The Patient’s Health: Social Determinants

Subject: Public Health
Pages: 7
Words: 2083
Reading time:
8 min

Educational Status

The patient’s education and health are two interrelated notions; nevertheless, seemingly, they cannot be reduced to relationships of cause and effect. It is stated that persons with higher education, as in the case of E. G., live longer and lead healthier lifestyles than those without it (Zajacova & Lawrence, 2018). Hence, lower levels of education can be correlated with worse health levels, as socioeconomic status plays a significant role in both categories. E. G. ‘s higher-income and social status warrant access to better education and health care services, thus increasing levels of both. Contrarily, in households with lower income opportunities to obtain higher education are lesser, and economic hardship also leads to worse health outcomes. Taking this into account, both E. G. ‘s educational status and health levels have one underlying cause in common, that is socioeconomic status.

Healthcare Barriers and Opportunities

Being a college graduate, E.G. has a comparatively high educational status, and thus, supposedly, the healthcare barriers that he may face are not as numerous as for someone with no higher education at all. Among researchers in the domain, primary, and then higher education act as indispensable elements that ensure a healthier lifestyle (Zajacova & Lawrence, 2018). Higher income levels that university or college educational levels presuppose also provide access to psychological and social resources associated with a decrease in risk behavior, such as substance abuse. In this way, E. G.’s health benefits indirectly from the educational level that he received.

Effect of Health on Quality of Life

One of the most critical areas of modern medicine is the research on patients’ quality of life. The most common criteria on questionnaires to measure health-related quality of life that were applied to the E. G.’s case are the following: physical activity, general health, bodily pain experiences, viability, social activity, and mental health (Lim, Black, Lamping, Rowan, & Mays, 2016). E. G. ‘s physical condition allows for a higher life-quality, as he has no significant health problems – pain does not form a recurrent part of the patient’s daily life. Psychological health issues do not appear in E. G.’s family history, and the patient does not reference struggling severely with them at any point in his life. The patient is engaged in the life of his family and community, not experiencing a scarcity of essential social interactions. However, physical activity is one area that should be enhanced. Regular moderate exercising could be recommended to E. G. in order to improve his life-quality and reduce the possibility of complications related to his family history of diabetes, hypertension, and obesity.

Health Literacy

Health literacy constitutes an integral part of disease prevention planning. Educating E. G., for instance, about the potential influence of his family history of diabetes on his current health status and its implications is a way to prevent future health problems (obesity, heart failure, and cardiovascular disease). Numerous studies show the correlation between insufficient health literacy and poor health, inadequate medical care, increased barriers to treating diseases, and premature mortality (Batterham, Hawkins, Collins, Buchbinder, & Osborne, 2016). Moreover, it is argued that health literacy levels are closely associated with behavioral risk factors such as lack of physical activity, unhealthy diets, smoking, and excessive use of alcohol. All these factors that lead to numerous severe health conditions and diseases can be, to a degree, eliminated by educating patients on personal health maintenance.

Neighborhood and Environmental Impact

The patient lives in a safe and stable neighborhood that can ensure a sense of emotional security, which is crucial, given the gravity of psychological distress effect on a health condition. A well-developed neighborhood with middle- and high-income populations, in one of which E. G. lives, facilitates the process of obtaining a healthier lifestyle, increasing life quality altogether, as maintaining a healthy lifestyle is linked to reduced death rates in all socioeconomic environments (Warren Andersen et al., 2018). Therefore, the neighborhood of E. G. ‘s residence and his living situation overall seem not to affect the patient’s health negatively.

Healthcare Received in Low- and High-Income Areas

Income has a significant impact on the quality and general accessibility to health care services. It is reported that urban areas with low-income tend to have a lesser number of primary care physicians per capita comparatively to more well-off zones (Henrikson, 2017). Healthcare insurance is not always able to ensure the needed treatment, as certain payments are required to be made by patients, preventing them from accessing these services (Henrikson, 2017). Even though primary health care may be similar for patients in both low- and high-income areas, disparities between them are more noticeable.

