Social Determinants Impact on Elderly Healthcare: A Hong Kong Study

This report investigates the impact of culture, ethnicity, and diversity on the social determinants of healthcare for elderly individuals in Hong Kong, contrasting the experiences of those residing in old-age homes with those living with family. It addresses the challenges posed by an aging population and cultural factors that influence healthcare-seeking behaviors, such as the reluctance of some elderly individuals to seek help due to cultural values. The report examines social determinants like economic and social support, health-related factors, access to healthcare, health choices, and housing conditions. It highlights issues such as poverty, mental health, and the influence of government policies and healthcare access limitations. The analysis provides strategies for addressing identified risk factors and mitigating deficits within the healthcare system, including recommendations for improved resource allocation, accessible medical facilities, and educational initiatives to promote better health choices and outcomes for the elderly population.

NURSING

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
Social determinants of health.......................................................................................................1
Health related factors of both the groups.....................................................................................2
Access to Health Care..................................................................................................................2
Health Choices.............................................................................................................................3
Housing Conditions.....................................................................................................................3
Strategies for addressing the identified risk factors in health care system..................................4
Strategies to mitigate deficits.......................................................................................................5
CONCLUSION................................................................................................................................5
REFERENCE..................................................................................................................................6

INTRODUCTION
The assessment aims at finding out how culture, ethnicity and diversity have a link with
social determinants of health care. It has been discussed in the two selected cases: Elderly live in
Old-age-home vs Elderly live with Family (live in home). Nowadays, Hong Kong is facing
ageing issues which are getting serious day by day. According to the study, it is identified that
elderly belief that they can tackle the problem by themselves without consulting with their
family, friends and others. Chinese culture is the reason due to which they want to lose face.
Those people live with their families and privately manage their issues. However, it is easy to
manage the issues of elderly people who are living in old age homes as they get to consult with
the therapists and professional doctors and treated through observation and care. People living
with their families belong to the same category to that of people living in old age care. However,
the difference is present in their culture and it is difficult to change them and their beliefs.
Further, people living in western countries have different situation. Elderly people living there
seek assistance when suffering from any mental or physical health issues. The difference is due
to their education which is implanted in every citizen and hence they understand the importance
of going to the doctor and as such they opt for medical care, when they are ill or suffering from
any disease. Another reason from cultural matter is there is a lack of social support due which
people living in Hong Kong do not ask for assistance from SARHK government. For instance, it
takes around 3 hours in order to meet a doctor for health consultation purpose. The target of the
assignment is to examine enormous social determinates of health care for both the elderly aged
people who resides with their family and others who live in old aged people. It will cover various
aspects i.e. health care access, housing conditions and health choices as well. On the basis of it,
appropriate recommendation will be made to overcome the issues.
MAIN BODY
People suffering from mental illness and depression tend to opt for suicides rather than
getting it treated from the doctors. It prevents their families from unnecessary financial burden.
Further, they are also not comfortable in living in old age homes and consider themselves as
abandoned by the family and useless for the community.
Social determinants of health
Social determinants of health depend upon the economic and social support extended by
the country for elder citizens. According to the data of 2015, it can be revealed that one out of 3
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elderly people living in poverty in Hong Kong are associated with the disease of poverty
(Marmot. 2005). In Hong Kong, poverty rates among older adults have increased significantly
over past two decades (The Hong Kong Council of Social Service 2013). Further, it is
experienced that the issue has not improved yet. There is a high prevailing emotional distress in
form of anxiety, depression and suicidal psychology in the society among the elderly class who
are living with their family and do not get medical support to cope up with the disease (Barros &
et.al., 2011).
