Case Study of Carla: Social Determinants of Health and Strategies
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Case Study
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This case study examines the life of Carla, a 54-year-old woman from a coastal mining town, focusing on the social determinants of her health. The study explores how factors such as childhood experiences, family income, and education have influenced her well-being. Carla faced challenges including the early loss of her parents, financial struggles, and limited educational opportunities, which affected her and her children. The assignment analyzes the impact of these determinants and proposes strategies to address health disparities, including promotional programs focused on education and community-based initiatives. It also highlights the crucial roles of healthcare professionals, such as school nurses and community health workers, in improving access to healthcare and providing essential services. The study references relevant literature and emphasizes the interconnectedness of social factors and health outcomes, offering insights into how interventions can be designed to support individuals like Carla and improve public health.
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Running head: CASE STUDY OF CARLA
Topic: CASE STUDY OF CARLA
Name of the Student:
Name of the University:
Author’s Note:
Topic: CASE STUDY OF CARLA
Name of the Student:
Name of the University:
Author’s Note:
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1CASE STUDY OF CARLA
Answer 1:
The case study revolves around Carla who is 54 years of age. She have been born in a town
engaged in mining activities near the coastal area. She have been raised by her aunt as she
lost her parents when she was young. She have been married to John since her early teens and
they have two children. However, they separated after the birth of their second child, Annie.
Since then Carla have been living independently, handling the responsibilities of parent
single handedly for her children. They have faced a lot of financial crisis during their period.
Social models of health has developed as a result of the factors which affect the health
of an individual like cultural, social, environmental as well as political differences. For an
instance, low levels of self-esteem and stress contribute to the mental health of a society
(Cdhn.org 2019). Carla lives with her children in their house. John is supposed to help them
but he had lost his job and cannot support them financially. Hence, they live under
circumstances of immense financial crisis.
From the case study it can be seen that Carla strives to make monetary arrangements
for her family. Carla herself faced a lot of struggle trying to provide basic amenities for her
family. Although she had no difficulties working when her children were little, she faced
difficulties finding job when they grew up. Although her children have attended school, John
has finished class 12 and Annie, Carla’s daughter lives in a tiny apartment. Thus she and her
boyfriend cannot afford to live in a lavish apartment due to lack of money. Carla cannot
afford to provide monetary help to her daughter and visits her once a month due to lack of
money.
Answer 2:
The social determinants of health which are clearly evident from the case study of Carlaa and
her family are Childhood experiences, Family income, Education.
Answer 1:
The case study revolves around Carla who is 54 years of age. She have been born in a town
engaged in mining activities near the coastal area. She have been raised by her aunt as she
lost her parents when she was young. She have been married to John since her early teens and
they have two children. However, they separated after the birth of their second child, Annie.
Since then Carla have been living independently, handling the responsibilities of parent
single handedly for her children. They have faced a lot of financial crisis during their period.
Social models of health has developed as a result of the factors which affect the health
of an individual like cultural, social, environmental as well as political differences. For an
instance, low levels of self-esteem and stress contribute to the mental health of a society
(Cdhn.org 2019). Carla lives with her children in their house. John is supposed to help them
but he had lost his job and cannot support them financially. Hence, they live under
circumstances of immense financial crisis.
From the case study it can be seen that Carla strives to make monetary arrangements
for her family. Carla herself faced a lot of struggle trying to provide basic amenities for her
family. Although she had no difficulties working when her children were little, she faced
difficulties finding job when they grew up. Although her children have attended school, John
has finished class 12 and Annie, Carla’s daughter lives in a tiny apartment. Thus she and her
boyfriend cannot afford to live in a lavish apartment due to lack of money. Carla cannot
afford to provide monetary help to her daughter and visits her once a month due to lack of
money.
Answer 2:
The social determinants of health which are clearly evident from the case study of Carlaa and
her family are Childhood experiences, Family income, Education.

2CASE STUDY OF CARLA
As defined by World Health Organization (WHO) social determinants of health
(SDOH) are usually the various conditions under which people usually work live grow. It is
also inclusive of the social norms and policies along with political systems and economic
policies targeted at making the society and community a better place to live in (World Health
Organization, 2019).
As childhood experiences are concerned they are important in the determination of a
healthy community and an environment. Carla did not have a healthy family due to the
sudden demise of her parents and the similar situation has occurred with her children where
they have lived only with their mother. Both Robbie and Annie are not receiving the
complete care and attention which they should from their father and mother. Instead they are
living in a family run single handedly by their mother thus they cannot avail the basic
facilities like other children as their mother find it difficult to run her family single handedly.
The situation is becoming worse as they are growing up and often she cannot afford basic
facilities which they deserve to receive. According to Moore et al (2015), negligent and
inadequate caregiving along with weak or disrupted attachments are often thought to have a
negative impact on the upbringing of children.
