Social Determinants of Health /Healthy People

Tricia’s Post

The writer identifies the two social determinants as language and unreliable transportation. She explains that the patient is from a non-English speaking community speaking, Haiti, and hence required translation by the daughter when accessing medical services. Tricia provides more detail on how language and the translation process undermined the patients’ health such as how translating could alter the meaning of the data, omit important messages or become biased resulting in inaccurate diagnosis since the understanding of the translator influences the conversation (Green, 2017). However, I wish she clearly expounded on how lack of vehicle affected his access to care. Did his financial state allow him to hire a car to the hospital or seek alternative transportation means? What was the distance and geographical condition influencing the need for a vehicle?Social Determinants of Health /Healthy People

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The solution of educating the patient is relevant in increasing health literacy for both the father and the daughter as indicated in the post. Moreover, finding alternative transportation means will help in accessing services as noted by Tricia. However, I wish Tricia examined why she selected the particular social determinants of health in detail. Furthermore, the screening for social determinants and adjustments are not covered yet they are important aspects in identifying patients’ needs and formulating appropriate solutions. Screening would also identify more social determinants that could be of importance in the patient’s case.

It is also noted that regardless of the critical solutions recommended by the post, the missed opportunities for screening and evaluation are also not identified. This undermines the efforts to determine the health gaps as well as the progress of the patient influenced by the implementation of the suggested solutions (Andermann, 2018). Therefore, I wish these important issues were covered in the post.

References

Andermann, A. (2018). Screening for social determinants of health in clinical care: moving from the margins to the mainstream. Public health reviews, 39(1), 19.

Green, A.R. (2017). Language-based inequity in health care: Who is the “poor historian”? AMA Journal of Ethics, 19(3), 263-271. doi: 10.1001/journalofethics.2017.19.3.medu1-1703

Tricia:  Social Determinants of Health

When working on a telemetry unity, I encountered a 70-year-old Haitian male patient who came to the hospital for a hypertensive crisis. When taking the patient’s history, I learned that the patient did not understand English well and heavily relied on his daughter to answer any questions. I also learned that the patient was compliant with his medication regimen, but he did not monitor his blood pressure. The daughter also admitted that he had not seen his doctor in three months due to a lack of a vehicle. The two social determinant factors that most affected this patient was his language barrier and unreliable transportation. The patient had many other issues, but I chose these two determinants because I have encountered many patients who face these obstacles.Social Determinants of Health /Healthy People

Most often, the language barrier is a detriment to medication adherence and understanding. “Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive a lower quality of care by other metrics” (Green, (2017).

The best solution for the 70-year-old patient would be to reeducate both the patient and the daughter in their native tongue. The healthcare provider will educate them on the illness, medication administration, and the importance of monitoring blood pressures. Recommendations emphasize the use of translation services for healthcare providers who cannot speak the patient’s language. It is also important for both the patient and daughter to verbalize what they have understood. In the teach-back method, patients explain health information in their own words. “By using the teach-back method, health care providers can assess patients’ understanding and reteach or modify teaching if comprehension is not demonstrated (Yen & Leasure, 2019). Also, teaching the daughter is an essential factor because she is part of his support system.

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As was discussed previously, the patient also had issues with reliable transportation. “Transportation barriers often lead to rescheduled/missed appointments, delayed care, and missed or delayed medication use” (Syed, Gerber, & Sharp, 2013). Such delays in care may lead to a lack of appropriate medical treatment, chronic disease exacerbations, or unmet health care needs, which can accumulate and worsen health outcomes. There is no one size fits all solution to the transportation barrier; therefore, solutions are individualized to the patient’s needs. Specific solutions can include telehealth visits, programs that provide vouchers that allow patients to access public transportation, or use of a non-emergent medical transportation service. In the case of this patient, the had Medicaid was able to use a non-emergency transportation service.

References

Green, A.R. (2017). Language-based inequity in health care: Who is the “poor historian”? AMA Journal of Ethics, 19(3), 263-271. doi: 10.1001/journalofethics.2017.19.3.medu1-1703

Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of community health, 38(5), 976–993. https://doi.org/10.1007/s10900-013-9681-1 (Links to an external site.)

Yen, P. H., & Leasure, A. R. (2019). Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 36(6), 284–289.Social Determinants of Health /Healthy People

Your response should consist of the following:

Pick two issues that impact a patient or patients that you have personally cared for in any healthcare setting. Discuss the Social Determinants that affect their healthcare. Offer a possible solution for each of the two issues described. Be consistent with the information.

Briefly explain why you chose these Social Determinants.

For each of the two issues, identify two specific areas and why they need to be addressed.

Briefly explain how the patients were impacted by these social determinants.

Describe how you, the healthcare provider can screen for social determinants and adjust care accordingly.

Offer solutions and consider missed opportunities for screening and evaluations.

Writing should be in APA format with at least 2 references per posting.  Succinct writing is expected.

Each student is to respond to 2 posting from within their assigned group.  These responses should have at least 1 or more references and must address the pertinent issue(s) at hand.

**Writing ‘I agree” or “good job” is not acceptable.  Acceptable responses include supportive and constructive feedback. Social Determinants of Health /Healthy People