Sociology of Health and Illness- Diabetes, Essay Example

Health is an essential human right and is defined as being in an incomplete state of social, psychological, and physical health and lacking infirmity. In the case of illness, there is a variation in the body’s functionality (Rovesti et al., 2018). Having health literacy is essential because of the ethnic and linguistic diversity of populations. These populations differ in terms of their beliefs about health and illness. Cultural health beliefs impact how they feel and think about their health problems, how, when, and from whom to seek healthcare, and how they respond to treatment adherence and healthcare interventions. Cultures also differ in communication, and health literacy requires a mutual understanding between the healthcare provider, patients, and their families. Health literacy and culture impact health care outcomes. This report entails a comprehensive analysis of social and environmental determinants of health and how they influence diabetes, how to empower the community, and increase health literacy and self-care strategies.

Social and Environmental Determinants of Health

Determinants of health are defined as circumstances or situations in which humans are born, live, grow, find work, and age. These conditions are usually shaped by economic, social, political, and political forces (Islam, 2019). For example, poor governance, policies, and unfair economic arrangement may cause unfavorable conditions. Social factors are those related to the stability of social connections, cohesion, neighborhood efficiency, education, work, and stability of households. Environmental factors may include health-related resources like transportation systems, recreational resources, and harmful substances. Below are examples of social and environmental determinants of health and an explanation of how they influence those with diabetes, taking the case of Rhonda in the second video covering diabetes.

Poverty and Deprivation

Deprivation is a lack of necessities to live in good health. Poverty is a broader term to explain deprivation. It is mainly understood as the inability to meet the minimum subsistence level critical for human survival (Rowley et al., 2021). Poverty and deprivation are critical factors when it comes to the issues of diabetes. For example, research shows that poverty is highly linked to the burden of non-communicable diseases like diabetes. Most patients living with diabetes come from low-income communities. This factor makes this population lack awareness and experience difficulties accessing health and medications; hence they do not achieve optimal diabetes prevention and management (Karachaliou et al., 2020). People living with diabetes are estimated to be 415 million, projected to rise to 624 million by 2040.

Education

The education factor is generally associated with good health.  For example, even in countries like the US, which is highly developed, research shows that people with lower educational attainment experience poor health compared to other populations. There are also health inequalities related to education. Regarding diabetes recent research shows that diabetes incidents are highest in individuals with less than high school education attainment (10.4% out of 1000 people). Those with a terminal high school have a prevalence of 7.8 %/1000, while those with above high school are 5.3% per 1000 people (Hill-Briggs et al., 2020). Therefore, the lower the education level, the higher the odds of diabetes.

Food

Food as a health determinant is the absence or presence of food that impacts people’s diet. It covers areas like the distribution of food stores, locations’ proximity, and how people obtain food. It is a collection of sociocultural conditions, economic and physical opportunities, policies, and conditions that influence beverage and food choices and nutritional status. In marginalized areas, people are highly affected by inaccessibility to supermarkets and healthy foods. Instead, many fast restaurant outlets offer them energy-dense foods, which negatively affects their health. When associating the food environment and diabetes, research shows that higher food accessibility is associated with a lower prevalence of diabetes. Some people have access to grocery stores, fewer fast-food restaurants, and availability of direct supplies from farmers; hence have healthy food choices. However, those with less access to healthy food record a high prevalence of diabetes cases.  For instance, 20% of the diabetic patient report having food insecurity (Hill-Briggs et al., 2020). Therefore, food insecurity, lack of affordability, poor access, and healthy choices highly impact those with diabetes.

