Social Determinants of Health and Health Equity Assignment

Assignment Task

Lily is a 19-year-old single mother of one daughter Mia, aged 3. Lily and Mia live in a large high-rise apartment block. Their apartment is small but has 2 bedrooms and is affordable as it is a social housing property with low-cost rent. They have lived there 2 years. Before the apartment, they lived in free residential accommodation provided by the Australian Red Cross (a not-for-profit organisation) and Lily took part in their Young Parents Program, which she built her confidence as a young mum.

Lily has a new boyfriend who is not Mia’s father. She became pregnant aged 16 when she was in year 10 of high school and she left school midway through year 10 so did not receive any certification. Mia’s father did not want Lily to have the baby and has not offered any financial or emotional support at any stage. He stopped talking to her when she decided to go ahead with the pregnancy.  Lily’s parents disapproved of her pregnancy. They were ashamed that she was pregnant so young and did not want their friends from church to find out. They were also horrified she would not finish high school and go on to study at university. They told her if she had the baby she would have to leave home and they would not support her. She left home that night with a bag of clothes and her mobile phone and hasn’t seen them since – Mia has never met her grandparents. 

After Lily left school, she lost her friendships with most of her school friends, who are now studying at university. She can’t really afford to meet up with them to catch up and she can’t get to the city for a night out anyway as there is no public transport near their apartment. Mia can’t drive but she has a bicycle she rides to and from work. Unfortunately, it has no seat for Mia, so they have to walk everywhere, with Mia often in a stroller.
Lily has a Health Care Card as she earns a low income working in a local supermarket as a casual checkout operator, sometimes working late shifts stacking shelves for more money. She also receives Parenting Payment Single (PPS) and Child Care Subsidy from Centrelink. Lily has always worked since she left home, only taking a short time off after Mia’s birth. She takes pride in their independence and enjoys the social contact at work. Her neighbour and a friend she met in the Young Parents Program take turns minding Mia when Lily is at work. Mia also attends 2 days of subsidised childcare. Lily has enrolled in TAFE to study beauty therapy this year and is excited to start learning, although she is very nervous about it as she missed so much schooling. She doesn’t have a computer and isn’t confident using one.

Lily has very recently been diagnosed with cervical dysplasia caused by human papillomavirus (HPV) as she missed the HPV vaccination days at high school. She contracted genital warts during unprotected sex. When she first discovered the warts, she spent some time searching online for a GP who bulk billed appointments. Visiting the bulk-billing clinic required a long bus trip each way. The GP suggested she had cervical screening while there and the practice nurse did a Pap smear. A few days later Lily received a phone call from the GP, who advised she would need to come back to the clinic as soon as possible for a further procedure called a colposcopy and biopsy. She was very worried about how much this would cost and wondered if Medicare would cover it, but she was too scared to ask. She booked the appointment and rang her work supervisor to tell him she would no longer be available to work a shift she had previously been allocated – and as a result, she lost her casual job on the spot. She rang Centrelink to see if she was eligible for further support but was told there is a wait time. She is now concerned that she will have to withdraw from TAFE, if she cannot pay for fees and equipment without the income from her job.

Two weeks after the biopsy Lily had to go back to the GP for the results. The biopsy revealed CIN3 cells, which the doctor said were ‘pre-cancerous’. Lily was shocked and upset by this, and unsure if this meant she has cancer. She didn’t want to ask, as the doctor talks fast and she doesn’t understand everything he says. He said that she needs to have a ‘cone biopsy’, which is a day procedure in a hospital that may require an overnight stay. Lily is currently trying to decide whether to go ahead with the surgery but doesn’t know who to talk to about it. She is not sure if she can afford it. Lily has never had a night away from Mia. She is also concerned about finding a new job and doesn’t want to miss the start of TAFE.

Task description

To complete this task, you must:

• Identify relevant social determinants of health that are positively or negatively impacting on the health or health outcomes of the central character (lily) .
• Explain what is meant by health equity.  Consider if / how any of social determinants identified act as a potential enabler or barrier to the health equity of the person in the case study.
• Explain the function of the Ottawa Charter for Health Promotion and describe the five action areas (operational strategies) of the Charter.
• Suggest an action/activity that demonstrates how one (1) of the five (5) action areas (operational strategies) from the Ottawa Charter could be used to improve one (1) of the  social determinants of health that you identified as having a negative impact on the person in the case study.

Cast Study Additional Information

When planning your assignment, it is useful to deconstruct the assessment question and marking rubric to see what the examiner is looking for you to include in your response.

In this assessment task you are required to write an essay which has several components that need to be addressed. These components are easier to identify when you separate out the assessment instructions.

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