Rural versus Urban Healthcare Access

Living in a rural area impedes not only access to health care institutions, but it also, possibly, makes the response to medical emergencies in case of extreme remoteness not as prompt as in cities and towns. Geography is a well-researched constituent that correlated with a health condition and health care access – it also is viewed as a considerable barrier in this regard. Caldwell et al. (2016) argue that “living in a rural area may heighten exposure to unequal social conditions that perpetuate disparities in access to health care” (p. 1463). Poor health literacy, risky behaviors, and substance addictions can also be associated with a lack of health services access. Telehealth may be an adequate solution for remote provincial territories, although it has an array of significant limitations.

Neighborhood Healthy Food Options

Such social determinants of health as access to food markets and shops could help the patient achieve healthier nutrition. Additionally, E. G. has private transportation and thus more straightforward access to grocery shopping. The area of E. G.’s residence has several grocery shops and a food market in relatively close vicinity. Proximity to resources, the level of health, and life quality overall are strictly related factors, and for E. G., these social determinants have a positive impact on his well-being (Levasseur et al., 2015). Resources availability helps to meet everyday basic needs, such as access to health food stores, health institutions, and public transport.

Identification of Social Determinants

In the case of E.G., his living area, educational level, and socioeconomic status are the primary social determinants of health. Living in a suburban area may pose certain problems to healthcare access. Higher education brings E.G. certain privileges, as it may be associated with higher income. Private transportation, stable housing, and secure full-time employment positively impact the patient’s socioeconomic status. In general, social determinants in E. G.’s case are favorable to his health condition.

Patient Plan of Care

Taking into consideration E.G.’s family medical history and the social determinants impacting his health condition, the patient should be advised to take preventive measures, since his age is a factor that can influence the potential progression of certain diseases. Healthy nutrition throughout life helps avoid the problem of malnutrition in all its forms, as well as prevent a number of non-communicable diseases and conditions. Firstly, the patient should reconsider his diet: healthy alimentation, especially one that is low with carbohydrates, would be recommended. In the case of human males, metabolism is much more active; naturally, there are more muscle tissues that require active nutrition consisting of protein foods (Gulanick & Myers, 2016). On average, a human male eats about 2000–2900 kcal per day (Gulanick & Myers, 2016). This information, as well as the necessity of additional physical activity, should be communicated to E. G. so that he could implement it in his daily routine. A substantial reduction in total fat intake helps to prevent unhealthy weight gain in adults, and this factor applies to the patient’s case. A higher intake of fruits and vegetables could also be beneficial for the patient.

The fact that the patient has health insurance demonstrates his general ability to access health care facilities. This social determinant of health care services accessibility is strongly influenced by a person’s place of residence (Caldwell, Ford, Wallace, Wang, & Takahashi, 2016). In comparison to an urban one, living in a rural area brings certain disadvantages, as it is shown that access to health care services is worse in this type of territory. Considering this information, E.G. ‘s ability to access primary care and pharmacies within 5 miles seems instead as an exceptional situation.

Plan Implementation

Social determinants of health facilitate the implementation of the nursing plan of care in the patient’s case. Private transportation, a socioeconomic determinant, alleviates the issue of distance to a health care facility, making the plan easier to implement. Proximity to healthy food is determined by a beneficial location of E. G.’s place of residence, which is another social determinant that renders the plan more practicable. Additionally, professional stability and socioeconomic status would help E. G. implement more exercising in his daily routine and solve the issue of insufficient physical activity, which is a crucial element for the plan implementation.

Implementation Barriers

Distance may be the primary barrier to the patient’s plan of care implementation. As the patient lives in a rural area, access to the medical facility may be complicated by the issue. This social determinant may limit the number of visits and their duration, reducing the quality and amount of sessions. Nevertheless, E. G. can visit his local primary care provider in a case if he needs medical consultative services. Since the patient is securely full-time employed, socioeconomic instability does not seem like a barrier, nor does daily resource availability. E. G.’s education level seems like an advantage rather than a barrier. The patient’s living conditions, resources proximity, and employment status render the patient plan of care implementation sufficiently feasible. The level of physical activity is also partially determined by E. G.’s neighborhood, as exercise facilities or roads suitable for running may or may not be present there.

