NRNP 6552 WEEK 1 Social Determinants of Health Among the Female Population
NRNP 6552 WEEK 1 Social Determinants of Health Among the Female Population
Social determinants of health include where a person is born, resides, receives their education, and work. These factors can affect a person’s quality of life and health outcomes. I currently reside in Durham, North Carolina. With over 300 medical and health related companies, Durham is known as the “City of Medicine” (Welcome to the City of Durham | Durham, NC, 2023). Located in the piedmont region of North Carolina, Durham has a current population of 287,794 residents (Durham, North Carolina Population 2020 (Demographics, Maps, Graphs), 2023). However, of those 287,794 residents, 13.5% live in poverty; 5.47% more than the United States’ average. Of that 13.5%, Blacks and Hispanics make up the majority of impoverished ethnic groups. Durham was once the nation’s center for tobacco and textile production. However, as those jobs have disappeared and education and income requirements have risen, the original working class residents, who are often poor and Black, are being priced out of the city and forced to move to more rural areas (De & Hunt, 2018). This migration diminishes Black and Hispanic women and mothers’ access to higher wages, better education options, health care, and public transportation.
The population in Durham has increased significantly. So much so, that there is now a housing shortage. With limited supply and high demand, the cost of buying or renting a residence has significantly increased. According to Mobility Metrics for Durham, North Carolina (2021), for those living in poverty, there are few affordable housing options. They estimate that for every 100 low-income households there are only 34 affordable units available in Durham County. This shortage has forced some residents into homelessness, living in shelters, or staying in motels for extended periods of time. In 2020, there were 134 reported cases of domestic homicide. 77 victims were women and 99 offenders were male (Report on Domestic Violence Related Homicides for Calendar Year 2020, 2020).
The city is also challenged in improving the public transportation system for its patrons. In the documentary “Challenges To Equitable Transit – A Durham Documentary”, low income, Black, and Brown residents were interviewed about the transportation issues in Durham. According to the documentary, residents were seeking better sidewalks, safer transit connection locations, benches or shelters at bus stops, faster and more direct routes to healthcare facilities and colleges, and more reliable service (Law, 2021).
The North Carolina budget signed into law on November 18, 2021 will gradually decrease the state’s corporate tax to 0% by 2030 (Skinner , 2023). This bill will make the state more attractive to corporations. However, it will not address the individual tax rate that is currently at 4.75% (Skinner , 2023). With more than 300 medical businesses in Durham possibly contributing zero tax dollars, middle and lower income residents will be required to pay more. I would propose changing this law and taxing corporations that choose to do business in the state. Those tax dollars could be used to install and fix sidewalks, provide more affordable housing options for low-income families, and improve public transportation.
De, A., & Hunt, H. (2018). Racial Inequality, Poverty and Gentrification in Durham, North Carolina. https://fpg.unc.edu/sites/fpg.unc.edu/files/resource-files/durham_final_web.pdf Durham, North Carolina Population 2020 (Demographics, Maps, Graphs). (2023). Worldpopulationreview.com. https://worldpopulationreview.com/us-cities/durham-nc-population
Links to an external site. Durham, North Carolina Population 2020 (Demographics, Maps, Graphs). (2023). Worldpopulationreview.com. https://worldpopulationreview.com/us-cities/durham-nc-population
Law, J. (2021, April 16). Challenges to Equitable Transit – A Durham Documentary. Www.youtube.com. https://www.youtube.com/watch?v=Fad5McQnDw8&t=3s Skinner , V. (2023, January 24). Analysis: North Carolina’s corporate tax rate lowest in the country. The Center Square. https://www.thecentersquare.com/north_carolina/article_22c487ce-9c2d-11ed-87a0-8f2cf dee8809.html
Mobility Metrics for Durham, North Carolina. (2021). Urban.org. https://upward-mobility.urban.org/sites/default/files/mobility-metrics-data-pages/999_cou nty-pages/37063/index.html
Report on Domestic Violence Related Homicides for Calendar Year 2020. (2020).
Skinner , V. (2023, January 24). Analysis: North Carolina’s corporate tax rate lowest in the country. The Center Square. https://www.thecentersquare.com/north_carolina/article_22c487ce-9c2d-11ed-87a0-8f2cfdee8809.html
Welcome to The City of Durham | Durham, NC. (2023). Www.durhamnc.gov. https://www.durhamnc.gov/1457/Welcome-to-The-City-of-Durham
I agree with you that social determinants of health include information on people’s residence, education, economic status, careers and development. Social determinants of health plays an important role in determining access to healthcare services (Turner-Musa et al., 2020). For instance, people in the lower economic status are limited to certain healthcare services due to their low financial strength. However, affluent individuals use their financial muscles to obtain varied healthcare services. Similarly, social determinants of health determine access of healthcare services among different racial groups. Regrettably, African-Americans and Latino Americans struggle to get quality healthcare services in the U.S due to healthcare disparities (Palmer et al., 2019). The majority of Americans who are Whites enjoy the privilege of quality healthcare services. Similarly, healthcare disparities has interfered with the access of healthcare information that influence individual choices on lifestyles and nutrition. Social determinants of health are multiple factors that influence access of healthcare services among different people. Low-income households due to their low economic status are at risk of struggling to access quality and affordable healthcare services.
Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: future directions for health disparities research. American Journal of Public Health, 109(S1), S70-S71. https://doi.org/10.2105/AJPH.2019.304964
Turner-Musa, J., Ajayi, O., & Kemp, L. (2020, June). Examining social determinants of health, stigma, and COVID-19 disparities. In Healthcare (Vol. 8, No. 2, p. 168). MDPI. https://doi.org/10.3390/healthcare8020168
Thank you, Needra, for sharing your insights on the social determinants of health in Durham, North Carolina. You have highlighted several important factors that contribute to health disparities in your community. I would like to provide additional insight and suggestions related to the issues you raised. Regarding Safe housing, transportation, and neighborhoods, the housing shortage in Durham, coupled with the rising costs, has led to limited affordable housing options, homelessness, and prolonged stays in shelters or motels. To address this issue, it is crucial to invest in affordable housing initiatives and increase the availability of subsidized housing for low-income families. Additionally, improving public transportation infrastructure, as advocated by residents in the documentary you mentioned, can enhance access to essential services and opportunities. In addition to addressing the housing shortage, it is important to consider the quality and safety of existing housing options. Ensuring that affordable housing is not only available but also meets health and safety standards is crucial (Crear-Perry et al., 2021). Furthermore, improving neighborhood infrastructure, such as sidewalks and street lighting, can enhance safety and promote physical activity. Collaborating with community organizations and residents to identify specific areas that require improvement can help prioritize and address these issues effectively.
You highlighted the racial disparities in poverty rates, which disproportionately affect the Black and Hispanic populations in Durham. Addressing systemic racism and discrimination is vital for promoting equitable health outcomes. Encouraging community dialogues, implementing anti-discrimination policies, and supporting organizations that focus on racial justice can help create a more inclusive and equal society (Cabral & Cuevas, 2020). To tackle racism and discrimination in Durham, community engagement and education are vital. Promoting diversity and inclusion in all aspects of society, including healthcare, education, and employment, can help create a more equitable environment. Implementing policies that address systemic racism, supporting implicit bias training for professionals, and fostering dialogue between different racial and ethnic groups can contribute to reducing disparities and promoting social cohesion.
The decline of traditional industries like tobacco and textiles, along with increasing education and income requirements, has resulted in economic challenges for the original working-class residents, particularly those who are poor and Black. To address this, it is important to invest in education and job training programs that provide accessible pathways to higher-paying jobs. Promoting equitable employment opportunities and supporting entrepreneurship can also contribute to reducing income disparities. In addition to job training programs, it is important to focus on educational opportunities for all residents, a process that includes providing access to quality early childhood education, addressing achievement gaps in schools, and ensuring that higher education is affordable and accessible (Cabral & Cuevas, 2020). Supporting initiatives that promote entrepreneurship and small business development can also create more job opportunities and increase economic mobility.
Access to healthy foods and opportunities for physical activity are crucial for maintaining good health. Strategies to improve food access include promoting community gardens, supporting farmers’ markets, and implementing policies that incentivize the establishment of grocery stores in underserved areas. Additionally, creating safe and accessible recreational spaces can encourage physical activity and improve overall well-being. In addressing food deserts and limited access to nutritious foods, considering strategies such as mobile markets, community-supported agriculture programs, and collaborations with local farmers can be effective (Crear-Perry et al., 2021). Additionally, creating safe recreational spaces in underserved areas, promoting physical education in schools, and partnering with community organizations to offer low-cost or free physical activity programs can help increase opportunities for regular exercise.
Polluted air and water can have detrimental effects on health as you have noted. Collaborative efforts between the government, industries, and communities are necessary to reduce pollution levels and improve environmental quality. Implementing stricter regulations on emissions, supporting renewable energy initiatives, and investing in clean water infrastructure are some measures that can be considered. Efforts to improve air and water quality should involve implementing and enforcing stricter environmental regulations. Collaborating with environmental agencies and community groups to monitor pollution levels and identify sources of contamination can help target interventions effectively (Crear-Perry et al., 2021). Supporting initiatives that promote renewable energy sources and sustainable practices can contribute to long-term environmental health.
Language and literacy skills are fundamental for individuals to access healthcare services, educational opportunities, and job prospects. Supporting literacy programs, providing language assistance services in healthcare settings, and promoting culturally sensitive education can help address language and literacy barriers and improve health outcomes. Addressing language and literacy barriers requires these comprehensive approaches for more complete resolution of persistent problems (Hill-Briggs et al., 2021). Providing language assistance services, such as interpreters and translated materials, in healthcare settings can improve access to care for non-English speakers. Investing in adult literacy programs and promoting early childhood literacy initiatives can help improve literacy rates and educational outcomes. Collaborating with community organizations and schools to provide language support and culturally relevant educational materials can also make a significant difference especially in a community such as Durham, North Carolina.
