CNA151: Analyzing Social Determinants of Health in Australian Case

This case study revolves around Carla, a 54-year-old woman in a small coastal mining town in Australia, and the various social determinants impacting her health and her family's well-being. Carla's early life was marked by limited educational opportunities and early marriage, hindering her personal development. The case highlights financial struggles exacerbated by her husband's unreported head injury and her daughter's unplanned pregnancy and gestational diabetes. Key social determinants identified include early childhood development, gender, housing affordability, income, and disability. The analysis emphasizes the impact of low income on the entire population, leading to food insecurity and health inequality. The study also mentions the role of healthcare professionals in addressing these issues and the Australian government's strategies to improve healthcare access for vulnerable populations. This document is available on Desklib, a platform offering a wide range of study resources, including past papers and solved assignments.

Running head: CASE STUDY
CASE STUDY
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1CASE STUDY
Characteristics of the Individuals
The given case study revolves around life of Carla, who is 54 years old who lives in a
small coastal mining town. Her parents had died when she was very young and was brought
up by her older aunt who could not read or write, therefore, she struggled through the
educational years. Educational success or school success is an important parameter of early
childhood development (Australian Institute of Health and Welfare 2019). She married early
and got divorced when she had her second child. Hence, it could be understood that she was
hindered from developing any other educational or personal development skill. According
to Cohen and Syme (2018), educational attainment is one of the factors of social determinant
of health and well-being. Carla supported her husband and children after her husband had
head injury while working which went unreported. The unreported head injury resulted in
depression and forgetfuness for Carla’s husband. Therefore, her husband was dependent on
her financially and mentally. After her children grew up it was difficult for her to manage
the financial condition. Her daughter and son had did not well at school, however, her
daughter got pregnant with her boyfriend. Carla’s daughter and her boyfriend share mixed
emotions because they are unsure about the affordability of renting when the baby arrives.
Therefore, her daughter is not educationally sound and financially dependent as well.
However, Carla’s daughter has developed gestational diabetes due to which she feels tired
and weak, therefore, she wants her mother to be there. However, travelling for Carla is
becoming prohibitive due to the expenditure. Due to which Carla is saving money by eating
toast as an evening meal so that she can meet her daughter on a regular basis. In the case
study it could be inferred that Carla was supportive but poverty stricken and had been trying
hard to cope with the current situation.
Social determinants of health

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From the case study it is evident that Carla was deprived of educational support in
her schooling years. Educational support as well parental care and support is one of the
important part of child’s early development. The social determinants of health in this case
study are:
1. Early Childhood Development
2. Gender
3. Housing and Rent
4. Income
5. Disability
Early childhood development, here is an important factor in Carla’s case because she
had to handle huge responsibility when she was young. Being a mother, she had to take care
not only of her husband but also her children. Education plays an important part of early
childhood development which can affect the child’s future and career. According to Allen
et al. (2014), a person ability is developed by a person’s social, physical environment and
economic stages of life. Moreover, raising them along with working is a difficult task for a
woman. Gender identity is often overlooked when considering the social determinant of
health therefore, being a woman and supporting the entire family financially is extremely
challenging given the background she comes from. There are health inequities between men
and women that need to be addressed (Hawkes and Buse 2013). Housing and Renting is a
challenging factor and due to which the environment as well asocial determinant of health
gets affected. Financial hardship along with the housing unaffordability can lead to poor
health (Mason et al. 2013). According to Baker et al. (2014) further confirms that there is
bidirectional relationship between health and affordable housing outcomes, in fact, the
housing affordability can predict health outcomes as well. According to Paul and Gilbert
(2013) in their study using HILDA (Household, Income and Labour Dynamics) survey as one

