CNA151 Health And Health Care In Australia 2

Case Study:

Carla is a 54-year old woman who was born in a small coastal mining town. Her parents died when she was little, so she was raised by an older aunt. Her aunt did not know how to read and Carla struggled in school. She married John while in her late teens and had two children by the time she was 21 years old. Carla and her husband separated just after the birth of their second child. Carla had sole-parent responsibilities for the children. Initially John helped financially, but when the youngest was only 5 years old the mine he worked in closed and he could not find consistent employment. He worked for a casual employer and sustained a head injury at work. John had felt okay at the time of the accident and was embarrassed and worried about the job, so did not report it or get treatment. Afterwards, he became forgetful and later developed depression. Despite being divorced Carla takes care of John in times of crisis. Carla had no trouble finding work when the children were little. She worked in grocery and retail positions around town. She and her neighbours shared childcare duties and would work opposite shifts. As the children grew up she found it harder and harder to stay employed and money kept getting tighter. With the closure of the mine. other businesses in town turned over quickly and more and more people left town. Many of Carla’s life long friends have moved away. Currently. she volunteers at the RSPCA and makes a little money cleaning at the post office and the town hall. Carla’s children grew up and moved to the city looking for employment. Neither of them did well at school. but her son Robbie finished Grade 12. Her daughter Annie lives with her boyfriend Josh in a tiny one room apartment. Josh is working and going to school in the evenings. They are struggling to make ends meet. Annie is pregnant and has developed gestational diabetes. She feels very tired all the time and wants Carla to move to the city too. Carla wants to be closer to help her daughter but the cost of visits on public transport is prohibitive. Carla saves money for visits by eating toast for her evening meal, but can still only afford to visit monthly. Annie and Josh are excited about the baby but also worried about how they are going to be able to afford rent when the baby arrives. Josh is thinking about quitting school.

Task:

• What are the characteristics of the individuals in this case study?

• What are the social determinants of health that are evident in the case study?

• Select one of these social determinants and describe the best way(s) to address this issue in order to have an impact on the whole of population?

• What roles should health professionals play in addressing this issue?

Answer:

Characteristics of individuals in the Case Study

The case study has six characters that are related by blood and marriage. They are Carla, John, Carla’s Aunt, Robbie, Annie and John. Carla’s parents died and she got raised by her aunt. Carla got married to John at an early age and after getting children they divorced. These individuals live in a small coastal mining town and Carla’s children moved to the city to seek employment. The characteristics of individuals in this case study have; little money, low literacy level, no jobs, minimal social support and poor health behaviours.

There is evidence in the case study that supports the individuals’ characteristics. First, Carla is brought up with her auntie and ends up bringing up her children as a sole parent. Carla’s lifelong friends also left the town to other places. Secondly, John lost his job and he was unable to find another one and could not support his family financially. Annie and her boyfriend live in a tiny room and struggle to make ends meet and Carla cannot afford to visit her daughter and has to save to meet the cost. The main mining company in town closed down and other businesses were negatively affected and people had to look for employment elsewhere or work as casuals. Thirdly, Carla was brought up with her aunt who did not know how to read and she struggled in school. Carla’s children also did not do well in school. Lastly, Carla eats toast as her evening meal and her daughter who is pregnant has gestational diabetes.    

Social Determinants of Health in the Case Study

There are several social determinants of health that are evident in the case study. Social determinants of health are conditions that individuals are born, live, grow, work, and age that shape distribution of power, money and recourses influencing their health status (Braveman, Egerter, and Williams, 2011). The social determinants of health present in the case study are; education and literacy level, employment and working conditions, level of income, social support, and healthy behaviours. To begin with, education impacts almost all individuals in the case study. Education impacts how the individuals in the case study make health decisions and get employment opportunities (Mitrou et al., 2014). John fails to make an important decision about his health to get treatment for a head injury. This causes him to get forgetful and depressed deteriorating his health (Richardson, Lester, and Zhang, 2012). Carla had inadequate education and could not find good employment opportunities. Josh also struggles with his current job because it does not compensate enough to meet his needs. Secondly, employment and working conditions affected the health and wellbeing of the individuals in the case study. Employment and working condition impacts an individual income consistency and the environment that they interact with (Allen et al., 2014). John doesn’t find a consistent employment and had to find a casual job. This made it impossible to support his children financially. The casual working condition led to John having an accident. Thirdly the level of income impact how individuals in the case study make purchase and where they live. Carla cannot meet the cost of visiting her daughter and she has to sacrifice evening meals. She compromises eating balance diet that can negatively impact her health by inadequate uptake of nutrients. Low income also impacts Josh’s health and wellbeing by pressuring him to work during the day and go to school in the evening. Josh lacks enough time to take a rest that can negatively impact his health and he even thinks of quitting school. Another social determinant of health and wellbeing in the case study is social structure. John divorces his wife and lives alone that impact his mental health (Allen et al. 2014). Lack of a family structure limits social structures that enable individuals get resources and change attitude towards health decisions. Carla lacked a family structure that could have helped her get educated. Carla’s lifelong friends also moved away from the town that destroyed her social structure making her vulnerable to stress and anxiety. Lastly is healthy behaviours has impacted the individual capacity to make healthy choices and actions (Small, Taft, and Brown, 2011). Carla takes unbalanced diet to save money while Annie unhealthy behaviours while pregnant led to gestational diabetes.  

