Clara Case Study

This case study explores the life of Clara, a 54-year-old woman living in poverty with low social status. It discusses the social determinants of health, including income and social status, employment and working conditions, education and literacy, childhood experiences, and healthy behaviors. The study also suggests strategies to address these issues and highlights the role of health professionals in addressing them.

Clara Case Study 1
CLARA CASE STUDY
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Clara Case Study 2
CLARA CASE STUDY
Characteristics of the Individuals
The people in this case study include Clara who is a 54-year-old woman. She is
impoverished with low social status and cannot afford enough food or public transport due to
low income, poor working conditions, and lack of reasonable employment. She is unschooled
enough because of the death of her parents which forced her to live with her illiterate aunt at a
tender age making her drop out and get married to John at teens. Clara worked in grocery and
retail position while her kids were little, but has been forced to leave the work as the money is
small and cannot even offer her basic needs. She has to save money to go see her daughter at the
expense of healthy eating, but still find public transport prohibitive. John is also in the case
study, as a husband to Clara. John has a depression following her head injury that went untreated
because he was embarrassed to report the issue to his casual employer. John and Clara married
only for a few years and they separated. John cannot help Clara financially as the mine is closed
and has failed secure consistent employment thereafter leaving all the responsibilities to Clara
who even helps him during crisis despite their separation. They have two kids Annie and Robbie
who are equally unschooled and did not do well in school. Both Annie and Robbie have moved
to the City in search employment but cannot land any reasonable work due to their low literacy
levels and are subjected to deplorable living conditions. Annie lives with her boyfriend, Josh, in
the city in a tiny room apartment and she is pregnant with gestational diabetes. Josh works and
goes to school in the evening, but get very little to keep his wife and even worried how they
would pay rent when the baby arrives and also cater for their baby.
Social Determinants and Description
Income and social status

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Income and social status of the people, in this case, are very low. Despite working in
the grocery and retail positions, Clara would find it increasingly hard staying employed as
money also kept becoming tighter. This makes her life hard to even save to pay for public
transport to go to the city and help her daughter. She is forced to save money every month but is
forced to eat toast for her evening meals.
Employment and working conditions
The people in this case study lack employment and work in poor working conditions.
Clara’s children went looking for employment in the city. Josh, Annie’s boyfriend is forced to
work to make ends meet but get very little and cannot afford to pay rent in the tiny one-room
apartment as their baby arrives. Clara’s husband, John only worked in in the mine and struggled
to get consistent employment following the closure of the mine which made him unable to cater
for Clara. John’s working condition was poor as he sustained a head injury working as a casual
employee leading to depression. Clara had no challenges in getting employed when her children
were still little. She worked in grocery and retail positions around her town.
Education and literacy
This is evident throughout the case. Starting with Clara, she did struggle in school and
this leads to her poor health as she cannot feed herself. Clara’ aunt never knew how to read and
was illiterate making her led a poor life. Clara’s children never did well in school and this makes
them live in deplorable conditions in the city. Her son, Robbie finished only Grade 12.
Childhood experience
Clara’s childhood experience is demonstrated in the case study. She struggled while
young following the death of her parents. The death of Clara’s father forces her to stay with her

Clara Case Study 4
who cannot even read and this compound Clara’s schooling as she struggled in school. This
makes her get married while still in early teens after dropping out of school.
Healthy Behaviors
The people in this case study lacks healthy behavior. This is seen when John feels
embarrassed when he gets a head injury and failing to report when this accident happens or even
get treatment which deteriorated his health. This is seen when John becomes forgetful and
subsequently developing depression. Clara has bad healthy behavior as she decides to save
money to go help her daughter by eating toast for her evening meals.
One Social Determinants and Strategies to Address
The selected social department is healthy behaviors. To address this issue, there is a
need to create awareness in the community regarding healthy behaviors (Adler, Glymour and
Fielding 2016). This would have helped John never to be embarrassed not to report the issue to
the employer and get treatment. There is a need to come up with a public health promotion
campaign to sensitive people on the need for healthy behaviors (Garg et al. 2015). By having
this campaign, it will create awareness on the risks that the people in the community like Clara
are putting themselves into by eating a toast for evening meals (Thornton et al. 2016).
Annie (Clara’s) daughter also has gestational diabetes and having this public health
campaign can also help and her and other people in the community who might be having the
same problem to know its causes, risks factors to avoid, and also the danger it might cause to the
baby and how to manage it to ensure it does not affect the fetus. By running this public health
campaign on healthy behaviors, people with this condition will be made aware of such risks
factors as aged above 25 years, family or personal health history, excess weight and nonwhite
race (Garg, Boynton-Jarrett and Dworkin 2016). This will help explain to such women that the

