Social Determinants In Health Care

1. Describe and discuss the social determinants associated with the case you have chosen. A large collection of evidence has been accumulating over the past two decades, revealing the impact that social factors have on health at both individual and population levels [1]. This is not to say that medical has no impact on health outcomes, rather that evidence suggests medical care is not the only contributor when determining who is more vulnerable to becoming injured or ill [2]. This has been highlights in an early study by McKeown [3], who attributed the large increase in life expectancy since the 19th century to be due to a change in living conditions. Although advances in medical care would likely have made significant contributions towards

lives a socially reclusive lifestyle, given he lives alone, is unmarried and states that he ‘has little in the way of social life’, with his only close social connection being his mother. From this, social isolation is likely to be a determinant of his health, which can be defined as a ‘reflection of a small network size and paucity of social contact’ [7, 8]. There has been a key finding that social isolation can be a predictor of mortality, that was on the same level as smoking, elevated blood pressure and high cholesterol [9], highlighting the importance of this social determinant and its impact on a person’s

The reason why these can be regarded as determinants of his health is because stress induces a pro-inflammatory response and involvement of hypothalamic-pituitary-adrenal axis [11]. A person’s employment and working conditions can therefore increase the vulnerability of an individual to becoming ill, such as Mr W.’s precarious employment. Precarious employment is considered as employment insecurity, with low wages and economic derivation as well as restricted social rights [12]. Research into its impacts have revealed that such types of employment have a stress related pathway to ill health and poor self-reported health [12], with mental health being reported as the most susceptible and responsive health outcome associated with this determinant