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Case Study 1: Mrs. Zaretsky (Health Illness and Disease) Mrs. Zaretsky a 64-year-old widow lives in...

Case Study 1: Mrs. Zaretsky (Health Illness and Disease) Mrs. Zaretsky a 64-year-old widow lives in a low-income area. She has multiple health problems including diabetes and hypertension. She eats a lot of fast food and smokes. She visits the clinic and community centre because of a sore on her foot that refuses to heal. She is on several medications but doesn’t always take them because she thinks they are too expensive so sometimes she doesn’t bother to get them refilled. She also has an intense dislike for the pharmacist who often chastises her for not getting her medications as scheduled. Mrs. Zaretsky has been encouraged to come to join the centre for lunch and meet some of the other ladies. She says she doesn’t mind the meal but really doesn’t like those old biddies.

1. What determinants of health could be affecting Mrs. Zaretsky?

2. Which of the following is a determinant for Mrs. Zaretsky? Age, gender, behaviour or social norms. Why?

3. What health modifications can be encouraged with her?

4. In a socioenvironmental approach to health, what questions would you need to address to decrease smoking behaviour with her (or in her area)?

Solutions

Expert Solution

1. There are 5 determinants of health that is affecting her

  • Nutrition: she consumes fast food
  • Life style: she smokes
  • Medical care: she has been suffering diabetes mellitus, hypertension. She has a non healing                                   sore   on foot. She refuses to take to drugs for that and think that it costs higher
  •        Income and social status: she arrives from low income family
  • Social support network: she refuses to join in the centre where many ladies are come

2. Behavioral is determinant to her health. She has behaviors problem. Because she consumes faulty nutrition, smokes daily. Even though she comes to visit clinic, she did not consume medication. She refuses to visit to go to center for meeting women in the centre. Age plays also important role in determinant of health, because she has low immunity comparatively, chances of infection of non healing ulcer in her foot. Age is lower than behavior determinants of health

3. Mrs. Zaretsky has to avoid fast food as she is diabetic and hypertensive. She has to consume diabetic diet along with low salt intake of homemade food. She can be encouraged to avoid smoking habits as it poses risks to heart and lung related problem by explaining in clearly and slowly manner. She is advised to continue her medication because non healing ulcer is result of diabetic complication. Explain her about diabetic and hypertensive complication if she does not continue her medication

4. In her area, is there any smoke free laws and tobacco control programmes available?

What is the cost of smoking cigarettes in her area?

Smoke free laws and higher tax imposed on tobacco products can reduce smoking equally in her area. Because socially imposed policy that bring down smoking habits nad conducting mass media campaigns that also bring down the smoking habits.


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