1. A comprehensive health assessment attempts all the subjective data about the patient and all the societal or behavioral factors associated with the patient that can affect the health behavior or medical history of the patient (Barnett et al., 2012). In this comprehensive case study the five key questions that have been asked to the patient includes:
- What is your health insurance status?
- What kind of care services have you accessed in the past?
- What kind of social life you have had in the past?
- Have you been a smoker or heavy drinker in the past?
- Are you comfortable with communicating her concerns in English?
1. The comprehensive assessment of the patient discovered that she had Medicare health insurance and is capable of understanding simple English and can easily interpret instructions and can express her own preferences and grievances for the patent so, there is no need for a language expert for the patient under consideration (Bircher & Kuruvilla, 2014). Another very important consideration that can be included in the care plan as per the subjective data gathered by the comprehensive health assessment of the patient, such as the patient is in need for refer the patient to community care services as the patient is incapable of affording her own care.
1. The patient under consideration in this assessment is a Haitian female with significant grip on English language, and has a medical insurance for herself as well. Hence it can be assumed that the educational status of the patient is satisfactory and with proper health literacy the patient is capable of understanding or interpreting the severity of the medical condition that the patient is presently going through. It has also been discovered from the comprehensive health assessment done for the patient, that the patient has clear idea of what preventative or health promotional behaviors and activities she had to undertake in order to management her present health adversity and prevent any further complications from occurring to the patient (Dahlgren & Whitehead, 2017).
1. It has to be mentioned in this context that educational status has a significant impact on the healthy literacy or responsible health behavior that an individual has. There are many preventative health behaviors that can help effectively in warding off a lot of communicable and non-communicable health adversities. According to the article by the Donini et al. (2013), educational status has been discovered as the most important or impactful societal determinant of health, as the level of education is directly linked to employment status and financial stability which is intricately linked with the socio-economic pattern of health care access as well. In this case, the patient under consideration has had a significant understanding of health promotional behavior however had not been economically stable, hence it can be stated that the patient had an educational status that helped her entertain significant health literacy and it also helped in clarity she had in following the instructions given to her to manage her preset health condition, but the economic constrain had contributed to lower lifestyle standards leading to many health care concerns (Garg, Jack & Zuckerman, 2013).
The health status of an individual can be considered as the present health behavior and the manifestation of the health care complications on the lifestyle and living conditions of a particular individual. It has to be mentioned in this context that the impact of different health complexity is differential, and the impact is directly reflected in the living conditions by the means of different restrictions. In this case the patient under consideration had elevated systolic blood pressure with a hysterectomy surgery in the past. Due to the mentioned health care complexities, the patient suffers from extreme anxiety fueled by the hypertension. This fact puts her in extreme risk of stress induced trauma and panic attacks which can be extremely detrimental for her as she lives alone with no one to care for her. Due to her present unemployed status, she refrains from socializing and does not get out of her much, which can further complicate her health adversities and enhance the risk for the patient having minor ischemic attacks due to her accelerating hypertension (Nagata et al., 2013).
b. There is a significant difference between the health care access that is provided to the residents of urban and rural areas. It must not escape notice that rural areas and the extremely difficult or time consuming communication to rural areas restricts to optimal health care delivery to the rural areas which is not a restriction that urban areas face. Along with that, it also needs to be mentioned that the urban areas are much more privileged in terms of better health acre infrastructure which is radically limited in the rural areas. If the socio-economic status of the residents is considered in this context, then the financial stability of the urban inhabitants are much higher than the residents of rural areas, it impart a strong affect on their ability to afford health care as well in turn affecting their access to health care (Nagata et al., 2013).
1. Considering the neighboring or housing status of the patient, she lives along in a house and is unemployed so she spends most of her time inside the house without much socializing or interacting with the neighbors. However, it has to be mentioned that the patient has a very limited access to funds and given her financial background, her access to healthy food is also limited and hence affects her health status as well. Her marginalized status can also affect her access to healthy food and living standards and affect her nutritional standards in turn deteriorating her health further.
1. The three social determinants for this patient are unemployment, living on her own and housing instability. The care plan for her included all three factors or priorities; for her over all care plan I have included educating her on applying for social security and government food assistance which will relieve her or the stress that she had been feeling due to her financial constrain. She had been living alone, hence the care plan will also include persuading her to join community acre where she will get the opportunity to interact with others and socialize. For her housing stability issue which indicates at her having a mortgage for her house, hence her over all care plan will include guiding her to apply for government housing assistance or residential community care services (World Health Organization., 2012).
It can be stated that the most of her hypertension related health problems were directly or indirectly linked with the social determinants of health. In order to judge the efficiency of the effectiveness of the care she will be advised to come for regular checkups, both physical assessment and counseling sessions which will be extremely beneficial in monitoring her mental health and how she is recovering from depression. For monitoring the hypertension, the patient will also be recommended PCP follow up and routine medication and checkups (Garg, Jack & Zuckerman, 2013).
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet, 380(9836), 37-43.
Bircher, J., & Kuruvilla, S. (2014). Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health. Journal of public health policy, 35(3), 363-386.
Dahlgren, D., & Whitehead, M. (2017). European Strategies for tackling social inequalities in health: levelling up part 2. Health.
Donini, L. M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., ... & Di Bella, G. (2013). Malnutrition in elderly: social and economic determinants. The journal of nutrition, health & aging, 1-7.
Garg, A., Jack, B., & Zuckerman, B. (2013). Addressing the social determinants of health within the patient-centered medical home: lessons from pediatrics. Jama, 309(19), 2001-2002.
Nagata, J. M., Hernández-Ramos, I., Kurup, A. S., Albrecht, D., Vivas-Torrealba, C., & Franco-Paredes, C. (2013). Social determinants of health and seasonal influenza vaccination in adults≥ 65 years: a systematic review of qualitative and quantitative data. BMC Public Health, 13(1), 388.
World Health Organization. (2012). World Health Day 2012: ageing and health: toolkit for event organizers.
World Health Organization. (2014). Social determinants of mental health. World Health Organization.