Crear-Perry, J., Correa-de-Araujo, R., Lewis Johnson, T., McLemore, M. R., Neilson, E., & Wallace, M. (2021). Social and structural determinants of health inequities in maternal health. Journal of Women’s Health, 30(2), 230-235. https://doi.org/10.1089/jwh.2020.8882
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., … & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review. Diabetes care, 44(1), 258-279. https://doi.org/10.2337/dci20-0053
Cabral, J., & Cuevas, A. G. (2020). Health inequities among latinos/hispanics: documentation status as a determinant of health. Journal of racial and ethnic health disparities, 7, 874-879. https://link.springer.com/article/10.1007/s40615-020-00710-0
Hello, Thank you for such an insightful post.
You have highlighted the impact of social determinants of health on safe housing, transportation, and neighborhoods among other factors in your community. You mention the high poverty rates in Memphis, which can contribute to inadequate housing conditions and limited access to safe neighborhoods. You also mention the lack of resources such as fitness centers and wellness centers in low-income areas. It’s important to address these issues as they can have a significant impact on the health and well-being of the community. In addition to the points you have mentioned, it would be beneficial to consider the availability and affordability of public transportation in the community. Limited access to reliable and affordable transportation can create barriers to healthcare services, employment opportunities, and other essential resources (Kolak et al., 2020). Improving transportation infrastructure and promoting public transportation options can help address this issue and improve health outcomes.
Regarding Racism, Discrimination, and Violence, you have discussed the influence of racism, discrimination, and violence on the social determinants of health in Memphis. You mention the disparities in exposure to polluted air, with black individuals being more affected than white individuals. It is crucial to recognize and address the systemic factors that contribute to these disparities, such as environmental racism. Racism and discrimination can also impact access to quality healthcare, education, and employment opportunities, further exacerbating health inequities. In addition to the points highlighted, it is important to consider the mental health impact of racism, discrimination, and violence on the community. Experiencing racism and discrimination can lead to chronic stress, anxiety, depression, and other mental health issues (Turner-Musa et al., 2020). Addressing the mental health needs of individuals affected by racism and discrimination is essential for promoting overall well-being. Providing culturally competent mental health services and creating safe spaces for community members to address their experiences can be beneficial.
As for Education, Job Opportunities, and Income, you have noted the impact of education, job opportunities, and income on social determinants of health, mentioning the low literacy rates and income levels in the community, which can limit access to resources and opportunities for individuals, particularly women. Additional Insight into this matter emphasizes the need to consider the intergenerational impact of limited educational opportunities and low income. These factors can contribute to a cycle of poverty and limited upward mobility, affecting not only the current generation but also future generations (Kolak et al., 2020). Investing in early childhood education, providing support for higher education, and implementing policies that promote income equality can help break this cycle and improve long-term health outcomes.
Regarding Access to Nutritious Foods and Physical Activity Opportunities, you discuss the challenges related to access to nutritious foods and physical activity opportunities in low-income areas and mention the lack of grocery stores with healthy food options and the limited availability of fitness centers and functional parks. These factors can contribute to poor nutrition and physical inactivity, leading to an increased risk of chronic diseases. Further points on this matter may include a consideration of the concept of food deserts, which are areas with limited access to affordable and nutritious foods. Addressing food deserts requires strategies such as increasing the availability of grocery stores, promoting farmers’ markets, and supporting community gardens (Castrucci & Auerbach, 2019). Additionally, creating safe and accessible spaces for physical activity, such as parks and recreational facilities, can help promote a more active lifestyle and improve health outcomes.
You have also outlined the issue of polluted air and water in the community, particularly in low-income areas. You described the impact of industrial emissions on air quality and the lower water quality in your neighborhoods and noted how poor air and water quality can have detrimental effects on health, contributing to respiratory problems, cardiovascular diseases, and other health issues. Additional insight into this course can include considering the long-term consequences of environmental pollution on the community. Exposure to pollutants can lead to chronic health conditions that require ongoing management (Turner-Musa et al., 2020). Efforts should be made to address environmental pollution through stricter regulations, promoting renewable energy sources, and advocating for sustainable practices. Additionally, raising awareness about the potential health risks associated with pollution and empowering individuals to take action can have a positive impact on community health.
On Language and Literacy Skills, you mention the impact of limited language and literacy skills on social determinants of health, highlighting the percentage of individuals in the community who speak a language other than English and the proportion of adults with limited reading skills. Limited language and literacy skills can create barriers to accessing healthcare services, understanding health information, and navigating the healthcare system. Further insight on this issue is to consider the need for culturally and linguistically appropriate healthcare services. Healthcare providers should ensure that language services are available for individuals with limited English proficiency (Castrucci & Auerbach, 2019). This can include providing interpreters, translated materials, and culturally sensitive care. Additionally, promoting literacy programs and educational initiatives can help improve language and literacy skills, empowering individuals to take control of their health and well-being.
Kolak, M., Bhatt, J., Park, Y. H., Padrón, N. A., & Molefe, A. (2020). Quantification of neighborhood-level social determinants of health in the continental United States. JAMA network open, 3(1), e1919928-e1919928. doi:10.1001/jamanetworkopen.2019.19928
Castrucci, B. C., & Auerbach, J. (2019). Meeting individual social needs falls short of addressing s