In: Nursing
One employee is confused by the term “determinants” and asks for clarification. You give a general definition, differentiating between downstream and upstream determinants, and provide the examples below. You ask them to identify which of the determinants below is the upstream determinant of not wearing sunscreen—the health behavior—for skin cancer prevention. They correctly select
Having a family history of skin cancer
Thinking there is no way you could get skin cancer
Hating how sunscreen makes your skin feel
Sunscreen not being available in local stores
Step 1
Social Determinant of Health are the environmental and social conditions in which individuals live and work. They are divided into three types : Upstream, Midstream and Downstream.
Upstream Determinants refer to something that is occurring at a macro level; regarding government policies and programs. Midstream Determinants refer to some intermediate factors like health behaviors. While Downstream Determinants include things at genetic or micro level.
Step 2
Upstream determinants are those factors that are beyond the control of an individual and they have a significant impact on other individuals of the society. For e.g., upstream pollution in a river affects the population downstream for a longer time, instead of the fact that this population have a little to no control over this issue.
On the other hand, downstream determinants can be controlled by a particular individual. It refers to an individual's eating habits or about reducing the risk of injury on the work place.
Step 3
Answer :
The upstream determinant of not wearing sunscreen is that -
Sunscreen not being available in local stores.
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