Family income is another social determinant pivotal to a health family and an
environment. It is clearly evident from the case study that Carla finds it difficult to provide
monetary support to her family. Although she has managed to provide financial support for
the schooling, only Robbie have been able to avail. John is legally bound to help his family
post separation but even has lost his job and instead Carla has to support him when needed.
Thus family income is affected as it is very limited amount in the case of Carla and her
family. As far as education is concerned, Carla cannot afford to provide education to her
children. Only Robbie has managed to complete till class 12. Annie have not received the
basic education and lives with her boyfriend. In Australia, education as well as care have
As defined by World Health Organization (WHO) social determinants of health
(SDOH) are usually the various conditions under which people usually work live grow. It is
also inclusive of the social norms and policies along with political systems and economic
policies targeted at making the society and community a better place to live in (World Health
Organization, 2019).
As childhood experiences are concerned they are important in the determination of a
healthy community and an environment. Carla did not have a healthy family due to the
sudden demise of her parents and the similar situation has occurred with her children where
they have lived only with their mother. Both Robbie and Annie are not receiving the
complete care and attention which they should from their father and mother. Instead they are
living in a family run single handedly by their mother thus they cannot avail the basic
facilities like other children as their mother find it difficult to run her family single handedly.
The situation is becoming worse as they are growing up and often she cannot afford basic
facilities which they deserve to receive. According to Moore et al (2015), negligent and
inadequate caregiving along with weak or disrupted attachments are often thought to have a
negative impact on the upbringing of children.
Family income is another social determinant pivotal to a health family and an
environment. It is clearly evident from the case study that Carla finds it difficult to provide
monetary support to her family. Although she has managed to provide financial support for
the schooling, only Robbie have been able to avail. John is legally bound to help his family
post separation but even has lost his job and instead Carla has to support him when needed.
Thus family income is affected as it is very limited amount in the case of Carla and her
family. As far as education is concerned, Carla cannot afford to provide education to her
children. Only Robbie has managed to complete till class 12. Annie have not received the
basic education and lives with her boyfriend. In Australia, education as well as care have

3CASE STUDY OF CARLA
been considered as a basic personal concern. Moreover, education enhances the capacity for
proper decision making regarding health and increase the resources vital for physical as well
as mental health (Beavis et al.2015).
Answer 3:
The main strategy for addressing the determinants of the society are Promotional
programs and activities which are directly linked to various social determinants of health like
education. According to Makenbach et al (2015), there have been chances of higher mortality
rates among lower education statuses and the relation between education and mortality varies
due to causes between death and populations. Thus the best of way of addressing education
related disparities, education promotional activities can be implemented. These activities
improve the health through behavioral, social environmental changes (Jancey et al. 2016).
Educational as well as community based programs play a pivotal role in enhancing the
overall quality of life. Moreover they aim in reaching people which is outside their traditional
settings like schools, health care facilities and worksites (Healthypeople.gov 2019). This
increases the awareness of people regarding the disadvantages of lower education and various
effects related to it like mental problems, depression, isolation and various health inequities.
The following strategies involved in the implementation of such community based programs
are changing the various aspects involving the organizational as well as physical
infrastructure, implementing policies and improvising the existing programs and practices.
Moreover, changing the various community attitudes as well as beliefs and social norms is
also one of the important strategies in implementing the programs (Powell et al. 2017).
For further addressing the wider determinants of the society like childhood
experiences, social interactive sessions can be incorporated for interacting with children and
been considered as a basic personal concern. Moreover, education enhances the capacity for
proper decision making regarding health and increase the resources vital for physical as well
as mental health (Beavis et al.2015).
Answer 3:
The main strategy for addressing the determinants of the society are Promotional
programs and activities which are directly linked to various social determinants of health like
education. According to Makenbach et al (2015), there have been chances of higher mortality
rates among lower education statuses and the relation between education and mortality varies
due to causes between death and populations. Thus the best of way of addressing education
related disparities, education promotional activities can be implemented. These activities
improve the health through behavioral, social environmental changes (Jancey et al. 2016).
Educational as well as community based programs play a pivotal role in enhancing the
overall quality of life. Moreover they aim in reaching people which is outside their traditional
settings like schools, health care facilities and worksites (Healthypeople.gov 2019). This
increases the awareness of people regarding the disadvantages of lower education and various
effects related to it like mental problems, depression, isolation and various health inequities.
The following strategies involved in the implementation of such community based programs
are changing the various aspects involving the organizational as well as physical
infrastructure, implementing policies and improvising the existing programs and practices.
Moreover, changing the various community attitudes as well as beliefs and social norms is
also one of the important strategies in implementing the programs (Powell et al. 2017).
