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. E. Analyze how the SDOH from part A could be detrimental to Bobby’s health outcomes, using a current, relevant, credible source to support your response.
F. Analyze how the SDOH from part B could be detrimental to Annie’s health outcomes, using a current, relevant, credible source to support your response.
G. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Bobby's Health Outcomes and SDOH
Bobby's situation highlights several Social Determinants of Health (SDOH) that can negatively impact his health. His family's financial instability, resulting from medical bills and his mother's death, leads to food insecurity. Skipping breakfast and lunch, combined with relying on convenience store food high in sodium and fat, puts Bobby at risk for nutritional deficiencies and potential weight problems. According to the American Academy of Pediatrics, "Children and adolescents who experience food insecurity are more likely to have poor overall health, iron deficiency anemia, asthma, and to be hospitalized" (Council on Community Pediatrics, 2015). Living in a rural area with limited access to fresh, affordable food exacerbates this issue. The lack of a consistent caregiver in the mornings due to his father's night shift work further disrupts Bobby's routine and access to healthy meals. Additionally, the emotional stress of losing his mother and the family's financial struggles can impact Bobby's mental health and well-being.
F. Annie's Health Outcomes and SDOH
While Annie's family lives in an affluent area, her access to healthy food options is still compromised. Although her mothers work in restaurants, the meals they bring home may not always be nutritionally balanced. Annie's reliance on convenience store coffee and sweets for breakfast contributes to excess sugar and caffeine intake, potentially leading to weight gain, dental problems, and difficulty concentrating. The long working hours of her mothers limit family mealtimes and opportunities for shared healthy eating habits. Furthermore, the pressure to maintain their lifestyle in an expensive area could create stress within the family, impacting Annie's emotional well-being. The Centers for Disease Control and Prevention (CDC) states that "Adverse childhood experiences (ACEs) – such as experiencing violence, abuse, or neglect; witnessing violence in the home; or having a family member attempt or die by suicide – are linked to chronic health problems, mental illness, and substance misuse in adulthood" (CDC, 2023). While not explicitly stated, the financial pressures and long working hours could contribute to stress within the family, potentially increasing the risk of ACEs.
G. Sources
American Academy of Pediatrics, Council on Community Pediatrics. (2015). Promoting Food Security for All Children. Pediatrics, 136(5), e1431-e1440.
Centers for Disease Control and Prevention (CDC). (2023, June 28). About Adverse Childhood Experiences. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/aces/about.html