The policy of retirement that is extended by the government cannot be considered as an
adequate arrangement. Manulife Global Select (MPF) scheme has been designed by the
government so as to support long-term capital growth and provide sufficient quantum of
financial resources to facilitate retirement. Moreover, in Hong Kong, it is expected that all the
members who apply for OAA have good access to the financial resources. Elderly aged people
during the period of financial hardship will not be able to apply for the Old Age CSSA. Besides
this, in last few years, it is being noticed that political parties have also supported a universal
pension scheme; still, it shows a little bit progress due to the fiscal concerns (Promoting Health
in HK, 2013). The discrimination had affected the elder aged people with the reduction in
financial security, low self-esteem, poor life quality and health conditions and many others. Such
age disparities between elderly aged people who stay with family and those who do not live with
family when combined with the other prejudice like racial discrimination, biasness, health and
wellbeing results in poor health condition of the people. In addition to this, leaving the
employment by the people also may bring issues of poverty, abuse and others, which have a
significant impact on the health conditions of the people (Marmot 2005).
Health related factors of both the groups
Access to Health Care
It has been noticed that limited resources in context to finance impacts the medical care
aspects of elderly people. Around 65 percent of elders are suffering due to arthritis and
hypertension. Treatment process of such diseases requires a special supervision which costs high.
In order to have better treatment for elderly people the authorities also need to consider social
equality as critical aspect. It is because inequality impacts the overall development and create a
risk regarding health conditions. Most of the poor senior citizens lack private insurance and
depend on Medicare for assistance with their medical bills. It has also been witnessed that gap in
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application of Medicare benefits and insurance policies creates a financial burden. In addition to
this, it can be said that overall application of policies is not according to the set standards that
creates a gap. Due to such loopholes , the effectiveness of governmental health plans has also
been influenced in negative manner (Lau and et.al., 2017). Key issues that elderly people faces
are, related to delayed payments and reimbursements. It hampers the overall effectiveness of
treatment process so management need to consider it effectively.
Along with this, it has also been evaluated that doctors do not provide such responsiveness
to the elder patients as compared to other age groups. It also creates communication issues and
affects the functioning of the health care system adversely. It is necessary for members to ensure
that access to medical treatment must be advanced through showing more concern towards
elderly people during process.
Health Choices
In order to have effective implementation of healthcare policies and better access to health
outcomes the government also need to focus on educational advancement. It is because many of
elderly people are not having appropriate selection of health choice because they are not aware
about key principles. By creating better awareness among them regarding health care plans and
policies they can be benefited. Information about proper diet also needs to be promoted so that
health choice options can be advanced. With the use of advanced equipments and technologies,
better health care facilities and proper treatment can be provided to the people to improve their
life satisfaction (Lee and et.al., 2017). Along with this, for having an effective development of
health choices the details in regard to diseases and their symptoms also need to be shared with
the people. It has been witnessed that many of elder people are facing issues in regard to dental
diseases but they are not aware about the options available which creates a delay in the treatment
process. In addition to this, it can be said that poor health choice selection can be considered as a
result of limited knowledge in respect to healthcare. By setting out diverse standards the issues
can be overcome and improve the health choices.
Housing Conditions
Financial resources’ limitation can be considered as a key factor which impacts the health of
aged people. Housing conditions is a factor that results in poor health outcome and affects the
overall life satisfaction of the people. If individual is having a low-income level then it
influences the selection of treatment process. Along with this, it can be said that primary reason
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that people are not having appropriate selection is that they are living in rural areas. It has been
noticed that rural areas do not have appropriate arrangements in respect to income and further
facilities (Oxfam, 2010). It also creates a barrier in selection of process. For example, if heaters
are not functioning during the winter, people can suffer from hypothermia. It indicates that
housing conditions can also have impact on health conditions. It means Chinese government can
also focus on further values that can improve housing aspects so that better protection can be
provided to elderly people. Along with this, some of elders are facing issues due to high level of
stress. Moreover, improper methods of stress reduction are also creating a health issues. For
example, drinking and smoking affects the health conditions of individual so such aspects also
need to be considered for improvement in healthcare.