For further addressing the wider determinants of the society like childhood
experiences, social interactive sessions can be incorporated for interacting with children and
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4CASE STUDY OF CARLA
people who have undergone traumatic experiences during their childhood and thus reduce
stress (Browne et al. 2017). The strategies used for implementation of programs with affected
children are downstream as they deal with the children who are affected. Upstream strategies
are involved in the educational promotional activities for raising awareness among education
based disparities (Thornton et al.2016). Thus, downstream strategies have been taken as they
are only involved in specific groups in the society. These strategies will work as earlier
implementation of community based programs have attained success in creating awareness
among people and successfully informing them about atrocities regarding low education
levels (Mitchell et al.2016).
Answer 4:
According to World Health Organization, Health Care professionals play an important
role in the improvement of access for medical amenities and quality of healthcare aimed at
the population (WHO, 2019). Health care professionals are important for the provision of
essential services for the promotion of health, prevention of diseases as well as delivery of
healthcare services to various individuals including their families as well as communities who
are based on the heath care approach (WHO, 2019). Thus the roles played by various
healthcare professionals in the present situation of Carla are addressed in the paragraph.
Among healthcare professionals, the school nurse would help in providing health education
to school students. Moreover, they can help in spreading awareness among people of all age
groups through the implementation of health policies as well as programs (Lewallen et al.
2015). Community health workers play an important role in creating various connections
among health care systems and vulnerable populations (Eldredge et al. 2016). Moreover, they
help in reducing social isolations among various patient populations. Moreover, they help in
determination of eligibility as well as enroll individuals into various health insurance plans.
people who have undergone traumatic experiences during their childhood and thus reduce
stress (Browne et al. 2017). The strategies used for implementation of programs with affected
children are downstream as they deal with the children who are affected. Upstream strategies
are involved in the educational promotional activities for raising awareness among education
based disparities (Thornton et al.2016). Thus, downstream strategies have been taken as they
are only involved in specific groups in the society. These strategies will work as earlier
implementation of community based programs have attained success in creating awareness
among people and successfully informing them about atrocities regarding low education
levels (Mitchell et al.2016).
Answer 4:
According to World Health Organization, Health Care professionals play an important
role in the improvement of access for medical amenities and quality of healthcare aimed at
the population (WHO, 2019). Health care professionals are important for the provision of
essential services for the promotion of health, prevention of diseases as well as delivery of
healthcare services to various individuals including their families as well as communities who
are based on the heath care approach (WHO, 2019). Thus the roles played by various
healthcare professionals in the present situation of Carla are addressed in the paragraph.
Among healthcare professionals, the school nurse would help in providing health education
to school students. Moreover, they can help in spreading awareness among people of all age
groups through the implementation of health policies as well as programs (Lewallen et al.
2015). Community health workers play an important role in creating various connections
among health care systems and vulnerable populations (Eldredge et al. 2016). Moreover, they
help in reducing social isolations among various patient populations. Moreover, they help in
determination of eligibility as well as enroll individuals into various health insurance plans.

5CASE STUDY OF CARLA

6CASE STUDY OF CARLA
References
Beavis, A.S., Hojjati, A., Kassam, A., Choudhury, D., Fraser, M., Masching, R. and Nixon,
S.A., 2015. What all students in healthcare training programs should learn to increase health
equity: Perspectives on postcolonialism and the health of Aboriginal Peoples in
Canada. BMC medical education, 15(1), p.155.
Browne, C.A., Falcon, E., Robinson, S.A., Berton, O. and Lucki, I., 2017. Reversal of stress-
induced social interaction deficits by buprenorphine. International Journal of
Neuropsychopharmacology, 21(2), pp.164-174.
Cdhn.org. 2019. Retrieved from
https://www.cdhn.org/sites/default/files/downloads/FACTSHEETS%201_Screen%20View
%281%29.pdf
Eldredge, L.K.B., Markham, C.M., Ruiter, R.A., Kok, G., Fernandez, M.E. and Parcel, G.S.,
2016. Planning health promotion programs: an intervention mapping approach. John Wiley
& Sons.
Healthypeople.gov 2019. Educational and Community-Based Programs | Healthy People
2020. [online] Healthypeople.gov. Available at: https://www.healthypeople.gov/2020/topics-
objectives/topic/educational-and-community-based-programs [Accessed 15 Mar. 2019].
Jancey, J., Barnett, L., Smith, J., Binns, C. and Howat, P., 2016. We need a comprehensive
approach to health promotion. Health Promotion Journal of Australia, 27(1), pp.1-3.
Lewallen, T.C., Hunt, H., Potts‐Datema, W., Zaza, S. and Giles, W., 2015. The Whole
School, Whole Community, Whole Child model: a new approach for improving educational
References
Beavis, A.S., Hojjati, A., Kassam, A., Choudhury, D., Fraser, M., Masching, R. and Nixon,
S.A., 2015. What all students in healthcare training programs should learn to increase health
equity: Perspectives on postcolonialism and the health of Aboriginal Peoples in
Canada. BMC medical education, 15(1), p.155.
