resources efficiently, thereby overcoming barriers related to economic instability. By having control over his financial situation, Andrew can ensure sustained access to essential services and goods, contributing to better health outcomes and enhanced well-being. This approach aligns with the Charter’s emphasis on empowering individuals with the knowledge and skills necessary for making health-enhancing choices, thereby facilitating an environment conducive to health equity. Therefore, it can be said that employing the “Develop Personal Skills” strategy can substantially mitigate the impacts of economic instability in Andrew’s life by fostering financial literacy and management skills, which are crucial in navigating and optimizing limited financial resources for better health outcomes and a more equitable life.

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