Question

5.49 Social determinants of health A B G Competency VI.8 6 6 6 For the following scenario, identify how each of the five domains of social determinants of health (economic stability, education, health and healthcare, neighborhood and built environment, social and community context) could negatively influence the patient's healthcare outcomes. An 86-year-old native Russian woman lives alone in an apartment on the outskirts of the city. While her husband was alive, they lived in a house in a Russian-speaking community where they both grew up after immigrating. Since his passing last year, she had to move to this tiny second floor walk-up apartment in an unfamiliar area with neighbors who speak Spanish. She has not made many friends there since she moved in ten months ago. All of her physicians and the nearest hospital are on the other side of the city, and it takes almost fifty minutes to get there. There is no bus service to that part of the city from where she lives, and she does not drive anymore. She relies on old friends to take her to medical appointments when they can, as her only child lives out of state and taxis are too expensive. She frequently misses appoint- ments due to transportation issues or because she has confused times or places. She lives on a fixed income with Medicare and a very small pension from her husband. Her academic educa- tion is at a seventh-grade level. 1. If this patient was being seen at a provider's office where you were part of the team, propose solutions that could help mitigate at least three domain issues you identify. 2. What inferences can you draw about this patient's healthcare literacy? Provide support for your answer.

5.49 Social determinants of health
A
B
G
Competency VI.8
6
6
6
For the following scenario, identify how each of the five domains of social determinants of health
(economic stability, education, health and healthcare, neighborhood and built environment, social
and community context) could negatively influence the patient's healthcare outcomes.
An 86-year-old native Russian woman lives alone in an apartment on the outskirts of the city.
While her husband was alive, they lived in a house in a Russian-speaking community where
they both grew up after immigrating. Since his passing last year, she had to move to this tiny
second floor walk-up apartment in an unfamiliar area with neighbors who speak Spanish. She
has not made many friends there since she moved in ten months ago. All of her physicians and
the nearest hospital are on the other side of the city, and it takes almost fifty minutes to get
there. There is no bus service to that part of the city from where she lives, and she does not
drive anymore. She relies on old friends to take her to medical appointments when they can,
as her only child lives out of state and taxis are too expensive. She frequently misses appoint-
ments due to transportation issues or because she has confused times or places. She lives on a
fixed income with Medicare and a very small pension from her husband. Her academic educa-
tion is at a seventh-grade level.
1. If this patient was being seen at a provider's office where you were part of the team, propose
solutions that could help mitigate at least three domain issues you identify.
2. What inferences can you draw about this patient's healthcare literacy? Provide support for your
answer.

Added by David H.

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