Where You Live (Housing and Neighborhood)

The places where people, including the type of housing and the neighborhood, impact their health. First, some people experience housing instability. For example, some live in their cars, others stay with relatives or friends, and others are evicted and have trouble paying rent. Research done in the US in 2020 showed that 17 out of 10,00 are considered homeless. The more significant percentage of this population consists of African Americans (40%), followed by Latinos and Hispanics, representing 22% of the homeless people (Hill-Briggs et al., 2020).  Housing instability is highly associated with the prevalence and outcomes of diabetes. For instance, housing instability makes it difficult to afford diabetes medications, eat healthy foods, self-manage, and engage in self-care. Also, the neighborhood is acritical is someone’s health. For example, some people live in neighborhoods with highly toxic environmental exposures and pollution. Research shows an increased risk of diabetes for people living in neighborhoods with toxic chemicals, pollution, and poor sanitation.  See figure 1 for more detailed information about some social and environmental determinants of health discussed above.

Ways In Which to Engage and Empower the Community and Increase

Health Literacy on Diabetes

Health literacy is the degree to which people access, process, gain an understanding, and share information about health issues essential to making informed decisions. It is a broad term requiring specific skills to interpret and communicate health-related information to meet various unique demands depending on the individual and their setting (American Association of Diabetes Educators, 2019). Health literacy requires demands and skills ranging from oral communication and numeracy and attention to cultural relevance.

Health literacy Impact on Diabetes

There are many ways in which health influences the outcomes of diabetes. For example, it impacts the acquisition of new knowledge about the disease, improving self-efficacy, and adherence to self-care behaviors (Dang et al., 2020).  There are also patient characteristics assisted with literacy skills, including reading fluency, the complexity of the printed messages, prior knowledge, individual capacity, and norms.

Engaging and Empowering the Community

A nurse handling a community with diabetes needs to be highly knowledgeable about the disease and possess high overall health literacy. One of the ways to engage the community is by educating the patients to understand basic health information about the disease and explaining various services required to make appropriate health decisions. For example, educate them on the history of the disease and how it is acquired and managed. Also, they can be taught about daily activities to improve their health. For example, there are numeracy skills that patients should know, including carrying out self-care tasks like blood glucose monitoring, carbohydrate counting, and insulin titration (Dang et al., 2020). With the involvement of technology, many aspects of diabetes are manageable with combined efforts from the patient and the provider.

To empower this population, they need health literacy regarding lifestyle management, self-testing procedures, self-management, and good medication usage and adherence. Many studies show that patient with low literacy rates experiences poor health outcomes (American Association of Diabetes Educators, 2019).  Also, such diabetic patients are likely to remain in a poor state, have lower self-confidence, and have problems following medication instructions.

Therefore, a nurse needs to understand that every time they interact with people with diabetes, they have an opportunity to empower them and improve their health. For example, they can also provide community outreach programs instead of waiting for the patients to reach clinics for help (Dang et al., 2020).  They can also utilize an app to share information about diabetes prevention and management. This technology focuses on food tracking, blood glucose tracking, physical activities, and weight loss.

Communication and Cultural Issues to Consider

When communicating with patients, it is important to consider language differences and culture because they offer essential health information and messages. For example, different cultures perceive health and illness differently. For example, some individuals may experience language and cultural barriers preventing seeking care and disease management. Also, some cultures have stereotypes that influence health outcomes (American Association of Diabetes Educators, 2019).  Besides, when communicating with patients from different backgrounds, a nurse should communicate effectively to avoid misunderstandings and conflicts which may limit care.

Also, it is essential to consider that patients have different educational backgrounds and use appropriate language when explaining the disease symptoms, and avoid using racial and ethnic labels and language that is person-centered and stigmatized. (Dang et al., 2020).  Cultural concepts also include religious beliefs, which are potent filters for how information is perceived and processed. Therefore, cultural diversity is critical in health literacy. It involves more than understanding people’s language, norms, beliefs, and values. A nurse must gain relevant insights and develop cultural humility to create positive and respectful relationships with this population.

Health Literacy Challenges of People with Diabetes

If diabetes is managed well, it does not become fatal. However, if it is not treated, it can cause organ complications causing acute and chronic morbidity, which cause amputations, blindness, renal disease, or even death. Thus, for a patient to prevent these complications, they need to know more about this disease, self-care abilities, and self-management. However, the health literacy level of the patients influences their levels of knowledge and control of diabetes (Mogessie et al., 2022). Some challenges associated with low literacy include more hospitalizations and medical expenses, poor preventive behaviors, and poor glycemic control, which cause several complications.  For example, some patients cannot read or write, and others cannot understand diabetic-related material and leaflets.