Best Way to Address Healthy Behaviours

Health behaviours impacts individuals’ and communities’ health by engaging in activities that increase health risks. Health behaviours of an individual are shaped by health choices and external constraints (Marmot, 2011). Positive health behaviours promote good health and wellbeing and it prevents diseases while negative behaviours lead to risky health choices that cause harm and illness (Baum and Fisher, 2014). The best strategy to address unhealthy behaviours is to undertake a health promotion campaign. Health promotions enlighten community members on how to make healthy choices and minimize risky health behaviours. Health promotion strategy enables individuals to increase control of their choices and improve their health. Therefore, health promotion strategy will inform and empower individuals to make healthy decisions and behaviours that take control and improve their health. The health promotion strategy can be done through educating and training people, sponsoring mass media campaigns, public service announcements, newsletters, health fairs, and having medical camps for checkups.

Health promotion strategy can be well adopted to address unhealthy behaviours in the case study. John, Carla and Annie had negative healthy behaviours that impacted their health.  John failed to report or get treatment for the head injury because he felt embarrassed. Carla compromised eating a balance diet to save money while Annie used a lot of sugar while pregnant. The health promotion strategy will enlighten these individuals on the importance of making healthy choices. The healthy behaviours to be promoted are need for eating a balanced diet, seeking medical attention, and observing conducive working environment. These behaviour changes will control and improve the people’s health that is influenced by choices and actions.

The health promotion strategy for behaviour change will be a downstream strategy. The strategy will aim to change individuals’ unhealthy behaviours as an intervention to prevent illness and enhance wellness. The strategy will work because people make unhealthy choices or action due to lack of information. Therefore empowering individuals to take control and improve their health will reduce the consequences of unhealthy behaviour as a social determinant of health. According to (Walters et al., 2012), health promotion empowers behaviour change through increased knowledge.

Role of Health Professionals in Addressing Social Determinants

Beyond provision of individual care, health professionals have a role in controlling social determinants. Health professional should get engage to address social determinant of health because prevention is better than curing (Marmot, 2011). Health professionals should disseminate information and educate people of the public about social determinant and how they impact their health. Health professionals should also advocate for favourable physical environments and working conditions for the public. In addition, health professional should advocate for equal access of health facilities for all people. Therefore, health professional should take an active role in formulating and implementing interventions that minimize negative impact of social factors impacting health and promoting social factors that enhance health and wellbeing.    

References

Allen, J., Balfour, R., Bell, R. and Marmot, M., 2014. Social determinants of mental health. International review of psychiatry, 26(4), pp.392-407.

Baum, F. and Fisher, M., 2014. Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of health & illness, 36(2), pp.213-225.

Braveman, P., Egerter, S. and Williams, D.R., 2011. The social determinants of health: coming of age. Annual review of public health, 32, pp.381-398.

Marmot, M., 2011. Social determinants and the health of Indigenous Australians. Med J Aust, 194(10), pp.512-3.

Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E. and Zubrick, S.R., 2014. Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14(1), p.201.

Richardson, S., Lester, L. and Zhang, G., 2012. Are casual and contract terms of employment hazardous for mental health in Australia?. Journal of Industrial Relations, 54(5), pp.557-578.

Small, R., Taft, A.J. and Brown, S.J., 2011. The power of social connection and support in improving health: lessons from social support interventions with childbearing women. BMC public health, 11(5), p.S4.

Walters, J.A., Cameron-Tucker, H., Courtney-Pratt, H., Nelson, M., Robinson, A., Scott, J., Turner, P., Walters, E.H. and Wood-Baker, R., 2012. Supporting health behaviour change in chronic obstructive pulmonary disease with telephone health-mentoring: insights from a qualitative study. BMC family practice, 13(1), p.55.