Population Health Case Study

The development of population health in many countries faces various problems although the respective solutions may seem evident. To understand this issue better, it is required to analyze specific examples, such as communities, families, and separate individuals. An example of such analysis is the case study of a young female, Donna, and her family living in Liverpool, the UK, who may serve as an example of a disadvantaged population group. The consideration of such factors as nutrition, education, family, environment, physical activity, and psychological health in Donna’s family and the girl reveals specific problems related to the population health. The result obtained from the analysis of social determinants related to health in Donna’s family allows the local and state authorities to initiate an effective public health response initiative. The response to the endangered social determinants of health should target the education of the parents, which should include the strategies for the promotion of psychological health, socialization, and education of their children girl, whereas her family requires financial assistance from the relevant authorities and agencies.

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The role of Bio-psycho-social Factors in Donna’s Life

A variety of biological, psychological, and social factors in the life of a person constitute critical social determinants of health that require adherence in case there is a need for the improvement of his or her life. To ensure more efficient response strategies, it is possible to classify the analysis of the social determinants of health into the three categories of biological, psychological, and social factors. These needs are structured according to Abraham Maslow’s theory concerning the hierarchy of needs according to their impact on the life of an individual and its quality respectively (Lester, 2013). Consequently, the scholar presumed that the deprivation of specific needs led to the degradation of the quality of a person’s life. For example, Maslow associated the need for deprivation with the development of psychopathologies (Lester, 2013). Therefore, biological needs are the basics followed by psychological and social ones, whereas the fulfillment of each need fosters the development of a person through the improvement of well-being and the quality of his or her life.

Biological Factors

The Need for Sleep

The biological factors of Donna’s life include her nutrition, sleep, daily physical activity, medical care, and others. Moreover, according to the presented case, they are endangered by different issues. The girl reports that she frequently sleeps at school as she watches the television overnight (“Journeyman Film Company,” 2010); therefore, her biological need for proper sleep is deprived. The need for sleep is critical for any individual as sleep positively correlates with such health determinants as wellness, performance, and adaptation (Buysse, 2014). Due to the loss of sleep, Donna may be less performing at school as she loses concentration and the ability to memorize the school material. In addition, the loss of sleep may foster the incidence of different diseases due to a weakened immune system (Buysse, 2014). Consequently, Donna’s health is at risk of the negative impact caused by the repetitive loss of sleep at night time and the reduced amount of sleep overall.

The Need for Healthy Body Mass Index and Nutrition

An additional negative issue associated with sleep in the girl is overweight and obesity, which results from the peculiarities of her nutrition. The experts approve that high body mass index is prevalent in children who have short sleep duration (Fatima, Doi & Mamun, 2015), such as Donna, as she does not sleep most of the nights. Overall, children, who typically have short sleep, have twice the risk of becoming overweight or obese (Fatima et al., 2015). Currently, this correlation is not evident as the girl is extremely slim but it may develop in the future considering the evidence of excessive body weight in her mother. Concerning the issue of nutrition, the girl reports that occasionally the refrigerator is empty (“Journeyman Film Company,” 2010), which indicates that the financial disadvantage severely harms the access to proper nutrition in the family. This drastic impact on the family’s health is aggravated by the fact that Donna has three young siblings, who also require the appropriate nutrition for their physical and mental development.

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The Need for Physical Activity

Finally, the analysis assumes that Donna maintains the recommended level of physical activity approved by the secondary evidence on the video. Reviewing the analyzed video, one may notice that the girl runs with a ball and plays in the yard performing different tricks related to calisthenics, whereas she is also fit. If these activities are regular and habitual for Donna, the girl is likely to have protection from the risk of having cardiovascular disease or metabolic problems in the future (Hills, Dengel & Lubans, 2015). In addition, it is possible to assume that the girl is not at risk of hazards from underdeveloped mental and physical health (Hills et al., 2015). Therefore, although Donna is endangered by some of the negative aspects related to her biological needs, such as the need for sleep, they are partially equal due to the high level of her physical activity. However, the family occasionally meets the need for proper nutrition, which public assistance nurses and agencies should consider.

