Reference no: EM133246625

The case study:

Jim is a 72-year-old Aboriginal man who was born in the Wheatbelt town of Quairading in Western Australia. Jim has a number of health issues including problems with his eyes. His son Barry gave him a lift to Perth from Quairading, but then travelled back to his family in Sydney. Jim has been in Bentley hospital for two weeks recovering from an operation on his right eye. Including the time Jim has spent in Royal Perth Hospital, he has been in Perth for a period of five weeks. He is constantly telling the staff that he wants to go home.

He tells his son he wants to go home, is lonely, and he is starting to get depressed. The son tells hospital staff "He is pining for his Country, and I am afraid he will become sicker than he already is." Jim's doctor explains that Jim must remain to keep his bed in hospital and his place in the queue. The doctor has also voiced his concern that if released Jim may not return for further treatment. Barry reluctantly agrees, especially considering the logistical issues of getting him home and back again without him travelling back from Sydney.

The doctor tells Jim that Barry also thinks Jim should stay in hospital. Upon hearing the news Jim refuses to eat and drinks very little, becoming dehydrated. Jim is given IV fluids to keep him hydrated however his condition is deteriorating every day. The doctors contact Barry, saying that they are very concerned. Barry flies back and upon seeing his father's condition becomes very angry at the staff, and security needs to be called.

Question: Discuss land as a social determinant in depth and the consequence of this determinant linking it to the case study above.

The social determinant of health chosen is 'land' which is inclusive to Aboriginal Australians.

Below is the same question but the social determinant I chose was social support.

Social support is an important contributor to health that is relatable in this case. Jim tells his son he wants to go home, is lonely, and starting to get depressed. His family is all back at home, and he is away from his Country, taking away his sense of belonging.

When he's informed that his son agrees that he should stay in the hospital, his health began to deteriorate. In this situation, Jim feels a sense of betrayal from his son, who was likely his only source of social support in the hospital, which caused his mental and physical health to plummet. According to Cobb (1976), social support can be seen as ''information leading the subject to believe that he is cared for and loved, is esteemed and valued and belongs to a social network of communication and mutual obligation.''Having social support has a powerful effect on health. Support from others may encourage healthier habits, such as being physically active. Furthermore having aid and emotional support to the impact of a stressor may help alleviate the impact of the stressor, which could otherwise be harmful towards ones health (Marmot and Wilkinson, 2005). The lack of social support and social exclusion is associated with higher risk of poor mental and physical health, such as premature death and higher rates of depression and disabilities following chronic illness (Marmot and Wilkinson, 2003). An example of this is with a study following the mortality rate of post-myocardial infarction, in which it was found that those not married and with no confidant had significantly higher mortality rates post-infarction (Marmot and Wilkinson, 2005) This is also supported by countless other studies, such as the Kuopio Study in Finland that outlined among 2682 men, those with increased risk of death reported lack of social support and low quality of social relationships (Kaplan et al., 1994). Social support also functions at a societal level. The existence of mutual trust and respect within different areas of society contribute to the way people value their health. Communities with high levels of social cohesion ,such as with high levels of participation in communal activities and membership in community groups, are found to experience better health outcomes compared to those with low levels of social cohesion (Marmot and Wilkinson, 2005).