CASE STUDY
Carla is a 54-year old woman who was born in a small coastal mining town. Her parents died when she was little, so she was raised by an older aunt. Her aunt did not know how to read and Carla struggled in school. She married young and had two children but separated from her husband just after the birth of her second child. She sole-parented her children from a young age.
Initially her husband helped financially, but when the youngest was only 5 years old the mine he worked in closed and he could not find consistent employment. He worked for a casual employer and sustained a head injury at work. He had felt okay at the time of the accident and was embarrassed and worried about the job, so did not report it or get treatment. Afterwards, he became forgetful and later developed depression. Despite being divorced Carla ends up caring for him in times of crisis.
Carla had no trouble finding work when the children were little. She worked in grocery and retail positions around town. She and her neighbours would share childcare duties and work opposite shifts. As the children grew up she found it harder and harder to stay employed and money kept getting tighter. Without the mine, other businesses in town turned over quickly and more and more people were leaving. Many of her life long friends have left the town. Currently, she volunteers at the RSPCA and makes a little money cleaning for the post office and the town hall.
Her children grew up and moved to the city looking for employment. Neither of them did well at school, but her son finished Grade 12. Her daughter lives with her boyfriend in a tiny one room apartment. Her boyfriend is working and going to school in the evenings. Despite their long hours they are struggling to make ends meet. Her daughter is pregnant and has developed gestational diabetes. She feels very tired all the time and wants Carla to move to the city too. They are excited about the baby but also worried about how they are going to be able to afford rent when the baby arrives, and her boyfriend is thinking about quitting school. Carla wants to be closer to help her daughter but the cost of visits on public transport is prohibitive. She has been saving for visits by eating toast for her evening meal, but can still only afford to visit monthly.
Excerpt from Assessment 2 criteria
Case study questions
• What are the characteristics of the individuals in this case study?
o Who are they? Where and how do they live?
o What evidence can you find that supports this?
o Information and statistics about household incomes, family structure, education, employment, housing
• What are the social determinants of health that are evident in the case study?
o What are the specific social determinants that apply to this case study?
o How do these social determinants impact on the health and wellbeing of the individuals in the case study?
o Refer to evidence that links social determinants to health issues
• Select one of these social determinants and describe the best way(s) to address this issue in order to have an impact on the whole of population?
o This question requires you to think beyond the level of the individual to the community or population level
o You may choose to focus on one strategy or discuss a range of strategies in your answer, however, please ensure that you discuss the strategy(ies) in enough depth to demonstrate your understanding
o What strategies can you identify that relate to addressing the wider social determinants in your case study?
o Are these strategies upstream, midstream and downstream?
o Why are these strategies likely to work? What is the evidence to support this?
• What roles should health professionals play in addressing this issue?
o This question requires you to consider the broader role of health professionals - beyond providing individual care or treatment.
o What is the role of health professionals in addressing social determinants of health?
Assessment Criteria
• Demonstrate knowledge of the social model of health
• Find and apply health data to selected case study
• Describe a strategy(ies) to address the issue in the case study that demonstrates an understanding of social determinants of health
• Academic writing skills (1200 words)