1-Social determinants of health are environmental conditions

1-Social determinants of health are environmental conditions that… 1-Social determinants of health are environmental conditions that affect people in regard to health, quality of life, and risks depending on where they are born, live, learn, work, age, play, or worship (Health People 2030, n.d.). Everyone has been affected by a social determinant in one way or the other through economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, or social and community context. An aspect that is very important that should be addressed is healthcare access and quality, especially since I’ve seen this firsthand being from a rural area. Having access to healthcare is very important especially in life threatening situations. Getting to a healthcare facility in a timely manner can literally be life or death. Being from a rural area and the nearest healthcare facility being almost an hour away deters people from going to the doctor regularly which in turn causes health issues to worsen until an event happens that can be life changing. Even during the event, the amount of time it takes for a rescue squad to get to the hospital or for them to call a helicopter for the patient to be taken to facility that is more equipped to handle critical cases, that is even further away, is a problem that needs to be addressed.Kreatsoulas and Anand state that cardiovascular disease (CVD) is the leading cause of death in high-income countries and by 2030 it is projected to be the leading cause worldwide (2010). The authors determined that social determinants are risks factors that have caused a persistent health gap that is shaped by the distribution of money, power, and resources at a global, national and local levels (Kreatsoulas & Anand, 2010). As a nurse I can use holistic care by focusing on the patient’s social history more to get a better picture of what they are truly dealing with at home and within their community. By doing that I would be able to find resources to help them as well as educate them on their health to make them more aware of the importance of routine care to avoid complications. On a political/legislative level I can advocate for patients and bring issues to local attention the adversities people are facing to get the healthcare they deserve. In hopes of possibly establishing clinics in areas that have a greater distance to travel to the nearest doctor or hospital. Another solution to go along with that would be to equip the nearest hospital with staff that are trained for critical conditions. Both suggestions are easier said than done but it takes an issue being brought to light and someone to speak up to start making a difference.  2-Growing up with a mother who works in the hospice industry, I have many heard horror stories about patients who have had extremely uncomfortable deaths, because their provider kept treating a patient long after it was ineffective. Death is very personal, and some people (which is their right) don’t believe in hospice- but I believe it is unethical for providers not to, at least, refer a patient (and/or the patient’s family) for a hospice consult, once treatment is no longer effective. I’m not aware of any specific laws defining terminal patients, and what constitutes harm regarding treatment – but I believe this needs to be something codified. In Campos-Calderón’s study, of 202 terminal patients (108 male/94 female) only 47.1% of females (vs 52.9% of males) were registered as terminal patients (Campos-Calderón, 2016). This number isn’t exactly glaring in a study of 94 women, but if a larger study is done, that represents a lot of women, who aren’t even offered a choice in their end of life plan.One way that I could advocate for patients like this, is to spread awareness among my peers in healthcare. Even in healthcare, there is a misconception that “hospice kills people” – hospice doesn’t euthanize patients, hospice provides comfort care for patients to peacefully pass. Another way I could advocate for these patients is to start the discussion among nursing organizations. Nursing organizations can be very politically involved, and I could suggest this topic for the next rally.Health Science Science Nursing NUR 4833

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