Browne, C.A., Falcon, E., Robinson, S.A., Berton, O. and Lucki, I., 2017. Reversal of stress-
induced social interaction deficits by buprenorphine. International Journal of
Neuropsychopharmacology, 21(2), pp.164-174.
Cdhn.org. 2019. Retrieved from
https://www.cdhn.org/sites/default/files/downloads/FACTSHEETS%201_Screen%20View
%281%29.pdf
Eldredge, L.K.B., Markham, C.M., Ruiter, R.A., Kok, G., Fernandez, M.E. and Parcel, G.S.,
2016. Planning health promotion programs: an intervention mapping approach. John Wiley
& Sons.
Healthypeople.gov 2019. Educational and Community-Based Programs | Healthy People
2020. [online] Healthypeople.gov. Available at: https://www.healthypeople.gov/2020/topics-
objectives/topic/educational-and-community-based-programs [Accessed 15 Mar. 2019].
Jancey, J., Barnett, L., Smith, J., Binns, C. and Howat, P., 2016. We need a comprehensive
approach to health promotion. Health Promotion Journal of Australia, 27(1), pp.1-3.
Lewallen, T.C., Hunt, H., Potts‐Datema, W., Zaza, S. and Giles, W., 2015. The Whole
School, Whole Community, Whole Child model: a new approach for improving educational
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7CASE STUDY OF CARLA
attainment and healthy development for students. Journal of School Health, 85(11), pp.729-
739.
Mackenbach, J.P., Kulhánová, I., Bopp, M., Deboosere, P., Eikemo, T.A., Hoffmann, R.,
Kulik, M.C., Leinsalu, M., Martikainen, P., Menvielle, G. and Regidor, E., 2015. Variations
in the relation between education and cause-specific mortality in 19 European populations: A
test of the “fundamental causes” theory of social inequalities in health. Social Science &
Medicine, 127, pp.51-62.
Mitchell, J.J., Gillon, K.E., Reason, R.D. and Ryder, A.J., 2016. Improving student outcomes
of community-based programs through peer-to-peer conversation. Journal of College Student
Development, 57(3), pp.316-320.
Moore, T.G., McDonald, M., Carlon, L. and O'Rourke, K., 2015. Early childhood
development and the social determinants of health inequities. Health promotion
international, 30(suppl_2), pp.ii102-ii115.
Powell, B.J., Beidas, R.S., Lewis, C.C., Aarons, G.A., McMillen, J.C., Proctor, E.K. and
Mandell, D.S., 2017. Methods to improve the selection and tailoring of implementation
strategies. The journal of behavioral health services & research, 44(2), pp.177-194.
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.
Who.int 2019. WHO | Health professions networks. [online] Who.int. Available at:
https://www.who.int/hrh/professionals/en/ [Accessed 15 Mar. 2019].
World Health Organization 2019. Who we are?. [online] World Health Organization.
Available at: https://www.who.int/social_determinants/about/en/ [Accessed 15 Mar. 2019].
attainment and healthy development for students. Journal of School Health, 85(11), pp.729-
739.
Mackenbach, J.P., Kulhánová, I., Bopp, M., Deboosere, P., Eikemo, T.A., Hoffmann, R.,
Kulik, M.C., Leinsalu, M., Martikainen, P., Menvielle, G. and Regidor, E., 2015. Variations
in the relation between education and cause-specific mortality in 19 European populations: A
test of the “fundamental causes” theory of social inequalities in health. Social Science &
Medicine, 127, pp.51-62.
Mitchell, J.J., Gillon, K.E., Reason, R.D. and Ryder, A.J., 2016. Improving student outcomes
of community-based programs through peer-to-peer conversation. Journal of College Student
Development, 57(3), pp.316-320.
Moore, T.G., McDonald, M., Carlon, L. and O'Rourke, K., 2015. Early childhood
development and the social determinants of health inequities. Health promotion
international, 30(suppl_2), pp.ii102-ii115.
Powell, B.J., Beidas, R.S., Lewis, C.C., Aarons, G.A., McMillen, J.C., Proctor, E.K. and
Mandell, D.S., 2017. Methods to improve the selection and tailoring of implementation
strategies. The journal of behavioral health services & research, 44(2), pp.177-194.
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.
Who.int 2019. WHO | Health professions networks. [online] Who.int. Available at:
https://www.who.int/hrh/professionals/en/ [Accessed 15 Mar. 2019].
World Health Organization 2019. Who we are?. [online] World Health Organization.
Available at: https://www.who.int/social_determinants/about/en/ [Accessed 15 Mar. 2019].
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