Week 1: Determinants of Health

Week 1: Determinants of Health What are some factors that make some people healthy and others ill? Healthy People 2020 identifies five determinants of health that influence the health of individuals and populations. Healthy People 2020 describes them as "a range of personal, social, economic, and environmental factors that influence health status" (U.S. Department of Health and Human Services, 2018, About Determinants of Health, para. 1). Determinants fall into five categories, including (a) policy making, (b) social factors, (c) health services, (d) individual behavior, and (e) biology and genetics. Professor and class, Healthy People 2020 discussed five determinant of health which are policymaking, social factors, health services, individual behavior, and biology and genetics (U.S. Department of Health and Human Services 2018). All of the determinants are related and somewhat intertwined with each other. In home health, one of the determinants that we encounter on a regular basis is social factors. Social factors, as described but the U.S. Department of Health and Human services (2018) that can be seen in home health include limited income, unhealthy foods, social support, socioeconomic conditions, transportation options, and physical barriers. Unfortunately all of the social determinants listed have an impact on each other. In fact, one patient can be observed to have more than one social determinant at any given time. A lot of the elderly patients do not have family or friends to assist with care. Because of physical barriers and sometimes limited transportation options they are unable to leave the home for adequate health care. Socioeconomic conditions can affect the patient’s diet, transportation to adequate health care, and home safety measures due to physical barriers. Limited income or fixed income can affect the patient’s ability to purchase healthy foods for the prescribed diet, paying for transportation, attending doctor appointments, needed home improvements, and purchasing much needed medication. Lack of social support can be detrimental to the patient’s mental health and decrease transportation options. Community health nurses or public health nurses “use the Nursing Intervention Wheel to define the scope of public health nursing practice by the type of intervention and the level of practice” (Wisconsin Department of Health Services 2016). The intervention that I chose to discuss is collaboration. According to Nies and McEwen (2015) collaboration “commits two or more persons or organizations to achieve a common goal through enhancing the capacity of one or more of the members to promote and protect health” (p. 15). In home health is a form of community nursing. The nurse in the home completes assessments, educates patients on disease processes, case manages all the care the patient receives. The nurse or case manager places a variety of clinicians in the home to help meet the needs of the patient. The patient can receive physical therapy, occupational therapy, speech therapy, a home health aide, and a medical social worker. All of the disciplines collaborate to ensure that all the social determinants to the patient’s health and healthcare are addressed. The collaboration of the multi-disciplinary team under the supervision of the CHN can address physical barriers, provide meal options such as meal on wheels for healthy food options, and assist in Medicaid and other community resources for transportation needs and other financial assistance. References: Nies, M., McEwen, M (2015). Community/Public Health Nursing: Promoting the Health of the Population (6th ed). St Louis, MO: Elsevier Inc. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2018). Healthy People 2020: About Determinants of Health. Retrieved from Wisconsin Department of Health Service (2016). Public health nursing: the public health intervention wheel. Retrieved from