NUR388 Population Health
Assessment of Social Determinants of Health (SDOH) Case Study
Assessment of Social Determinants of Health (SDOH) Case Study
Case Study
E. Z. is a 41-year-old woman who presents to her local, low-income Community Health Clinic
after suffering a severe headache for 24 hours, along with intermittent nosebleeds. The client has
taken over-the-counter pain relievers without relief. She states that she is not currently on any
medications and has not seen a medical provider in 5 years. When asked about recent stress
factors, Mrs. Z. reports that she is worried about her 16-year-old son who is struggling with his
homework assignments because they don’t have internet service and it is difficult to get to the
library. A Nurse Practitioner completes a physical assessment, diagnoses Mrs. Z. with new onset
of hypertension, and prescribes an anti-hypertensive medication. The nurse reviews the client’s
social history to prepare for patient teaching. The history reveals that Mrs. Z. is divorced, and a
single mother of one son. She speaks English, and appears to understand simple questions, but
her primary language is Russian. Mrs. Z. is worried that her headaches will prevent her from
working. She says she has only been able to find part-time work and if she misses even one day
she can’t keep up with her bills. When the nurse hands the client her the prescription, Mrs. Z
looks concerned and asks how much the medication will cost. The nurse explains that there may
be services to help pay for the medicine and other needs and asks Mrs. Z to complete the clinic’s
Social Needs Screening Tool. The client is willing to answer the questions, but indicates she is
not sure she will understand them. A Russian language health interpreter is contacted through an
online service to help the client complete the form. Refer to the Social Needs Screening Tool to
view the client’s responses on the tool as you answer the Case Study questions below.
Case Study Questions
1. In the Table below, identify 2 of the SDOH Domains from the Healthy People 2030
(HP2030) list that are affecting Mrs. Z’s health. Provide the evidence from the Client’s
Social Needs Screening Tool that supports your answers.
Social Determinant of
Health Domain
Evidence of Need in the
Social Needs Screening Tool
1) Economic Stability Client struggles to make ends meet and worries that she won't have
enough money for meals after her next payday. She struggles to afford
rent, health insurance, and heat. The client worries about paying her bills
and keeping a stable job because she can't work because of headaches.
She needs help trying to maintain her employment considering her health
condition (Office of Disease Prevention and Health Promotion. (n.d.)).
2) Social and
Community
Context
Client is a divorced woman raising her 16-year-old child alone. When
questioned, her son's lack of internet access at home and the difficulty of
getting to the library due to transportation issues were her stress factors.
She lacks a network of support and frequently feels alone, unhappy, and
hopeless. Client also claims that she doesn't find any enjoyment or
interest in doing this in her daily life. She occasionally receives verbal
abuse from friends and family. She needs help with everyday tasks
(Office of Disease Prevention and Health Promotion. (n.d.)).
