Social Determinates of Health and Chronic Conditions

what is a social determinant of health?

The circumstances in which people are born, grow, live, work, and age, and the systems put in place to deal with illness

When did HealthyPeople begin their quest for health initiatives?

1980 set a vague 10 year objective

Which HealthyPeople 2030 goal is most pertinent to OT?

"create social, physical, and economic environments that provide attaining the full potential for health and well-being for all"

What are the 5 categories of the social determinates of health?

1 - Education Access and Quality

2 - Economic Stability

3 - Health Care Access and Quality

4 - Neighborhood and Built Environment

5 - Social Context and Community

Social Determinant: Economic Stability

poverty, employment, food insecurity, housing instability, income, expenses, debt, medical bills

Social Determinant: Education Access and Quality

addressing issues of high school graduation, proficiency levels of math and reading skills, access to services for developmental delays

Social Determinant: Health Care Access and Quality

improving health by helping people get care that is timely and high-quality taking into account factors such as health insurance PCP and service utilization, public versus private sector services, and distance to such services

Social Determinant: Neighborhood and Built Environment

improving health and safety in communities taking into account negative aspects of crowded neighborhoods and desired walkability, addressing crime, access to safe drinking water, reduction of exposure to unhealthy air, decreasing MVA deaths, reduction of respiratory diseases and banning indoor smoking

Social Determinant: Social Context and Community

addressing getting social support from community members taking into account factors such as safety, discrimination/bullying, support for parents incarcerated, aiming to reduce anxiety and depression in caregivers, increase voting, increase adult readiness for foster adolescents, increase tech use for health data, eliminate very low food security in children

What is health disparity?

a particular type of health difference that is closely linked with economic, social, or environmental disadvantage;

NIH "differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the [US]"

What is healthy equity?

each person is allocated resources necessary to reach the needed level of health; the value underlying a commitment to reduce and ultimately eliminate health disparities *striving to equalize opportunities to be healthy

What are health differences?

the objective difference between two groups

For example - the fact that those who ski suffer more ski-related injuries than those who do not

What is health equality?

the distribution of the same resources, including opportunities, to all individuals within a population

What is the three step process to health management skills for clients with chronic conditions?

1. medical management of chronic condition

2. coping with a chronic condition

3. maintaining a normal life with a chronic condition

What are examples of medical management of chronic conditions?

development of healthy eating practices, regular physician follow ups, diagnostic and level testing

What are examples of coping with a chronic condition (heart disease)?

reflection of how eating practices became dysfunctional, redefining physical fitness longevity goals, wearing health tracking device for data collection

problem-solving and making decisions

What are examples of maintaining a normal life with a chronic conditions?

decreased risk factors

decreased need for medication

increased awareness of symptoms related to conditions

increased longevity and participation in ADL and IADL activities

Acute disease

sudden and severe onset

Chronic disease

long-developing syndrome

What is the three tier model of approach?

Tier 1: Universal services or health promotion

Tier 2: Targeted services or disease prevention

Tier 3: Intensive services

What is OT's role in Chronic Conditions?

know signs and symptoms to be able to know when contribute to current status, when to refer, where to refer, next steps to take

often, people are now having to live with the implications of a chronic condition (see management skill model) and OT can help incorporate these additional challenges or changes into the lives of their clients