Understanding Social Determinants of Health and Health Disparities PDF

Understanding social determinants of health and health disparities Dr. Alleya James Keesee, OTD, OTR/L OTD 5050 Health Conditions Fall 2024 About Dr. JK: - Pronouns: She/Her/Hers - Specialize in pelvic health of all sexual orientation...

Understanding social determinants of health and health disparities Dr. Alleya James Keesee, OTD, OTR/L OTD 5050 Health Conditions Fall 2024 About Dr. JK: - Pronouns: She/Her/Hers - Specialize in pelvic health of all sexual orientations and genders. - Additional specialities: ortho/UE rehab, vestibular rehab - Work in outpatient ortho clinic with PTs - MU OTD ‘22 graduate - Fun fact -> Cat lover - Spare time -> spending time with family and friends, cooking, and reading (when I have the chance) - Favorite show -> Bob’s Burgers and Big Bang Theory COURSE FORMAT Once a week 2:00 - 3:45 – Didactic (lecture) content 4:00 - 4:45 – Case Application & Lived Experience  Questions without assumptions Are you comfortable Daily routines telling us more about… I am interested to know GUEST about…..from your experience Work or school INTERACTIONS & How has {health QUESTIONS condition} impacted your Leisure activities functioning/participation in Relationships Being in the community or certain spaces ASSIGNMENT CONSIDERATIONS Evidence-Informed Credible Current Cited Use of Artificial Intelligence (ChatGPT etc) Use as a brainstorming tool, a starting point You add the reasoning, application, and final review for validity If used, citation and acknowledgement required GRADES Reading Quizzes: low stakes (10% for 6) & corrections opportunity Midterm and Final Exams Health Disparity Reflection Case Study Interview Paper (w/OTD 5200) OTPF Health Condition Concept Map (Product + Presentation) Overwhelmed? Tell Me More! This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY-SA-NC  What are we going to talk about? Social Determinants of Health Occupational Justice Health and Health Disparities  WHY ARE WE STARTING HERE? Impact Health Conditions Occupational Performance (Psychosocial Conceptual Practice Models in Occupational Therapy, 2007) ALL LEVELS OF IMPACT Pathophysiology: Performance Skill Body Structure – Impact on Body Function Function Lived Experiences Health & Health Disparities Defined Health is to reach a state of complete physical, mental and social well- being, an individual or group must be able to identify and to realise aspirations, to satisfy needs and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living…’ (WHO, 1986) Health inequalities are the systematic, avoidable, and unfair differences in health outcomes that can be observed between populations, between social groups within the same population or as a gradient across a population ranked by social position (McCartney, Popham, McMaster, Cumbers, 2019)  Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care’ (Braveman et al, 2017). Health & Health Disparities Defined Health Disparities are: Due to the vulnerabilities Systemic and Unfair and Avoidable and created by Not inevitable not random unjust Unnecessary social structures and institutions.  Economic factors and poverty Education and literacy Factors contributing to Access to healthcare health services disparities Physical environment and neighborhood conditions Social and community support  Racial and ethnic disparities Gender disparities Examples of health disparities Geographical disparities (urban vs. rural) Age-related disparities Group work: Impact on vulnerable populations Who are all the parties involved? Who are the vulnerable populations? How are they impacted? Impact on occupation? Long term effects? GROUP #1 GROUP GROUP #2 GROUP #3 #4 Strategies for change Collaboration between Policy changes to healthcare (that’s us!), reduce income, government, and housing, childcare community inequality organizations Creating inclusive, Investing in education accessible healthcare and job opportunities systems  Definition of occupational therapy and its holistic approach to health Introduction to Importance of considering occupational social determinants of health therapy and in occupational therapy SDOH practice Overview of how occupational therapy can contribute to reducing health disparities  Social determinants of health (SDOH) Explanation of social determinants of health (SDOH) Examples of SDOH: socioeconomic status, education, employment, social support and access to resources/services Impact of SDOH on health and well-being Healthy People, 2030  WHAT ARE SDOH? Economic policies & systems Economic Stability Development agendas Education Access and Quality Social norms Health Care Access and Quality Social policies Neighborhood and Built Racism Environment Climate change Social and Community Context Political systems (CDC, 2022). (HHS)  SDOHs are found here!! Account for up to 80% of an individual’s variance in health outcomes (Lott et al., 2021) Incorporating SDOH into occupational therapy Case study Occupational therapy showcasing the impact practitioners consider of SDOH on an social determinants of individual's health in assessments occupational and interventions performance OCCUPATIONAL PROFILE DAVID David, a 30-year-old man, has been diagnosed with multiple sclerosis (MS). He lives in a rural community with limited access to healthcare resources. Despite his determination, he faces significant challenges in managing his MS due to various health disparities and social determinants of health.  DAVID Health Disparities and SDOH Factors: 1. Geographical Disparity: David lives in a remote rural area, far from specialized medical facilities. The lack of local neurologists and MS experts makes it challenging for him to receive timely and appropriate care. 2. Limited Health Literacy: David has a high school education but struggles to understand complex medical information. This hinders his ability to follow his treatment plan effectively. 3. Unemployment: Due to limited job opportunities in his area and the unpredictable nature of MS symptoms, David struggles to find stable employment. This affects his access to health insurance and financial stability. 4. Social Isolation: David's remote location and limited mobility due to his condition contribute to feelings of isolation and lack of social support. DAVID Impact on Health and Functional Performance: Health Outcomes: David's limited access to specialized care results in delayed diagnoses and suboptimal management of his MS symptoms, leading to increased disability progression. Daily Activities: Fatigue, mobility issues, and cognitive challenges associated with MS impact David's ability to perform meaningful daily tasks independently. Employment: David's unemployment and financial instability hinder his ability to afford medications and transportation to medical appointments. Psychosocial Well-being: Social isolation and lack of access to mental health support exacerbate feelings of depression and anxiety, common among individuals with neurological conditions. Occupational injustice and health disparities Definition of occupational justice 4 Occupational Rights Outcomes of occupational injustice Occupational injustice contributes to health disparities Role of occupational therapists in advocating for occupational justice and equitable access to meaningful activities  Addressing disparities through occupational therapy Collaborative approach to addressing SDOH: working with other healthcare professionals, community organizations, and policymakers Adapting interventions to fit the cultural, socioeconomic, and environmental contexts of diverse populations Approaching all client interactions with humility and seek to understand their unique experience with and impacts of health conditions References 1. Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public health reports, 129(suppl 2), 19–31. 2. WHO (1986). The Ottawa charter for health promotion. 3. Card AJ. Moving beyond the WHO definition of health: a new perspective for an aging World and the emerging era of value- based care. World Med Health Pol 2017;9(1):127e37. 4. Healthy people 2030. (2020). Social determinants of health. U.S. Department of health and human services. 5. World health organization. (2021). Social determinants of health. Retrieved from https://www.Who.Int/health-topics/social-determinants-of-health 6. McCartney, G., Popham, F., McMaster, R., & Cumbers, A. (2019). Defining health and health inequalities. Public health, 172, 22-30. 7. Doll, J., Malloy, J., & Gonzales, R. (2023). Health Policy Perspectives—Social determinants of health: Opportunity for occupational therapy. American Journal of Occupational Therapy, 77, 7704090010. 8. Chat GPT: David Case (Accessed on: 8/19/23)