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Social Determinants


Empirical research proves that the health of people is dependent not only on biological factors but also on environmental and social conditions. With the strong association of some diseases with the lifestyle and schedule of a person, it appears that human health is often predetermined by social conditions and environmental peculiarities. Healthcare policies that are provided in some regions, health equity, and overall social justice influence the state of patients and should influence the choice of the most effective treatment in various cases. The current paper is aimed at analyzing how social determinants of health are important on the example of a Hispanic female. Such determinants as ethnic background, lack of registration, geographical area, family issues, and lifestyle will be addressed to show that the medical condition of the chosen patient is strongly dependent on the social determinants.

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Background Information

The analysis will focus on a Hispanic female, who is 45 years old and lives in the US. She lives in North Miami Beach with her family and works as a housekeeper. Her family consists of a 10-year old son and husband. She also has a daughter, who does not live with them because she studies at the university. The woman feels healthy. Sometimes, she has migraines and allergies, but they are effectively resolved with the use of Flonase and Ibuprofen. However, the fact that she is undocumented has a strong influence on the medical care she gets. Lack of medical insurance deprives her of the opportunity to get regular medical examinations. No driver’s license or method of transportation also predetermine the daily issues that that the woman faces.  The following indexes and signs should also be considered: height: 5’5″; weight 61.4 Kg; BMI:22.5; BP:118/70; T: 97.4; P: 72; Pain: 0. The last mammogram was normal and showed no problems or deviation. The Last Pap/HPV exam is also within the norm.


Some scholars including Engels, Snow, and Virchow have proved that the diseases of people are the defects of the society. On the international level, the WHO Commission is in charge of the conditions in which people have to live.  Therefore, in order to understand the underlying factors that predetermine the health of the Hispanic women, it is necessary to refer to the issues of poverty, discrimination, housing, and education in North Miami Beach. Moreover, the policies of the government and social mechanisms deserve particular attention. With regard to the high number of immigrants, these mechanisms are constantly reviewed. According to the community report by Christianson, almost one third of Miami population lacks health insurance due to the fact that they are immigrants. Moreover, the majority of the uninsured people are Latinos, whose ability to speak English is limited.

Out of the public policies, one should point out the “Healthy People 2000” that affects healthcare throughout the US since the year 2000 and is aimed reducing health disparities. Moreover, the next campaign called “Healthy People 2020” is also quite effective in ensuring better opportunities to all Americans, addressing the health disparities, and struggling against social, economic, and environmental challenges. Providing additional help and support to those, who are in greater risk is the essential underlying principle of community that can ensure the welfare of people. Fair Housing Act and Equal Opportunity Employment are the essential structural factors that are applied to population groups that are documented, but often fail to regulate the life and income level of the illegal immigrants. Among the other factors that contribute to the health state of people, one should consider the environment.

The undocumented immigrants are not covered by the Medicaid. Therefore, for the current patient, all of the healthcare services require money. Therefore, the position of the above mentioned patient and of her family is not as sure when the medical insurance is needed. The conditions provided to the undocumented immigrant are obviously unequal to those that are provided to the citizens. Nevertheless, there are emergency treatment funds that become helpful in critical situations. Moreover, separate hospitals gather funding for the support of the immigrants. Jackson Memorial Hospital in Miami, for instance, collects approximately $50 million yearly for the Emergency Medicaid funding that is helpful for the undocumented immigrants. Such gathering is officially supported by the Agency for Health Care Administration. Some other hospital systems are independent and also provide supportive programs to the immigrants.  Among are the Baptist Health South Florida, UHealth, the University of Miami system, and others. Providing trauma or burn care and organ transplantation are essential tasks. However, the problem is that immigrants need greater support of the healthcare than currently exists.