3CASE STUDY
of their data among the Australian population it is revealed that both income and wealth
reduce the financial stress of a population. In Carla’s case, the income and housing and
renting become social determinant of health especially when the baby is going to come.
Disability is one of the concern in Carla’s case which lead her husband depend on her
financially, and hence disability is another reason why disability is another social determinant
of the health. According to Shim et al. (2014) poor mental health had been related to food
insecurity, low education (educational inequality), and poverty as well as housing instability.
Evidently it has been witnessed that homes, schools, workplace background and all these
have great impact on health, and can further lead to health inequalities (Thornton et al. 2016).
One of these determinants that has an Impact on whole population
Low income is a challenging determinant of health in Carla’s case and her family, but
at a greater prospect, low income is factor that can affect the whole population as well as food
insecurity. Here, in relation to Carla’s case, she had been faced by faced by monetary
challenges at each step of her life. The effect of poverty is not limited to this case only. The
effect of poverty, especially in the rural and remote areas, brings economic instability as well
health inequality (Crowe and Butterworth 2016). According to Kjӕrgård, Land and
Bransholm Pedersen (2013), there is an inadequate integration of health promotion and
sustainability dimensions at local, regional and global levels. The low income can affect the
education of the people and hence can also close employment options and level (Badland et
al. 2014). The health education and awareness are the most primary reasons for which health
choices and nutritional choices depend upon (Shankaran et al. 2013). With respect to that, the
Australian government has taken earnest step to address the social and health needs of the
rural, elderly people, Aboriginal and Torres Strait Islander peoples and for the ones who stay
in remote areas. Accessibility and primary health care promotion is one of the important
strategy which can reduce the basic or the primary health care needs of the people (World

4CASE STUDY
Health Organization 2019). Two such strategies are National Strategic Frameworks for
Chronic Conditions and National Primary Health Care Strategic Framework (Australian
Government-Department of Health 2019). According to the first frameworks, the behavioural
and biomedical risk factors, which are involved in social determination of health. The
framework aims to improving screening of the diseases as well as improving access to the
primary healthcare facilities, so that there can be improved accessibility of health care needs
for those who cannot afford it. Therefore, from these strategies, we can help people like Carla
and their families and eliminate food insecurity and address their health care needs.
Roles of Professionals
Understanding the health care needs of the population is important, and hence, health
care professionals are the intermediate subunits by which there can be a better collaboration
between the people staying in rural area (Australian Institute of Health and Welfare 2019).
As health care professionals, we can visit the rural and remote places and open a
screening procedure of disease where the diagnosis and treatment go faster. In this way it
will help the Aboriginals and Torres Strait Islander people, or people who are old and cannot
afford to travel and visit the hospital based in cities. There are policies and funding which
cover the eating and accommodation expenses for older people who have to travel.
Addressing the primary health care needs will not only educate them but also make them
informative about diseases and make them aware about the existing frameworks in Australia.
Therefore, collaborating with people from different communities would help the health
care professionals to not only collaborate but also create strong awareness in their
respective communities about disease and other help promotion. Nursing in rural place can
strengthen the bond and also eliminate the different health equalities among older population
and cannot afford expensive treatments.

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References:
Australian Institute of Health and Welfare, 2019. Australia’s health 2016. Retrieved from:
https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/
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Badland, H., Whitzman, C., Lowe, M., Davern, M., Aye, L., Butterworth, I., Hes, D. and
Giles-Corti, B., 2014. Urban liveability: emerging lessons from Australia for exploring the
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Baker, E., Mason, K., Bentley, R. and Mallett, S., 2014. Exploring the bi-directional
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Cohen, A.K. and Syme, S.L., 2013. Education: a missed opportunity for public health
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Crowe, L. and Butterworth, P., 2016. The role of financial hardship, mastery and social
support in the association between employment status and depression: results from an
Australian longitudinal cohort study. BMJ open, 6(5), p.e009834.
Hawkes, S. and Buse, K., 2013. Gender and global health: evidence, policy, and inconvenient
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Kjӕrgård, B., Land, B. and Bransholm Pedersen, K., 2013. Health and sustainability. Health
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health objectives in a context of economic crisis. Public Health Reviews, 35(1), p.9.

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Mason, K.E., Baker, E., Blakely, T. and Bentley, R.J., 2013. Housing affordability and
mental health: does the relationship differ for renters and home purchasers?. Social science &
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Thornton, R.L., Glover, C.M., Cené, C.W., Glik, D.C., Henderson, J.A. and Williams, D.R.,
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