SOCIAL DETERMINANTS OF HEALTH
Pre-pregnancy health behaviors and health status are influenced by a variety of environmental and
social factors, such as access to medical care and chronic stress. Some of these factors can affect
and compound others, creating a vicious cycle. For instance, factors ranging from age to medical
insurance coverage affect a woman’s general health status. A woman’s health status directly
influences her risk of pregnancy complications and her child’s cognitive and physical development.
For some, the cycle will continue with future pregnancies.
Understanding the many factors that affect women and infants—both negatively and positively—is
key to improving the health of all Americans, particularly the next generation.
Melinda, a 21-year-old pregnant client, arrives for her 16-week appointment at
the obstetrician’s office. The nurse is collecting information for her admission assessment, as
this is Melinda’s first appointment. Which of the following could negatively impact
Melinda’s pregnancy? Select all that apply.
Lack of reliable transportation can impact the client’s ability to get to and from work and her doctor’s
appointments as they are quite far from her home. Lack of support by the father can add emotional
and financial stressors for the pregnant client. Having only a GED can impact her job opportunities
and financial status.
Which socioeconomic conditions in communities and families may contribute to high
adolescent birth rates? Select all that apply.
Adolescent pregnancy is highly influenced by the status of the community and overall socioeconomic
status. Low (not high) education, low income, lack of knowledge, lack of awareness and importance
of sex prevention, poor or run-down communities, racial segregation, and lack of access to birth
control contribute to adolescent pregnancy rates. Lack of positive role models and constructive
community activities may increase adolescent pregnancy rates. Rural areas and southern states tend
to have lower incomes and higher rates of teenage pregnancy.
Pregnant women with LOW levels of education and who are YOUNGER in age, results in LATE
prenatal care utilization.
Younger clients with a lower level of education tend to access prenatal care much later than older,
more educated clients. This could be because of pregnancy denial, fear of telling caregivers, or lack
of access to care.
SOCIAL DETERMINANTS
Social determinants of health are the conditions in which people are born, grow, live, work, and age.
These circumstances are shaped by the distribution of money, power, and resources at global,
national, and local levels. They are mostly responsible for health inequities—the unfair and avoidable
differences in health status within and between countries.
Some examples of social determinants (Healthy People, n.d.) include: