Question

sara is a 50-year-old woman who lives in a poor village in india. unfortunately, sara’s health ... Question: Sara is a 50-year-old woman who lives in a poor village in India. Unfortunately, Sara’s health ha... Sara is a 50-year-old woman who lives in a poor village in India. Unfortunately, Sara’s health has deteriorated in the last year. Her blood pressure and cholesterol are too high. She is sometimes short of breath. She has developed diabetes. She is currently dependent on a regular supply of insulin, which she picks up monthly at a government clinic. Although she is only 50, she has already suffered some of the circulatory complications of diabetes. Because of this, Sara had to spend the equivalent of $20 on health services and transportation, and missed 2 weeks of work, during which she lost another $20 of income. The total cost of this illness was about 10% of Sara’s annual earnings. There is a common perception that diabetes is a disease that affects only people in high-income countries. This, however, is not the case. Rather, the prevalence of diabetes is growing rapidly in low-income & middle-income countries. India now has the largest number of people with diabetes. The highest percentage of an adult population with the disease can be found here in which 31% of adults have diabetes. Identify the health determinants of the case study. Comment on the social, political and economic risk factors. Having identified these determinants, articulate what could be done in the short and long run to address them.

Answer 1

Following are the health determinants, directly or indirectly mentioned in the case study......

1. Age and sex (These inborn factors play a part in determining lifespan and likelihood of developing certain illnesses. It is completely beyond an individual’s control) : Sara is 50 old woman post menopause woman who is very much into the middle adulthood . Both factors are not necessarily positive indicators for good health (with out other supporting factors).

2 . She is from a poor village in India who spends 20$ equivalent on health services and transportation, misses 2 weeks of work amounting to another 20$ and incurring 10% of her annual income on illness - This statement reveals following health determinants directly or indirectly.

A) Income and social status

Health status improves at each step up the income and social hierarchy. Higher income and status generally results in more control and discretion. Income determines living conditions such as safe housing and ability to buy sufficient good food. (here lack of it negatively contributing )

B) Physical environment

Safe water, clean air, healthy workplaces, safe houses, design of communities and transportation systems all contribute to good health. (here lack of all these negatively contributing)

C) Health services

Access and use of services that prevent and treat disease influences health.(here too lack of it negatively contributing)

D) Employment and working conditions

People in employment are healthier, particularly those who have more control over their working conditions. (here in a poor village possibly poor working environment and low earnings negatively contribute )

(Education

Health status improves with level of education. Education is closely tied to socio-economic status. It increases opportunities for job and income security, improves people’s ability to access and understand information to help them keep healthy.

Even though not mentioned, a poor village in India and a woman with lower income suggests lack of educational accessabilities)

Other social, political & economical risk factors and other contributing factors are

Co morbidity of other physical conditions like high blood pressure and cholesterol

High prevalence (31%) of diabetes in the country.

Culture and social hierarchies in a poor Indian village

Short-term solution :

Providing financial grant equivalent of illness cost including transportation, health services, lost work etc

Providing access to nutitional diet and continued support of medicines, insulin etc

Longer-term solutions

Creating health care infrastructure for bringing down high prevalence of diabetes in the country. Providing those in the villages along with good employment, educational and transprtational facilities and creating awareness among the general public. Creating community support centers .