Social Determinants of Health Community Module 2

What are the six social determinants of health?

• economic stability

• neighborhood & built environment

• access to and quality of education

• access to and quality of food

• social and community context

• access to and quality of healthcare

what do social determinants of health contribute to?

SDOH contribute to health inequities and disparities.

What is a major factor linked to disparities?

socioeconomic status is a major factor linked to disparities

What experiences influence school readiness?

Early childhood experiences influence school readiness

Children with what type of income may lack skills for success?

low income children may lack skills for success

what does poor education look like in a clinical setting?

• poor health literacy

• mismanagement of chronic conditions

How poverty affect health?

Poorer people have poorer health outcomes.

Where does being poor force a person to live?

poor people tend to live in hazardous living environments

what type of jobs do poor people work? do these jobs usually give them paid leave for illness?

Poor people work high-risk jobs. These jobs do not give paid leave for illness, so poor people usually work while they are sick.

Do poor people have better or worse healthcare access?

Poor people have a lack of healthcare access.

What are poor people exposed to because they live in cheaper housing?

Poor people are exposed to elements in their own home, like lead.

Do poor people usually drink from a contaminated water supply?

Yes, poor people usually drink from a contaminated water supply.

Are the homes of poor people cramped or open?

The homes of poor people are cramped, and there is a risk for overcrowding.

What type of stress do poor people experience?

Poor people experience long-term stress.

Are poor people homeless?

Yes, poor people are sometimes homeless.

What do less favored races experience in a clinical setting?

Black and brown people are more likely to be ill and die.

What two terms are used to describe inaccessibility to food?

• Food desserts

• food insecurity

What about someone’s insurance could make them have less access to quality healthcare?

Someone could have less access to quality healthcare if they are uninsured or underinsured, or if they live an area with less healthcare providers and facilities.

What two types of factors does vulnerability result from?

Individual and social factors result in vulnerability.

What are two individual factors that could make a person vulnerable?

age, preexisting illness

what are three social factors that could make a person vulnerable?

education, employment, housing

what does vulnerability increase the likelihood of?

more vulnerable people are more likely to develop health problems

what are more vulnerable people at a greater risk of?

more vulnerable people are at a greater risk of health disparities

what is the most common illness present in prisons?

incarcerated people are more likely to experience mental health disorders in prison

what are three risk factors that impact the health of incarcerated people?

• violence

• crowded living conditions

• limited treatment options

what is the nurses responsibility when caring for incarcerated folk

the nurse must maintain professionalism and care without unconscious bias

what are the homeless at higher risk of (5)?

• HIV

• alcohol drug use

• mental illness

• tuberculosis

• chronic illness

what is the nurse’s role when caring for the homeless? (what is the nurse’s three step plan)

• outreach

• advocacy

• care coordination

what are three common mental disorders common in veterans?

depression, PTSD, anxiety

what are three things that a veteran is at increased risk for?

• substance abuse

• physical diseases (amputation)

• somatic complaints (chronic pain)

what organization helps veterans gain healthcare access?

veterans affairs

what are two common mental disorders amongst LGBTQIA+ populations?

• depression

• anxiety

what are three things LGBTQIA+ folk are at risk for?

• substance abuse

• STIs

• suicide

what do nurses need to do when treating LGBTQIA+ patients? (4-step process)

• awareness

• sensitivity

• knowledge

• skills

who does adolescent pregnancy pose health risks to?

adolescent pregnancy poses risks to the mother and baby

why does adolescent pregnancy pose health risks to the mom and baby? (4)

• lack of prenatal care is common

• high blood pressure

• premature-birth

• low-birth-weight infants

where do adolescently pregnant mothers end up/ who are adolescently pregnant mothers?

mothers in foster system are common teen pregnancies

what three options should nurses discuss with adolescent pregnancies?

termination, adoption, parenthood

do rural populations usually have poor perception of health/functional status?

yes, people from rural populations typically have a poor perception of health/functional status

what type (high/low) of incidence of chronic illness do people living in a rural area experience?

