Health Assessment
Introduction
The social determinants of health are those instances, situations and environments to which humans are exposed to which causes illness or mortality. Social determinants play a huge role in molding the health of people, especially ethnic groups. According to some studies, ethnic and minority groups are more exposed to diseases and illnesses. One reason for this is the aspect of the social determinants of health. Ethnic and minority groups are more exposed to the harsh social and environmental conditions present in the world. Compared with the majority, minorities have more inclination to get sick and die. According to the Public Health Agency of Canada, some of the social determinants of health are: Income and social status, Social support networks, Education and literacy, e.g. health literacy, Employment/Working conditions, Social environments, Physical environments, Personal health practices and coping skills, Healthy child development, Biology and genetic endowment, Health services, Gender and Culture. Being exposed to different factors would often result in illnesses and even mortality. Studies have been conducted on the different socio-economic groups and the results have often pointed to the ethnicity and status of the group as the cause of the outcome.
It is no longer an enigma to us why so many people from third-world countries with low socio-economic status get sick and die more often than people from the opposite side of the scale. These people are exposed to: little food, unclean water, low levels of sanitation and shelter, failure to deal with the environments that lead to high exposure to infectious agents, and lack of appropriate medical care. Furthermore, these people suffer from other incommunicable diseases due to the same factors. The World Bank Global Burden of Disease have identified underweight, overweight, smoking, alcohol consumption, hypertension, and sexual behaviour as the major causes of morbidity and mortality around the world.
According to the article, “ A call to action on Maori cardiovascular health” by the research results state that further research is needed in order to come up with a way to lessen the disparities in mortality rates between the Maori and the non-Maori. Furthermore, the authors believe that Kaupapa Maori research should be taken in order to fully address the needs of these tribes. According to the authors, when research is done in the perspective of the Maori, the needs of the tribes can be properly addressed and taken into consideration. Furthermore, the Kaupapa Maori research also advocates for the use of Maori: non-Maori comparisons and produces results that have ‘equal’ meaning and relevance to Maori as non-Maori (2004). Also, the Maori Cardiovascular Advisory Group utilizes research techniques that address the needs of the Maori in the Maori perspective, therefore effectively addressing not only their medical needs scientifically, but socially and culturally as well.
Discussion
Being a part of a minority group implies a degree of inequity right away. Meaning there is an inherent disadvantage that one acquires to the moment he/she considers himself/herself a part of the minority. This has been the problem in any state with a highly diverse population. Though it is primarily seen in the United States, this situation is not restricted to its boundaries. This takes place in Europe and Asia. ( 1995, 2004) Thus, this establishes it as a universal phenomenon.
Factors that Greatly Contribute to Health Deterioration among Minority Ethnic Tribes
The factors that contribute to health deterioration among minority ethnic tribes are located in almost every exiting country, regardless of its economic status. The following are the reasons why these groups tend to develop illnesses more chronic than those of the majority.
Ø Economic and Social Factors – The economic and social factors play a great role in determining the health status of an individual. Being in the high rung of the social and economic ladder may not mean that one is exempt from ill health. However, their placement ensures that they get a better degree of treatment for their acquired illnesses. For those who belong to the lower portion of the ladder, however, it would be difficult for them to get treatments for their illnesses. Furthermore, their constant exposure to unhealthy environments, unhealthy food and unhealthy practices can be a sure road to more illness and even mortality. Low socioeconomic may precipitate reduced access to health care, poor nutrition, lower educational levels, and hazardous environments. Moreover, relationships with significant others involving abusive behavior, poor communication or high stress can negatively affect an individual’s health. For example, a poor aboriginal woman, who is the leader of her tribe, appears to have a successful and happy life. But in fact, she is constantly stressed by the troubles that her tribesmen face everyday, furthermore, less monetary income induces the stress.
Ø Biological Risk Factors – Some potential health problems are related to biological health risks attributed to the race or blood-related family members. For example, a local tribesman is at risk of having the same illness as his family members, heart failure. This local tribesman is at two times more risk of developing this illness due to the fact that he is a member of a family who is at risk of having this illness than a person who doesn’t have such a family history. Awareness of such health risks may motivate this person to seek medical assistance, if such is available to him. Furthermore, this tribesman can reduce such risks by altering some behaviors that may induce such illnesses.
