Ambulatory Care Exam 2- Social Determinants of Health

What are the 5 Social Determinants of Health?

• Education (Access and Quality)

• Economic Stability

• Social and Community

• Healthcare access and quality

• Neighborhood

Higher SES predicts what about health?

Better health outcomes and access to care

Lower SES predicts what about health?

Poorer health outcomes

The closer you go into the academic wheel of privilege what happens? 

Privilege increases 

LHI stands for

Leading Health Indicators

1. Drug overdose deaths

2. Homicides

3. Household food insecurity and hunger

4. reading skills for 4th graders

5. Use of tobacco products among adolescents

LHI that have gotten worse

How do you assess educational background & learning preferences? 

Health literacy 

In the modern day how can you check someones educational access and quality?

Digital literacy and access to technology

What is one way to assess if a patient has understood a health literacy teaching?

Using the teach back method

A patient with limited english proficiency nods and smiles during discharge teaching but later returns with complications. What social determinant should the nurse address?

Language barriers and health literacy

Asking about financinial concerns, employment and if they have enough food to eat is a way to assess…

Economic stability 

No reported indications of food access problems or limitations

High food security

One or two reported indications- typically of anxiety over food sufficiency or shortage of food in the house. Little or no indications of chages in diets or food intake

Marginal food security

Reports of reduced food quality, variety, or desirability of diet. Little or no indication of reduced food intake.

Low food security

Reports of multiple indications of disrupted eating patterns and reduced food intake

Very low food security

What is a food swamp? 

Food is available but not good food 

What is a food desert?

No grocery stores within 2 miles, multiple convenience stores and fast food restaurants.

How do you assess if someone has healthcare access and quality?

If they have insurance, geographical issues with accessing care, and determining if healthcare meets their cultural needs.

A community health nurse notes that a neighborhood lacks sidewalk, parks, and grocery stores selling fresh produce. Which intervention best addresses these social determinants of health?

Advocating for policy changes to improve neighborhood infrastructure.

Medicare A 

Hospital Insurance 

Medicare B

Medical insurance for visits

Medicaid

Low income (22k minimum for 1; 45k/yr family of 4)

Ages 1-44 are are risk for what cause of death?

Unintentional injuries

What medication is the #1 cause of drug overdose death in the US? 

Fentanyl 

What is the most common OTC med that people call as a result of unintentional overdose?

Acetaminophen

What is the most commonly used opioid in the US?

Oxycodone

What healthcare workers fall into this role…

• Can be ambulatory or inpatient; sometimes social workers get hired for these roles

Nurse care coordinator or nurse case manager

WIC

women, infants, and children 

SNAP

Supplemental nutritional assist program