Introduction

As healthcare systems move to value-based models which focus on positive results as opposed to individual treatments and procedures, the healthcare stakeholders are increasingly recognizing the significance of social determinants of health (SDOH) in achieving these efforts(Catalyst, 2017). There are five common SDOH that affect and influence family’s access to healthcare and health choices, including economic empowerment, education quality and level, social context, access to healthcare and the living conditions. Economic empowerment encompasses household income and influences the consumption patterns, including access to healthy food and healthcare services. Education quality and level affect the ability to get and maintain a job and the income level. The social context is how one relates with the society as encompass factors such as discrimination, distrust, racism and have an effect on individual development. Access to healthcare is the ability to access and pay for quality healthcare services. Living conditions include factors such as housing, access to basic amenities and public safety. The purpose of this paper is to present findings on how SDOH influence the health of the family, the health model best suited for the family and the strategies necessary to promote the overall health of the family.

Social determinants of health                           

The familyresides in a low-socioeconomic statusneighborhood. There are fairly good schools and healthcare facilities in the area. Having migrated to America, the family does not have a good support base in that their families live outside of America, and they have not made many friends in the neighborhood. Both the Father and mother are low-income earners, are not covered by the public health insurance and cannot afford private insurance. The family has three children, all minors and attend local schools. Both parents are not highly educated, and this has affected their access to employment and high income. The low income affects their access to quality healthcare services and good living conditions. The Father has recently been diagnosed with Type 2 diabetes and was put on insulin. While a local community health organization is helping with his access to insulin, the dietary recommendations by the doctor have presented a new affordability problem. All children relate well with the parents and do not appear to have developmental, physical or psychological issues.

Age-appropriate Screening Tools

There are no specific health concerns for the family to address. However, the limited access to healthcare services due to low income can indicate underlying health concerns which have not been detected. The Father’s diabetes, for example, was detected late, which complicated treatment. A complete health assessment through thorough health history and head-to-toe assessment tools will be appropriate for the family. Each family member needs to undergo this screening to identify any underlying health problems. In assessing the health history, the parents should be interviewed using open-ended questions for both their history and the history of the children. Any available health documents should also be assessed. The use of open-ended questions will allow the family to provide as much information as possible and the screener to use adaptive questioning to collect as much information as possible. The children should be screened from head-to-toe to identify any underlying physical injuries (Martino et al., 2017).

Health Model and action Plan

The Socio-Ecological health model is appropriate for this family. The model holds that health is influenced by the interaction between characteristics of the individual, environment and the community (Kilanowski, 2017). The individual is at the center surround by other systems. The most immediate system is the social network of the individuals followed by the environmental system, community factors and public policy.  The community contexts and social networks do not directly influence the family but exert both negative and positive forces on the family. The family has limited social support from family and friends. Joining social support groups will increase the social capital of the family. The individuals’ interpersonal factors such as skills, education level and income are the major factors affecting the family. However, they are also connected to other factors such as social institutions. Looking at the family as a unit at the center of the ecological system will ensure an appropriate plan is adopted. Health begins at home and within the community.

For this family, their low socioeconomic status places them at risk for deteriorating health. The plan should include ways of empowering the family to improve the socioeconomic status and health outcomes. Low income is the major factor, and the plan can focus on ways to improve the skills and capability of the parents to earn more income. However, the family can also access quality healthcare through other programs such as social support systems. The plan can incorporate the incorporation of available community support organizations that focus on equal access to health for individuals. Communication should be done in a way that is accessible and feasible for the family. In addition, any information provided to the family should be understandable and simple as per their skills.

References

Catalyst, N. E. J. M. (2017). Social determinants of health (SDOH). NEJM Catalyst, 3(6).

Kilanowski, J. (2017). Breadth of the socio-ecological model. Journal OfAgromedicine, 22(4), 295-297. https://doi.org/10.1080/1059924x.2017.1358971

Martino, S. C., Shaller, D., Schlesinger, M., Parker, A. M., Rybowski, L., Grob, R., …& Finucane, M. L. (2017). CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience. Journal of patient experience, 4(1), 37-45.https://doi.org/10.1177/2374373516685940