Ø Environmental Health Risk Factors –Environmental risk factors may be physical or socioeconomic. Physical risk factors are more clearly associated with specific health problems and are usually more amenable to change. For example, a person works with loud machinery and hearing damage is a risk. The risk can be lowered by using ear plugs. It is more difficult to identify health risk factors arising from socioeconomic factors. It may be difficult for an individual to change such socioeconomic factors. For example, consider a member of a minority group, Percival, a single, unemployed parent with four children, living below the poverty level in a rural area. He may be experiencing conditions that negatively affect health, but this may be difficult to identify and correct.
Ø Physical Health Risk Factors – these include air, water, food and noise pollution; radiation exposure; risks from unsafe products; and risks associated with certain occupations and recreational activities. Hazardous occupations may include fire fighting, surface mining, and police work, the lumber industry, working in a quarry, construction or foundry, and working with cement or clay and mineral products. Many accidents are caused by human failure and may be due to contributing factors such as stress, poor mental health, age and alcoholism.
Health assessment through Lifespan
The potential for developing certain health problems correlates with the individual’s age and sex, as well as biologic, environmental and behavioral factors. As one’s age changes, the risk of developing certain health problems also changes. For example, the risk of developing bowel cancer increases after age 50.
People may have similarities, particularly if they are the same sex, age race or cultural group, and if they share the same occupation, recreational activities, and health behavior or health problems. However, each individual also has differences, which account for the uniqueness of each person. In some circumstances, it is appropriate to look at valid and reliable research on a group’s genetic characteristics or similarities and apply these characteristic findings to an individual in the group. However, usually, such generalization is inappropriate and possibly even dangerous. This may be true of generalizations based on assumptions, limited experience or prejudice.
Assessing a person’s risk factors for future health problems and using age and sex characteristics for health screening testing are appropriate applications of group characteristics to an individual. These activities identify possible health problems. However, caution is still necessary. The person needs to understand when a health problem is potential, not inevitable.
Psychosocial information is often perceived as more personal and private than physiologic data. Some people find it difficult to disclose psychosocial information, especially if they feel that they are being “judged”. Psychologic patterns are non-physical components of human beings that are individual. Social experiences are the parts of an individual’s life, affected by or dependent on other people. The term psychosocial is used because psychologic factors and social factors are not entirely separated. In turn, psychosocial elements are not separate from the physiologic components. All components combine to form an individual. Physical health history assessment is intertwined with psychosocial health assessment. To completely assess physical health, one must learn the person’s physical history and have the person undergo physical examination.
Health Assessment and Possible Intervention
Psychologic, sociologic and physiologic assessments belong together. The three areas overlap and interact so extensively that significant information is lost if they are not considered in relation to each other. Psychologic assessment involves assessing variables affecting an individual’s mind and ways that they affect behavior. Thus, psychologic assessments includes factors such as behavior, mental status, motivations, personal strengths, values, beliefs and lifestyles.
It is useful to describe behavior than to guess what a behavior might mean. For example, one must state. “xxx is crying” rather than “xxx is depressed”. Without assessment, one would not know why xxx is crying. If xxx says he or she is depressed, then that would be the time to state that xxx is depressed. Considering a person’s behavior is central to all other components of psychosocial research.
Assessing a person’s mental status involves (a) formally observing a person’s verbal and non-verbal behavior and (b) asking questions to assess the person’s sensorium. Principal areas and usual documentation format for mental examinations are:
Ø General Appearance
Ø Motor Behavior
Ø Affect
Ø Mood
Ø Speech and communication
Ø Thought processes and content
When one assesses mental status, one must always individualize his or her discussion and questions. One must always make sure that the content of the discussion is relevant to the situation of the patient being assessed. For example, while it may be appropriate to ask a teenager the name of the currently popular singer, this question may not be appropriate for an elderly person. It is not appropriate to ask mathematical questions of someone who has never studied mathematics. Also, one needs to know the correct answers to the to the questions one asks the patient.
Everyone has a basic human need for love and belonging. To fulfill this need, humans establish a social network around ourselves. One’s social network can potentially fulfill important functions for each of us, such as:
Ø Intimacy
Ø Social Integration
Ø Nurturing Behavior
Ø Reassurance
Ø Assistance
When people enter the health care system, medical staff temporarily become part of their social network. However, people are still involved in and have the right to use the ongoing social networks that are part of their established lifestyles. A health care personnel needs to know something of a person’s established social network.
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