HSCN4102Y Health Determinant and Bio-Psyco Socio Case Study

Introduction

The purpose of this essay is to discuss the determinants of health by analysing the case scenario of Monica. In this assignment, the focus will be given to Dahlgren and Whitehead’s model of health determinants. Furthermore, this assignment will also discuss the impact of the bio-psycho-social on her life by viewing and understanding the biopsychosocial model. To meet the purpose of this assignment, focus will be given on social determinants like housing, individual lifestyle factors, education, unemployment, and social and community network along with health care services.

Discussion

Social Determinants of Health

Upon analysing the overall scenario of Monica, it was stated that Monica’s case vividly illustrates how social determinants of health can significantly impact the health and well-being of the individual. More specifically, Monica’s case scenario underscores the profound impact of social determinants of health, particularly in pediatric asthma management. Living in an overly crowded and small home with inadequate air circulation, and mold growth exposes Monica to the environmental factors which can exacerbate her asthma symptoms. More specifically, the overcrowding, and inadequate space for study, and sleeping on the couch refer to the financial strain and instability for Monica. On the other hand, as per case scenario, the presence of molds and lack of heating exacerbate her asthma, highlights the direct link between housing quality, respiratory health, and overall health and well-being of an individual. Food insecurity, stemming from poverty, further compromises her physical health and well-being (Ejiohuo et al., 2024). These factors create a chronic stress, which in turn can impact on mental health and wellbeing and potentially strain the family relationship of Monika detrimentally.

Additionally, as per the case scenario, Monika’s mother’s unemployment, and depression can add another level of complexity. Parental stress, and mental health issues can hinder the effective asthma management among children, which further leads to poor health outcomes.

Apart from the housing and lifestyle, parental unemployment, education, employment and social network can be considered as another social determinant of health and wellbeing of Monika (WHO, 2021). Frequent school absence due to asthma, potentially worsened by forgetting her inhaler, can lead to academic setbacks. Additionally, Monika has no friends or lack of social interaction due to her feeling of embarrassment, as she feels embarrassed to bring her friends to her home due to her poor living environment. It limits her interaction with other children and restricts her from improving and developing social interaction skills.

Lastly, health care accessibility and service facility is another social determinant of health. While Monika has been diagnosed with asthma and prescribed inhalers, the effectiveness of her treatment is compromised by several factors (World Health Organization, 2024). Her mother’s mental health related struggle may impact on Monika’s mental health and wellbeing, which may restrict her from taking medication regularly or on time and monitor he peak flow. This highlights the importance of family support in managing a chronic condition, particularly for the children. As a whole, Monika’s situation highlights the intricate interplay between housing condition, financial instability, caregiver mental health and educational challenges in managing the pediatric asthma. Addressing these social determinants through comprehensive nursing intervention can be considered to be important to improve the overall health and wellbeing of Monika.

Dahlgren and Whitehead model for Social Determinants of Health

The Dahlgren and Whitehead model, also known as the rainbow model, illustrates the various determinants of health. This model provides a comprehensive framework to understand the multifaceted determinants of health. This model was first developed in 1991, which illustrated how various layers of influence, starting from individual lifestyle factors to broader social, economic, cultural, and environmental conditions interact with each other to have a long-term impact on health outcomes of individuals (Dahlgren & Whitehead, 2021). The key components of the Dahlgren and Whitehead model of social determinants of health include gender, age, and genetic factors, which are largely non-modifiable. This model also includes several modifiable determinants, which include individuals’ lifestyle factors like alcohol consumption, diet, physical activities, which have a direct impact on the health and well-being of any individual. This model also includes the factors like social, community networks, living and working conditions of an individual, and general socioeconomic, cultural and environmental conditions, which can shape the context in which an individual lives (Dadaczynski et al., 2022). In Monika’s case scenario, her age (10 years old) and sex are fundamental aspects of her identity. However, her diagnosis of asthma at the age of five introduces a significant health challenge that interacts with other determinants of environments.

Encircling the individual core are lifestyle factors, which include personal choices and behaviors that influence health. For Monika, taking her asthma medication is an important lifestyle factor. Forgetting to take the brown preventer inhaler often reduces her capacity to control asthma, placing her at greater risk of major attacks and hospitalizations. Such non-adherence is the result of poor supervision and support at home, thus reflective of the interaction of individual behaviors and family support systems.

The second layer deals with social and community networks. Monika's difficult home life, with overcrowding and her mother's mental illness, restricts her social opportunities. This isolation can hinder the acquisition of vital social skills and lead to feelings of neglect and loneliness (Rokach, 2019). Additionally, the stigma of poverty might deter Monika from having friends over, further limiting her social network.

Working and living conditions constitute the next layer. Monika's living condition is characterized by poor housing conditions such as the lack of heating and the presence of mold, which worsen her asthma symptoms. The absence of a suitable learning space hinders her academic advancement, which could result in truancy and academic underachievement (Banerjee, 2016). In addition to this, unemployment by her mother and her dependence on benefits impose financial burdens on the household, reducing access to healthy foods and other essentials, thus impacting global health and well-being.

The most external layer includes wider socio-economic, cultural, and environmental factors. Systemic problems like economic policy, social welfare systems, and cultural norms affect the resources and support that families such as Monika's have access to. Restricted access to quality healthcare services, poor social support systems, and environmental risks in low-income communities all play a role in health inequalities. These systemic factors create cycles of poverty and poor health, and it is difficult for people to escape negative circumstances (De Schutter et al., 2023). The economic policies and the structure of the social welfare system directly impacted the financial stability and well-being of a family. In case of Monika, her mother’s reliance on benefits and Jobseeker’s Allowance indicates her limited financial resources, which are insufficient to meet the family’s basic needs. This financial strain is evident in their inadequate housing situation, where overcrowded and poor living conditions prevail. Such a condition can be linked to the adverse health outcomes, including increased susceptibility to illness and mental health challenges (Haushofer & Fehr, 2014). The cultural norms and social attitudes can influence the availability and utilization of the social support networks. In communities, where seeking assistance is stigmatized or where there is a lack of culturally sensitive services, families may struggle to access the necessary support. In case of Monika, her mother’s health condition, including depression, coupled with financial hardship limits her engagement with social resources, which, as a whole, affect her ability to communicate and interact with the surroundings. This lack of support can lead her to develop the feeling of isolation and neglect within the family and society.

