scholarly journals Determinantes sociais, equidade e consultório na rua

2018 ◽  
Vol 12 (12) ◽  
pp. 3513
Author(s):  
Andressa Hoffmann Pinto ◽  
Vivian Costa Fermo ◽  
Caroline Cechinel Peiter ◽  
Vanessa Martinhago Borges Fernandes ◽  
Ivonete Teresinha Schülter Buss Heideman

RESUMOObjetivo: apresentar as experiências vividas por uma enfermeira no exercício de suas funções numa equipe de Consultório na Rua. Método: trata-se de um estudo qualitativo, descritivo, tipo relato de experiência, acerca das vivências de uma enfermeira ao atuar em uma equipe de Consultório na Rua. Resultados: vivenciaram-se situações de discriminação da população em situação de rua pela sociedade, incluindo profissionais de saúde, dificuldades de acesso à Rede de Atenção à Saúde por pessoas em situações de rua, injustiças sociais e lacunas entre as políticas públicas existentes e a sua aplicação na prática. Conclusão: evidenciou-se que a atuação da enfermeira no Consultório na Rua submerge a reflexão sobre os determinantes sociais da saúde presentes na população em situação de rua. Necessita-se, face às fragilidades referidas, de investimentos em educação permanente dos profissionais, da efetivação das políticas públicas existentes, do empoderamento do usuário para o exercício da cidadania e de investimentos em estudos nesta área do cuidado. Descritores: Atenção Primária à Saúde; Equidade em Saúde; Determinantes Sociais da Saúde; Vulnerabilidade Social; Pessoas em Situação de Rua; Enfermagem em Saúde Pública.ABSTRACT Objective: to present the experiences lived by a nurse in the exercise of her duties in a team of Doctor's Offices in the Street. Methodo: this is a qualitative, descriptive study, a type of experience report, about the experiences of a nurse while working in a team at the Office. Results: there were situations of discrimination of the population in a street situation by society, including health professionals, difficulties in accessing the Network for Health Care by street people, social injustices and gaps between existing public policies and their application in practice. Conclusion: it was evidenced that the nurse's role in the Street Office submerges the reflection on the social determinants of health present in the street population. It is necessary, given the weaknesses mentioned, of investments in the permanent education of professionals, the implementation of existing public policies, the empowerment of the user to exercise citizenship and investments in studies in this area of care. Descriptors: Primary Health Care; Health Equity; Social Determinants of Health; Social Vulnerability; Homeless Persons; Public Health Nursing.RESUMEN Objetivo: presentar las experiencias vividas por una enfermera en el ejercicio de sus funciones en un equipo de Consultorio en la calle. Método: se trata de un estudio cualitativo, descriptivo, tipo relato de experiencia, acerca de las vivencias de una enfermera al actuar en un equipo de Consultorio en la calle. Resultados: se experimentaron situaciones de discriminación de la población en situación de calle por la sociedad, incluyendo profesionales de salud, dificultades de acceso a la Red de Atención a la Salud por personas en situaciones de calle, injusticias sociales y lagunas entre las políticas públicas existentes y su aplicación en la práctica. Conclusión: se evidenció que la actuación de la enfermera en el Consultorio en la calle sumerge la reflexión sobre los determinantes sociales de la salud presentes en la población en situación de calle. Se necesita, ante las fragilidades referidas, de inversiones en educación permanente de los profesionales, de la efectividad de las políticas públicas existentes, del empoderamiento del usuario para el ejercicio de la ciudadanía y de inversiones en estudios en esta área del cuidado. Descriptores: Atención Primaria de Salud; Equidad en Salud; Determinantes Sociales de la Salud; Vulnerabilidad Social; Personas sin Hogar; Enfermería en Salud Pública.

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.


2019 ◽  
Vol 26 (8-9) ◽  
pp. 895-899 ◽  
Author(s):  
Joseph J Deferio ◽  
Scott Breitinger ◽  
Dhruv Khullar ◽  
Amit Sheth ◽  
Jyotishman Pathak

Abstract Social determinants of health (SDOH) are known to influence mental health outcomes, which are independent risk factors for poor health status and physical illness. Currently, however, existing SDOH data collection methods are ad hoc and inadequate, and SDOH data are not systematically included in clinical research or used to inform patient care. Social contextual data are rarely captured prospectively in a structured and comprehensive manner, leaving large knowledge gaps. Extraction methods are now being developed to facilitate the collection, standardization, and integration of SDOH data into electronic health records. If successful, these efforts may have implications for health equity, such as reducing disparities in access and outcomes. Broader use of surveys, natural language processing, and machine learning methods to harness SDOH may help researchers and clinical teams reduce barriers to mental health care.


2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Matthew W. Kreuter ◽  
Tess Thompson ◽  
Amy McQueen ◽  
Rachel Garg

There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs. This article discusses the rapidly growing body of research describing the links between social needs and health and the impact of social needs interventions on health improvement, utilization, and costs. We also identify gaps in the knowledge base and implementation challenges to be overcome. We conclude that complementary partnerships among the health care, public health, and social services sectors can build on current momentum to strengthen social safety net policies, modernize social services, and reshape resource allocation to address social determinants of health. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.


2014 ◽  
Vol 48 (spe) ◽  
pp. 119-125 ◽  
Author(s):  
Celia Maria Sivalli Campos ◽  
Bárbara Ribeiro Buffette Silva ◽  
Deisi Cristine Forlin ◽  
Carla Andréa Trapé ◽  
Iara de Oliveira Lopes

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.


2020 ◽  
Vol 29 (11) ◽  
pp. 1437-1446
Author(s):  
Louise M. Henderson ◽  
Ellen S. O'Meara ◽  
Jennifer S. Haas ◽  
Christoph I. Lee ◽  
Karla Kerlikowske ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Pearson ◽  
◽  
K. Schwartzkopff ◽  
A. Dawson ◽  
C. Hagger ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


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