Self-Care Strategies

Regardless of the above challenges, patients can practice self-care strategies to improve their health and well-being. Self-care strategies include deliberate moves to look after one’s emotional, physical, and mental health.  It includes practices that involve food, medicine, exercise, sleep, emotion, medical care, and sleep. Self-care in diabetes is essential to figure out one’s needs and coping with the environment. These self-care activities include attending teaching sessions to learn more about the disease and how to manage it, performing adequate physical exercises as required, proper management of diet, attending medical checkups, drug adherence, self-monitoring of glucose levels, and foot care (Ayele et al., 2019; Eva et al., 2018). Self-care routines help in keeping the symptoms and health problems under control and preventing the progression of complications.

Conclusion

As a nurse, it is critical to have intensive knowledge of cultural safety and determinants of health and learn how to engage the community to facilitate change and improve care. Social and environmental determinants of health influence how people access health and health outcomes.  As a nurse, one has to act as a patient advocate to empower the community and increase health literacy and self-care strategies. Health literacy is a critical element, especially for diabetic patients. It is also essential to consider communication and cultural issues and educate patients on self-care strategies to live better.

References

American Association of Diabetes Educators. (2019). Cultural and health literacy considerations with diabetes. Diabetes educator. Retrieved November 26, 2022, from https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/cultural-and-health-literacy-considerations-with-diabetes.pdf

Ayele, B. H., Mengesha, M. M., & Tesfa, T. (2019). Predictors of self-care activities of outpatient diabetic residents in harar and dire dawa: A hospital-based cross-sectional study. SAGE Open Medicine, 7, 205031211986564. https://doi.org/10.1177/2050312119865646

Dang, Y., Patel-Shori, N., Barros, M., & Yu, D. (2020). Good literacy to enhance response in diabetes mellitus (glitter-DM). INNOVATIONS in Pharmacy, 11(3), 1. https://doi.org/10.24926/iip.v11i3.2406

Eva, J. J., Kassab, Y. W., Neoh, C. F., Ming, L. C., Wong, Y. Y., Abdul Hameed, M., Hong, Y.H., & Sarker, M. M. (2018). Self-care and self-management among adolescent T2DM patients: A Review. Frontiers in Endocrinology, 9. https://doi.org/10.3389/fendo.2018.00489

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A.,Thornton, P. L., & Haire-Joshu, D. (2020). Social Determinants of Health and diabetes: A scientific review. Diabetes Care, 44(1), 258–279. https://doi.org/10.2337/dci20-0053

Islam, M. M. (2019). Social determinants of health and related inequalities: Confusion and implications. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00011

Karachaliou, F., Simatos, G., & Simatou, A. (2020). The challenges in the development of diabetes prevention and care models in low-income settings. Frontiers in Endocrinology, 11. https://doi.org/10.3389/fendo.2020.00518

Mogessie, H. M., Gebeyehu, M. A., Kenbaw, M. G., & Tadesse, T. A. (2022). Diabetic health literacy and associated factors among diabetes mellitus patients on follow up at public hospitals, Bale Zone, South East Ethiopia, 2021. PLOS ONE, 17(7). https://doi.org/10.1371/journal.pone.0270161

Rovesti, M., Fioranelli, M., Petrelli, P., Satolli, F., Roccia, M. G., Gianfaldoni, S., Tchernev, G.,Wollina, U., Lotti, J., Feliciani, C., & Lotti, T. (2018). Health and illness in history, science, and Society. Macedonian Journal of Medical Sciences, 6(1), 163–165. https://doi.org/10.3889/oamjms.2018.056

Rowley, J., Richards, N., Carduff, E., & Gott, M. (2021). The impact of poverty and deprivation at the end of life: A critical review. Palliative Care and Social Practice, 15, 263235242110338. https://doi.org/10.1177/26323524211033873