Clara Case Study 5
condition is normal and should not make the worried and anxious (Bradley 2016). It will also
help show them the complications that might result from this condition to affect the baby
including excessive birth weight, early birth and respiratory distress syndrome, low blood sugar
or hypoglycemia, and death of the baby after and shortly after delivery if and type two diabetes
in later life if not treate (Poomalar 2015).
Health Professional Role in Addressing Issue
Health professionals are central to solving this issue brought by unhealthy eating
habits, failure to seek treatment, and how to deal with gestational diabetes which are the key
issues identified in this issue of healthy behaviors (Salazar, Crosby and DiClemente 2015). They
are experts in organizing a healthy behavior campaign and delivering it to this target group
(American Diabetes Association 2018). They will help Clara and other people who have
unhealthy eating habits to appreciate the need to eat healthily and how to do it to stay healthy.
Professionals will help people like John who do not seek treatment by educating them about the
importance of reporting injuries at the workplace and seeking treatment (Baker et al. 2018).
They will help Annie and other women suffering from gestational diabetes to avoid
the complications identified above by knowing exactly what they are required to do when they
are pregnant and when to see the doctors to diagnose them early enough and have the problem
solved at the early stages (Moore and Catalano 2018). Gestational diabetes lacks direct
symptoms but causes serious complications thus it will be effective if the public health
professionals create awareness in the community to tell pregnant women when to visit the doctor
(Greenwood, De Leeuw and Lindsay 2018).

Clara Case Study 6
References
Adler, N.E., Glymour, M.M. and Fielding, J., 2016. Addressing social determinants of health and
health inequalities. Jama, 316(16), pp.1641-1642.
American Diabetes Association, 2018. 13. Management of diabetes in pregnancy: Standards of
Medical Care in Diabetes—2018. Diabetes Care, 41(Supplement 1), pp.S137-S143.
Baker, P., Friel, S., Kay, A., Baum, F., Strazdins, L. and Mackean, T., 2018. What enables and
constrains the inclusion of the social determinants of health inequities in government policy
agendas? A narrative review. International journal of health policy and management, 7(2),
p.101.
Garg, A., Boynton-Jarrett, R. and Dworkin, P.H., 2016. Avoiding the unintended consequences
of screening for social determinants of health. Jama, 316(8), pp.813-814.
Garg, A., Toy, S., Tripodis, Y., Silverstein, M. and Freeman, E., 2015. Addressing social
determinants of health at well child care visits: a cluster RCT. Pediatrics, 135(2), pp.e296-e304.
Greenwood, M., De Leeuw, S. and Lindsay, N.M. eds., 2018. Determinants of Indigenous
Peoples' Health: Beyond the Social. Canadian Scholars, 14(2), 25-178.
Moore, L.E. and Catalano, P., 2018. Diabetes in pregnancy. Springer International Publishing
AG, 12(2), 34-117.
Poomalar, G.K., 2015. Changing trends in management of gestational diabetes mellitus. World
journal of diabetes, 6(2), p.284.
Salazar, L.F., Crosby, R.A. and DiClemente, R.J., 2015. Research methods in health promotion.
John Wiley & Sons, 16(1), 64-89.

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Taylor, L.A., Tan, A.X., Coyle, C.E., Ndumele, C., Rogan, E., Canavan, M., Curry, L.A. and
Bradley, E.H., 2016. Leveraging the social determinants of health: what works?. PLoS
One, 11(8), p.e0160217.
Thornton, R.L., Glover, C.M., Cené, C.W., Glik, D.C., Henderson, J.A. and Williams, D.R.,
2016. Evaluating strategies for reducing health disparities by addressing the social determinants
of health. Health Affairs, 35(8), pp.1416-1423.