Strategies for addressing the identified risk factors in health care system
There are five methods through which reasons behind non-adoption along with the stress
management preferences among aged people can be assessed that are mentioned here as under:
 Individual can express and share his or her stressful feelings with the friends and family
members
 They can take professional advices and consultation
 They can participate and take part in the religious activities
 Positive attitude and motivation leads to overcome stressful conditions
 They can enjoy various activities and events which will help them to reduce mental
stress.
Through attending religious function, elderly people can cope up with the
stressful situation via gaining an in-depth knowledge of religious framework to release
mental stress and encourage people to accept it with the favourable attitude. Religious
belief positively influences all the people by building a hope, optimistic and positive
feelings (Chou, 2017). Besides this, helping nature of the social network such as friends
and family members helps elderly people to get rid of stress. Helping nature of other
people, attending religious events as well as consolation helps people to maximize life
satisfaction and minimize stress and depression in the people whether they live in old-
aged homes or with their family. It is a cognitive method in which individual think
positively and manages their emotions in order to respond stress. Moreover, taking active
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participation in entertainment activities and enjoyable events distract people from their
life issues, worries, depression, anxiety and others.
Strategies to mitigate deficits
World Health Organization suggested that the resource allocation under health care
system must be designed considering the requirement of people rather than their payment
capabilities. Hong Kong government must create an appropriate system where all the people are
provided with their needed health care requirements to the elder people so as to provide them
best treatment and thereby improve their health conditions (Marmot, 2017). Proper medical
treatment, health vouchers helps to overcome their chronic diseases and mental sufferings i.e.
depression, stress and anxiety.
Medical facilities must be opened and accessible for all the members in the community.
Moreover, great technologies must be used in health and social care to promote the well-being of
the people. Government must put special efforts for educating the senior members because in
Hong-Kong illiteracy ratio presents that most of the proportion of the elder members of the
society is not well educated (Oxfam, 2010). They must make policies to control both the
communicable and non-communicable diseases and also offer consultation services regardless of
their payment abilities so as to cure them from the chronic diseases i.e. dementia and others.
CONCLUSION
From the investigation, it can be concluded that in the earlier times, elderly people think
that they are just burden for their families, which results in stress and depression. They do not
have any idea to overcome such stressful thoughts due to illiteracy. Disharmony & improper
balance in the flow of energy in the human body creates illness which make it necessary for the
people to make a balance and intake proper healthy diet. However, on the other side, the report
had investigated various differences i.e. elderly people who live at their residences have better
access to medical treatment hence, their physical health situation is much better in comparison to
the people who live in old aged home. In contrast, people in old aged home live with their similar
age group people hence; they can freely share their feelings and emotion without any hesitation.
They also suffer financial issues which in turn, results in depression and anxiety and lacks life
satisfaction.
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REFERENCE
Books and Journals
Barros, M. B. & et.al. (2011). Social inequalities in health among the elderly. Cadernos de Saude
Publica, 27(2), S198 - S208.
Chou, K.L. (2017). Social exclusion in old age: a validation study in Hong Kong. Aging &
Mental Health. pp.1-8.
Lau, J.T., and et.al. (2017). Incidence and predictive factors of Internet addiction among Chinese
secondary school students in Hong Kong: a longitudinal study. Social Psychiatry and
Psychiatric Epidemiology.pp.1-11.
Lee, A., and et.al. (2017). Trends and Determinants of Familial Consent for Corneal Donation in
Chinese. Cornea.36(3). pp.295-299.
Marmot M. (2005). Social determinants of health inequalities. Lancet 2005, 365:1099-1104.
Marmot, M.G. (2017). Dignity, social investment and the Indigenous health gap. The Medical
Journal of Australia. 207(1).pp.20-21.
Promoting Health in HK. 2013. Strategic Framework for Prevention and Controlof Non-
communicable Diseases. HKSAR government.
Online
Oxfam (2010). Research report on the living and health conditions of poor elderly not on
comprehensive social security assistance and their attitudes towards social security.
[Online]. Available through: <
http://www.oxfam.org.hk/content/98/content_8809en.pdf>. [Accesed on 25th July 2017].
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