Considering the overall layer of the model, it can be stated that the interplay between these systematic issues can create a cycle where poverty and poor health reinforce each other. Financial constraints can limit the access to quality healthcare services, consumption of nutritional foods, and living in a safe and healthy environment. These as a whole can lead to the poor health problem, which further can hinder an individual from employment and educational opportunities. In the health care aspect, Nurses play an important role to mitigate the impact of these systemic determinants (Wise et al., 2023). By adapting the holistic care approach to care, the nurses can address not only the immediate health needs but also the underlying socio-economic and environmental factors that affect the patient like Monika. This includes connecting families to social support services, advocating for improved living conditions, and providing necessary education on managing health conditions within the constraints of their environment. Such intervention can help in disrupting the cycle of poverty and poor health, which can promote better health outcomes for a vulnerable population (Chung et al., 2020).

As a whole, applying the Dahlgren and Whitehead model to Monika’s case scenario elucidates the complex interplay of various health determinants. Her health outcomes are not solely a result of individual choice but are profoundly influenced by her immediate environmental, social networks, living conditions, and broader socio-economic factors. Addressing these determinants needs a holistic approach which encompasses individual support, family assistance, community engagement, and systemic policy intervention to create an environment conducive to health and well-being.

Biopsychosocial model of Health

The biopsychosocial model offers a comprehensive framework for understanding Minika’s asthma by considering the intricate interplay of biological, psychological, and social factors.

The biological factors refer to the asthma, which was diagnosed when Minika was five. Considering the overall case scenario, it can be seen that Minika’s asthma is largely influenced by poor living conditions, like a dampened home, and mold at the wall, which exacerbate the respiratory issues. According to research, in the case of Monika, her asthma symptoms are triggered by allergens and respiratory illness, which highlight her biological vulnerability. Furthermore, the potential for incorrect inhaler use affects her overall health and wellbeing, which needs urgent medical attention.

The psychological factor refers to the difficult socio-economic condition, where Monika is living in. Residing in a difficult socio-economic setting, Monika is exposed to considerable psychological stressors. Her mother's depression and the economic difficulties of the family can lead to feelings of neglect and isolation. Low-income children tend to have higher levels of stress, which can negatively impact asthma control and mental health. More specifically, it can be stated that Children living in low-income households often experience increased stress, which can adversely affect asthma management and overall mental health, and numerous depressive symptoms have been linked to the higher rates of school absence and emergency department visits among children, which indicate the broader impact on their daily livelihoods (Lehman et al., 2017). Furthermore, parental stress due to financial constraints can be associated with exacerbated asthma symptoms among the children, which highlights the intricate connection between psychological stressors and physical health. This environment may hinder Monika’s social interaction and academic performance, further affecting her mental health and asthma management.

The socio-economic status of the family affects all aspects of Monika's life, such as housing conditions, availability of healthcare, and education. The poor living conditions restrict her time for study and socialization, which may undermine her academic performance and social growth. Second, restricted access to healthcare facilities may interfere with proper asthma management, causing higher morbidity (Bolton & Gillett, 2019).

Role of Nursing Intervention

Nurses play a pivotal role in addressing the multifaceted challenges faced by individuals like Monika through targeted intervention. To ensure the overall health and wellbeing, it should be important for Monika to receive education and support about the proper use of an inhaler, and hw to recognise early signs of asthma and its risks. Effective education can significantly improve the asthma management, reducing the frequency and severity of attacks (Alexandre-Sousa et al., 2024). Regular follow-up can reinforce the knowledge and address the emergency concerns. Monika can also be recommended to undergo a peak flow test to quickly check the measure of air flow out of the lungs. This measurement os known as PEFR or peak expiratory flow rate or the peak expiratory flow or PEF which seems to be important for the people living with asthma. In nursing intervention, the nurses can bridge the gap between Monika’s family and vital community resources. By connecting the patient to financial assistance programs, mental health services, and housing improvement initiatives, nurses should address the underlying social determinants that impact the health and wellbeing of the patient (Tao et al., 2023). This holistic approach can ensure that factors like economic hardship and inadequate living conditions are mitigated and Monika is receiving adequate healthcare services and supports to live a better and healthier life. Lastly, acting as advocates, nurses can collaborate with local agencies to improve Monika’s living environment, thereby reducing asthma triggers such as Mold and dampness. By addressing these environmental factors, nurses can help in creating a healthier living space, essential for effective asthma management. Additionally, advocating for policies that support low-income families can lead to systemic changes benefiting broader communities. Through this intervention, nurses not only can manage Mionika’s immediate health needs, but can also contribute to sustainable improvements in her overall quality of life and health.

Conclusion

To conclude this assignment, it can be stated that Monika's situation illustrates the profound influence of social determinants on health. Poverty, poor housing, and her mother's mental illness form a nexus of difficulties impacting her physical and emotional health. In particular, asthma control is undermined by environmental conditions and unreliable medication compliance. Education and social development are also impaired. Intervention by a nurse is vital in linking the family to support groups and resources to tackle these determinants so that Monika and the rest of the family have improved health outcomes. Holistic intervention on these factors is important in order to end the cycle of disadvantage.

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