rural people experience high incidence of chronic illness

are people in rural areas more or less likely to seek care?

people in rural areas are less likely to seek health care

what is a good option for rural populations who want to seek healthcare?

telehealth

what can nurses do to improve healthcare in rural areas?

advocate

are migrant populations typically poor?

yes, migrant populations are typically poor

what do migrant populations have limited access to?

migrant populations have limited access to healthcare

what working conditions do migrant populations typically endure?

hazardous working conditions are endured by migrant populations

are there a lot of or less regulations when working with migrant populations?

there is a lack of regulations for migrant populations

what should be the nurse’s focus when treating migrant populations, why?

infection prevention, because migrants typically live in crowded spaces

what do pediatric patients do to fulfill basic needs?

pediatric patients depend on others to fulfill their needs

what three environments affect a pediatric patient?

• family (parents, caregivers, siblings)

• social environment

• physical environment

what circumstances affect a pediatric patient?

economic circumstances and access to healthcare

what is the most important relationship for pediatric development?

caregiver relationship is the most important relationship for pediatric patients’ development

what beliefs play a role in pediatric development and health care? (3)

cultural, ethnic, and religious beliefs

what is important to watch out for in the home of a pediatric patient?

stress level

what are adverse childhood events (ACEs). give six examples of ACE

ACEs are events occurring in childhood that cause physical or emotional trauma

• abuse

• neglect

• household challenges

• exposure to substance abuse

• watching intimate partner violence

• death of a caregiver

what are ACEs linked to?

ACEs are linked to toxic stress

what do ACEs alter? what does this result it

ACEs alter brain development, which leads to issues with decision making, forming relationships, and chronic illness

how could a caregiver put a child at risk for ACEs? (5)

caregivers who:

• were abused as children

• have less than a high school education

• have no reliable support system

• lack financial resources

• are sole caregivers for the family

what are a nurses roles within vulnerable groups? (3)

• patient advocacy

  • equal treatment despite social factors

• culturally sensitive care

• address social determinants of health

list 8 vulnerable populations

• incarcerated

• homelessness

• veterans

• lgbtqia+

• adolescent pregnancy

• rural population

• migrant population

• pediatric patient

define health disparities

differences in medical conditions or health outcomes in a specific population

which groups do health disparities happen most often with?

marginalized groups are most likely to experience health disparities

what are health disparities rooted in?

systemic racism

what directly influences health disparities?

social determinants of health

draw out the cliff analogy

what type of nursing workforce is needed to address health disparities? why?

a diverse nursing workforce can address health disparities, because cultural similarities between nurses and clients improves outcomes

what should nurses develop to prevent health disparities?

nurses should develop cultural competency

what is implicit bias? is it good or bad? how long does it take to develop? what does it drive? what are common examples?

• unconscious assumptions we hold

• can be good or bad

• developed over a lifetime

• drive our actions towards other people

• often about race, gender, age, sexual orientation, and religion

what are nurses for individuals in the healthcare system?

nurses are usually the point of entry for patients into the healthcare system

what does not addressing implicit bias lead to?

implicit bias leads to health disparities

what should a nurse do to stop implicit bias?

self reflection

list 8 ways to counteract stereotypes

• stereotype replacement

• counter stereotypic imaging

• perspective taking

• inter group contact

• doubt objectivity

• increase motivations to be fair

• thinking slow (engaging in mindful, deliberate processing)

• count patterns and decisions or behavior and disparate outcomes that may be linked to bias

what is provision 9 in the ANA code of ethics?

provision 9 in the ANA code of ethics is the social justic statement

nurses should:

• address the history of racism in nursing

• take accountability for ongoing harm

• identify specific, measurable plans for creating more inclusive, diverse, and equitable professional organizations that meet the needs of all people

• condemn all forms of oppression

• demonstrate intentional efforts to reflect and act upon social justice issues

minnesota public health wheel: use it to identify 3 public health nursing interventions for each of the following vulnerable populations: veterans, LGBTQIA, adolescent pregnancy, migrant populations, rural populations, pediatric populations