Numerous researchers have proved that neighborhood characteristics are associated with higher risks of obesity and diabetes. Poverty and racial segregation are the characteristics that can lead to serious problems. With regard to overall condition of the patient, these issues are not common in the neighborhood. Barr emphasized that, with regard to the health state of the patient, the BMI of the patient is desirable and the above-mentioned risks are not immediate. Interestingly, the common diseases for the Latino people of Puerto Rican origin are asthma and obstructive pulmonary disease. Besides, the above mentioned respiratory diseases are commonly predetermined by poor living conditions and smoking. With the absence of the syndromes, the social determinants of the Hispanic patient can be defined as not smoking and living in the conditions that are not putting people at risk from the pulmonary diseases.

The cultural and societal norms are also factors that influence the health of people living on definite territories. For the Hispanic patient, living in Miami can hardly be a difficult cultural probation due to the loyal attitude to the Hispanic community and numerous means to share cultural values with American citizens. For instance, the Hispanic Carnival, which is one of the greatest parties of the Latinos in the country takes place in Miami for two days each March. This carnival lets people have fun and teaches them the cultural peculiarities of the Latinos including the language, dances, traditions, arts, cuisine, and costumes. Moreover, it shows the number of the Hispanic culture lovers in Miami and its neighborhoods. Finally, it is a serious proof that the intermediary factors of influence in Miami are rather favorable for the Hispanics. Racism as an issue is not likely to have a strong impact on the patient’s life due to the fact that the number of the Hispanics in the Miami region is quite high and reaches 1,6 million people. Moreover, each year their number grows, which makes this population group quite strong and resistant to racial discrimination.

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The social class commonly predetermines the better or worse health state due to the living conditions. With regard to the work as a housekeeper, one can conclude that the position is relatively high in comparison to some other Latinos, who work at lower positions. Moreover, the weight and BMI can be considered direct evidence that the income of the family is sufficient to live normally for the family of three and support a daughter, who is a student and lives apart. In addition to that, the absence of the driving license can be considered as both a beneficial and negative factor. On the one hand, depending on the neighborhood and distance to work, it can be a positive factor that encourages a woman walk more, which is good for the heart and entire body. On the other hand, using the public transport can become a risk factor because of various infections and negative experiences. In addition to that, Miami region is defined as one of those, where the Hispanics feel best economically. The metropolitan areas are considered as especially beneficial to this group of population to immigrate. Hence, it is the second proof that the social economic status and the income of the woman and her family is sufficient.

The psychosocial factors, such as stressors at home and at work have a crucial influence on the woman’s health. However, one can see that her emotional and physical state is quite stable. Hence, it is possible to assume that the level of satisfaction with life conditions it relatively high. However, the allergies and migraines can often be caused by the anxiety and stress. Moreover, the insufficient intake of vitamins and minerals from food can also be checked to find the underlying reasons of the patient’s conditions.

All of the factors discussed above need to be considered in treatment prescription. First, the patient is not be likely to consult a doctor due to the lack of insurance and the high prices of the insurance-less treatment and consultations. The housing of the family and the natural environment need to be checked for allergens. Moreover, the stressful situations, diets, and exercising need to be reviewed in order to define the real underlying reasons of the woman’s migraines and allergic reactions. Even though the pills are helpful, the symptoms disturb the comfort of the woman and are likely to be predetermined by social conditions and biological factors. Besides, all of the above-mentioned factors have a considerable impact on the patients’ well-being and the effectiveness of any treatment that can be prescribed to the patients in case of problems.


Any mediation at an individual or community level can have considerable impact on the emotional and physical health of the inhabitants. The intermediary and structural determinants of health are essential to provide direct or implicit influence on the human health. With regard to the situation in Miami, one can see that the position of the undocumented immigrants is supported by public and social policies as well as funding. The racial discrimination is not widespread and Hispanics have a strong community that can teach other citizens their values and culture. Even though there still are many uneducated immigrants, who can hardly speak English, the education of children is supported by public policies. Overall, the environmental and social in conditions in Miami can be evaluated as sufficient for decent living. Nevertheless, major healthcare problems that the Hispanics face are predetermined by the structural factors. In particular, the governmental program Medicaid does not allow the people to get the healthcare support in non-emergency cases for free. However, such issues as migraine and allergies also need treatment.

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