Individuals Involved in Interventions

The nursing plan of care gives instructions for the responsible nurse to adhere to and enumerates interventions to be completed if needed. The socioeconomic determinant of the plan may also require engagement from a supporting nurse and a person assigned to provide care for the patient at home – the patient and a caregiver. E. G. ‘s neighborhood, as a social determinant, and its community are another important part, as they modify the immediate environment. The nursing plan secures that a patient’s treatment is seen in a comprehensive, holistic manner by the family members involved and that the interventions are implemented progressively.

Plan Effectiveness

The estimation of nursing practices on the patient’s health is a nurse’s professional responsibility. The evaluation process commences with the identification of criteria on which it would be based, and then the results of identification are applied to the accumulated information regarding a patient’s treatment outcomes (Gulanick & Myers, 2016). The plan’s effectiveness in the E. G.’s case is evaluated by blood sugar levels that would continue to be healthy, blood pressure and body mass index. Moreover, adherence to the nursing clinical practice guidelines would also be taken into consideration (Gulanick & Myers, 2016). The process results in the revision of the patient’s nursing plan of care if an issue is perceived in the result; the plan also can be modified or continued if the outcomes are satisfactory.

Impact of Social Determinants

In conclusion, the patient’s living and working conditions could be considered to favorably affect E. G.’s health prognosis and life expectancy, disregarding the diseases present in his familial history. In spite of being located in a comparatively significant remoteness from an urban area, the neighborhood where the patient lives is described as safe and agreeable. Nevertheless, to reach a more in-depth conclusion about the effect of social determinants on the patient’s health, additional factors concerning work conditions and the sense of social exclusion should be determined.

Social determinants of health accompany and influence a person throughout their life. A comprehensive health assessment helps to form a more complete and profound understanding of a patient’s health. Moreover, trough examination of social determinants, additional insight into health care disparities and their causes is gained. Such a social factor as an area of residence can shape a number of behaviors and render them more or less risky, for example, dwellers of rural territories are more prone to act in health-damaging ways. Social determinants of health not only partially form a patient’s physical condition up to the date of an assessment but also continue to increase or decrease the probability of certain illnesses. Taking this into consideration, addressing social determinants of health in a comprehensive health assessment can also complete a prognostic function.


Batterham, R. W., Hawkins, M., Collins, P. A., Buchbinder, R., & Osborne, R. H. (2016). Health literacy: Applying current concepts to improve health services and reduce health inequalities. Public Health, 132, 3–12.

Caldwell, J. T., Ford, C. L., Wallace, S. P., Wang, M. C., & Takahashi, L. M. (2016). Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States. American Journal of Public Health, 106(8), 1463–1469.

Gulanick, M., & Myers, J. L. (2016). Nursing care plans – E-Book: Nursing Diagnosis and Intervention [GoogleBooks version]. Web.

Henrikson, N. (2017). Communication with physicians about health care costs: Survey of an insured population. The Permanente Journal, 21(16), 1–8.

Levasseur, M., Généreux, M., Bruneau, J.-F., Vanasse, A., Chabot, É., Beaulac, C., & Bédard, M.-M. (2015). Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: Results from a scoping study. BMC Public Health, 15(1), 1–19.

Lim, W. C., Black, N., Lamping, D., Rowan, K., & Mays, N. (2016). Conceptualizing and measuring health-related quality of life in critical care. Journal of Critical Care, 31(1), 183–193.

Warren Andersen, S., Blot, W. J., Shu, X.-O., Sonderman, J. S., Steinwandel, M., Hargreaves, M. K., & Zheng, W. (2018). Associations between neighborhood environment, health behaviors, and mortality. American Journal of Preventive Medicine, 54(1), 87–95.

Zajacova, A., & Lawrence, E. M. (2018). The relationship between education and health: Reducing disparities through a contextual approach. Annual Review of Public Health, 39(1), 273–289.