1. What are the determinants that affect the family’s health in this story?
Students should point out that where you live affects your health (housing, socioeconomic status).
2. Hypothesize as to the root causes of these health determinants.
There is no one root cause for determinants; they interact with each other. For instance, many people live in the zip code they live in because they can afford housing in that area. Their income is related to their level of education. Some health determinants are under our control (e.g., we can try to improve our education level), but others are not (e.g., we are unable to change our genetic endowment).
3. Apply the Evans and Stoddart field model of health and well-being to this situation, and discuss your findings.
The Evans and Stoddart model can be applied nicely to this example. Evans and Stoddart (1990) developed the field model of health and well-being, which proposes that health determinants— including, for example, one’s social and physical (natural and anthropogenic) environment, genetic endowment, prosperity, disease status, health care access, and individual behavior—all factor into determining the health of a population. It is important to note that some of these health determinants, to a certain extent, are under one’s control, and some are not. The model effectively illustrates that the health determinants interact to influence one’s health status. For example, the role of one’s economic prosperity will influence the quality of housing (physical environment) and access to nutritious food (physical environment) and healthcare (social environment). “The multidimensional approach offered by this model provides several targets for public health system-based partnerships, such as after-school programs, faith-based programs, farmer’s markets, etc. to develop interventions to improve a community’s health” (Caron 2015).
4. What are the population health outcomes you would use for families in a community like the one described here?
Students should think about accessing emergency room, urgent care, and community health clinic visit data to see who is accessing these health services and for what conditions. Are these conditions that could be prevented? Is there premature mortality? What are the vaccination rates in the community? What percentage of children are on free and reduced lunch? What is the adolescent pregnancy/birth rate? What do these indicators tell us?
Population Health: Principles an
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