Scenario One:
Eleven-year-old Bobby is white and lives with his dad and nine-year-old brother in a rural area outside of a small town. There is one small discount store that carries everything from groceries to toys to bath towels. Bobby's mom recently died from breast cancer. The medical bills created financial difficulties for the family. Bobby's dad began working the night shift at the local turkey processing plant to obtain the shift premium, which paid $5 more per hour. Bobby and his brother often skip breakfast if their dad doesn’t get home in time to make breakfast before the boys get on the bus. Bobby is a picky eater and frequently skips lunch. On the way home from the bus stop, Bobby may purchase nachos or a hot dog at the gas station convenience store.
Scenario Two:
Twelve-year-old Annie is African American and lives with her two moms in a downtown condo is in an affluent area overlooking the lake. Their condo is close to Annie’s school and the restaurants where the women work. One is a chef; the other is a server. To be able to afford rising rent, the women work long hours, often late into the night. For dinner, Annie usually eats meals that her moms bring home from the restaurant. Annie gets coffee and a sweet treat at the convenience store on her way to school. A. Describe three applicable SDOH for Bobby (Scenario One).
B. Describe three applicable SDOH for Annie (Scenario Two).
C. Explain how one of the SDOH affects Bobby and Annie similarly, using specific examples from the scenarios.
D. Explain how one of the SDOH affects Bobby and Annie differently, using specific examples from the scenarios.
A. Three SDOH for Bobby:
Economic Stability: Bobby's family is experiencing financial hardship due to medical debt and his mother's death. This leads to food insecurity, as evidenced by Bobby skipping breakfast and lunch. His father's need to work the night shift for extra income also disrupts family routines and reduces parental supervision.
Neighborhood and Built Environment: Bobby lives in a rural area with limited access to healthy, affordable food. The only nearby store is a discount store, and his after-school snack options are limited to the gas station convenience store. This restricts his access to nutritious meals and promotes unhealthy eating habits.
Social and Community Context: Bobby recently experienced the loss of his mother, a significant adverse childhood experience (ACE) that can have long-lasting impacts on his mental and physical health. The lack of a consistent caregiver in the mornings further contributes to instability in his life.
B. Three SDOH for Annie:
Economic Stability: While living in an affluent area, Annie's family faces financial strain due to rising rent costs. This necessitates long working hours for both mothers, impacting family time and potentially leading to Annie's reliance on less healthy convenience foods.
Neighborhood and Built Environment: Annie lives in a neighborhood with easy access to her school and her mothers' workplaces. However, her diet may be heavily influenced by restaurant food, which can be high in calories, sodium, and unhealthy fats, depending on the restaurant's offerings.
Social and Community Context: Annie's family structure, having two mothers, might expose her to social stigma or prejudice, although the scenario doesn't explicitly state this. The long working hours of her parents limit family meals and shared time, potentially impacting her social-emotional well-being.
C. Similar SDOH Effect:
Economic Stability affects both Bobby and Annie similarly by influencing their dietary habits. Bobby's family's financial hardship limits access to healthy food, leading him to skip meals or rely on cheap, less nutritious options from the gas station. Annie's family's financial strain, caused by high rent, results in her consuming restaurant food regularly, which may not always be the healthiest option despite its availability. Both children's diets are negatively impacted by their families' economic situations.
D. Different SDOH Effect:
Neighborhood and Built Environment affects Bobby and Annie differently regarding access to food. Bobby's rural environment limits his access to fresh, healthy food options. The discount store may not offer a wide variety of produce or healthy prepared meals, and the gas station primarily sells processed snacks. In contrast, Annie lives in a more affluent area with likely greater access to grocery stores and restaurants with varied menus. While she has access to more food options, the readily available restaurant meals, even in an affluent area, may not be nutritionally balanced, potentially leading to different health outcomes compared to Bobby's situation.