Social Determinants and Health Disparities

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Social determinants of health (SDOH) are defined by the CDC (2021) as conditions and factors based on where people live, work, learn, and interact which affect their personal health and a wide range of risks and outcomes. Healthy People (2030) identifies five key categories of SDOH including access to healthcare and its quality, education access and its quality, economic stability, social and community factors, and the physical neighborhood and environment. Since these factors are significantly different for each individual, household, community and population, health disparities arise. Health disparities are the preventable differences in the burden of disease, quality and access to healthcare, and opportunities that arise due to issues or inaccessibility in one or more determinants of health (Ndugga & Artiga, 2021). Health disparities often lead to consequential differences in health status among populations. For example, African American females living in inner-city neighborhoods are more likely to experience post-partum complications or maternal mortality in comparison to white women in suburban areas due to the difference in the access and quality of healthcare and social contexts of racial prejudice.

Despite being on the ground level of healthcare provision, nurses can play an important role in reducing healthcare disparities. This can be done through one’s professionalism by offering the best level of care possible to all patients regardless of the available resources and the patient’s background. Second, nurses can serve as powerful advocates for patient rights when they see the healthcare disparities in communities (The University of New Mexico, 2020). Advocacy can gain public attention as well as from appropriate agencies to provide at least some of the necessary resources ranging from interpreters to screening to better equipment and more free clinics in neighborhoods, to improve first and foremost access and quality of provided care. The main objective for nurses is to attempt to achieve health equity from the health disparity present.

Functional ability implies that the patient has the physical, psychological, cognitive, and social ability to participate in normal life activities. There are the basic activities of daily living (ADLs) such as eating, dressing, and moving around which the patient Dale Mayman may potentially fulfill. However, the more complex instrumental ADLs with complex functions of self-care and self-sufficiency, it is likely that the patient does not meet those standards. It is also evident that the patient has disrupted cognitive and psychological functions demonstrated through lack of awareness (disorientation), emotional outbursts, and a distorted psychological state due to threats to others and himself. The long-term care plan for Mr. Mayman should focus on entering him into long-term care, most likely a psychiatric facility. He needs to be in an environment where he is able to receive medical care for his hypertension but also be safe and be provided with psychiatric care for his declining cognitive state. However, the issue then becomes that of health disparities. It is likely that such facilities are unavailable in the vicinity of Hondros Village. Furthermore, the cost may be an issue as the profession of Mr. Mayman and the likely socioeconomic class of his family may make this a difficult choice.