nebulizer treatment is complete, Adam’s respirations are easy and unlabored, and his respiratory rate is down to 20. Lungs are clear to auscultation, and peak flow is 225. After resting in the nurse’s office and drinking a glass of water, Adam reports feeling well enough to return to class. Case Study Question #1 Considering Adam’s home situation, which of the following puts him at risk for starting to smoke later in life? a. Having asthma. b. Growing up in a house with people that smoke. c. Being an only child. d. Lacking access to health insurance. Answer : b Rationale : Growing up in a house with a smoker, having a spouse that smokes, and socializing regularly with smokers all contribute to smoking initiation. Case Study Question #2 Adam’s father has lost his job and health insurance. When it comes to healthcare and outcomes, being uninsured or underinsured may lead to which of the following? a. Delay seeking care. b. Less likely to receive preventive screenings. c. Not taking prescribed medications because of the cost. d. All of the above. Answer : d Rationale : Compared to insured individuals, those without insurance are more likely to delay care, forgo preventive screenings, and not take prescribed medication because of the cost. Every aspect of an individual’s life is important in determining their health status and in assisting them to manage their health. Where an individual lives or works, their level of education, the food they eat, their method of transportation, and their habits affect their opportunities to achieve and maintain a healthy lifestyle. Throughout the nation, in both urban and rural areas, there are areas of low socioeconomic status, higher crime, poorer schools, and transportation issues. Healthcare systems are increasingly examining the connections between social determinants of health, hospital/medical resource utilization, and chronic disease. Cockerham and colleagues (2017) cited several studies that found social contexts contribute to a person’s risk and course of a disease, whether it is because of infection, cancer, genetics, or metabolic factors. Adults living in poverty are more likely to report fair or poor health than those in higher socioeconomic status groups (Cockerham et al., 2017). Healthcare Consideration: Social determinants were previously regarded as distant influences on health but have been increasingly regarded as fundamental causes of health afflictions. The effects of social determinants extend to chronic disease and include cardiovascular disease, diabetes, cancer, lung disease, chronic kidney disease, and many other conditions. Studies have shown that the social context of an individual’s life determines the risk of disease exposure, susceptibility, disease course, and outcomes, regardless of whether it the disease is genetic, infectious, metabolic, cancerous, or degenerative (Cockerham et al., 2017).
Case Study Question #3 Which social and environmental conditions are impacting control of Adam’s asthma and his family’s ability to meet
basic health needs? a. Pets in the home. b. Airborne irritants such as cigarette smoke. c. Job loss and related economic strain. d. All the above. Answer : d
Rationale : Environmental irritants such as pet dander and cigarette smoke, along with economic factors such as unemployment and loss of health insurance, are all conditions that may impact this family’s ability to appropriately control chronic respiratory conditions such as asthma. Case Study Question #4 Children living in poverty or in poor neighborhoods have a higher risk of all of the following EXCEPT:
a. Cancer. b. Obesity. c. Asthma. d. Lead poisoning. Answer : a
Rationale : Children in poor neighborhoods have a higher risk of asthma, gastrointestinal disorders, lead poisoning, and obesity.
HEALTH EFFECTS OF SOCIAL DETERMINANTS ON HEALTH
Examination of the relationship between social determinants of health and the development of chronic disease reveals an interconnectedness between the components. The social determinants of health contribute to chronic disease development and affect the management and outcomes of the diseases. Although lifestyle choice does influence outcomes, multiple studies have found that the disadvantage and the risk of negative outcomes remains higher in individuals experiencing many of these factors. Oates and colleagues (2017) studied lifestyle, diet, socioeconomic status, presence of chronic disease, and perceived health in the mid-southern region of the U.S. compared to the remaining contiguous states. They found higher rates of diabetes, asthma, obesity, hypertension, and chronic kidney disease in African American men and women in the mid-south. Both White men and women reported a higher percentage of depression and COPD than African American men and women; additionally, White women reported more cancer. Findings were similar for other areas, except for African American women, who reported higher percentages of myocardial infarction and chronic obstructive pulmonary disease, and White men, who had more heart disease. Physical activity outside of employment was less likely in people making less than $25,000, and consumption of fruits and vegetables was consistently low among all in this income group (Oates et al., 2017). In addition to the impact on chronic disease, social determinants also have a significant impact on cancer screening, diagnosis, and treatment. Despite continued reductions in cancer mortality rates, deaths are higher among those of lower socioeconomic status than those in
EliteLearning.com/Massage-Therapy
Book Code: MTX1326
Page 68
Powered by FlippingBook