Psychological Factors

The Need for Stable Psychic Development

The psychological needs of any individual arise in case he or she meets the biological ones. Consequently, it is necessary to consider psychological issues related to Donna after assessing her level of access to basic biological needs. The first issue relevant to the psychological state of the girl is her constant worry about the financial perspectives of her future as the family occasionally struggles with poverty (“Journeyman Film Company,” 2010). There is a danger that the concern about the girl’s financial status would gradually transform into anxiety and even depression. The reason for this is the evidence that social phobia is one of the circumstances leading to the development of anxiety and depression in children and adolescents (Cummings, Caporino & Kendall, 2014). Another issue is the father’s experience of being a prison inmate (“Journeyman Film Company,” 2010), due to which both he and Donna may fear social stigmatization and develop an additional social phobia. Therefore, Donna’s parents and the assigned nurse should pay attention to the potential of the girl to develop a specific form of anxiety or depression linked to the income status of her family.

The Need for Family Support

A further factor that also affects their psychological state of Donna is her relationships with her mother, father, and siblings. Moreover, the scholarly investigations approve of this need claiming that the family factor is a valuable contributor to a child’s psychological health (Soenens, Deci & Vansteenkiste, 2017). Overall, children require support from their parents to feel protected, and valuable and copy specific behavioral patterns, which are important for socialization. However, the girl reports that occasionally her relationships with the mother worsen as they face different daily conflicts. Donna’s mother accepts the presence of this issue and attempts to solve it which may be different because she is not aware of the children’s psychology. Donna’s parents do not realize the importance of their support for the child’s healthy psychosocial adjustment, intrinsic motivation, acquirement of socially important behaviors, etc. (Soenens et al., 2017). It is important that the nurse, who assists the family, considers the revealed information and ensures relevant debriefings respectively.

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Social Factors

The Need for Active Socialization

The analysis of social factors in the case of Donna demonstrates that such an issue, as a way of her socialization, requires corresponding enhancement. The presented evidence approves this assumption as the girl complained to her mother that she requires them to broaden their social contacts (“Journeyman Film Company,” 2010). The considered child has a deficit in communication and socialization with different people due to the constant presence of a similar social environment consisting of her parents and siblings. As a result, Donna might fail to learn specific communication skills, which are critical for her future socialization (Garnica & King, 2014). A person typically develops these skills during the participation of the child in different social activities (Garnica & King, 2014). However, the major part of the social activities, on which the girl focuses, include playing at home, in the yard, and going to school, which is not sufficient to cover her need for communication.

The Need for Support of Socialization-associated Development

Another social factor also relates to the health status of the girl as a partial social withdrawal of Donna and her siblings depends on the specific disorders and health conditions. For example, Stockwell, Irigoyen, Martinez, and Findley (2014) report that some families lack knowledge and communication with healthcare providers to have the scheduled immunizations. As a consequence, Donna and her siblings may be at a higher risk of obtaining respiratory or other infections. In addition, there is secondary evidence that Donna’s brother had problems with verbal communication and articulation in particular (“Journeyman Film Company,” 2010). In addition, certain experts presume that the disparities related to language proficiency and cognitive development may also be related to the social withdrawal of a child (Rubin, 2014). According to the video, the nurse, who assists the family, helped to solve this issue. However, there is no information regarding the state of language proficiency of other children as they may have underdeveloped sound articulation, automaticity, or comprehension problems caused by partial social withdrawal (Rubin, 2014). Finally, Donna demonstrated the unfulfilled need for artistic expression as she was willfully painting different pictures together with the nurse. Therefore, the social indicators of public health in Donna’s family are also at risk of insufficient knowledge of the parents concerning the needs of their children.

Informing a Public Health Response

After the identification of the endangered social determinants of health in the case of Donna and her family, a community health nurse and other primary stakeholders have to develop a relevant public health response strategy. The analysis of Donna’s lifestyle, behaviors, and environment reveals that there are factors, which restrain her access to certain biological, psychological, and social needs. The corresponding reason, which allows assuming that each of these needs is critical, is that their role drastically increases if the affected individual is a child (Gifford & Nilsson, 2014). The experts indicate that poverty critically affects each of these aspects through material hardship, increased family stress, and cognitive and parental inputs (Chaudry & Wimer, 2016). Today, the poverty problem in the family is less acute but it is still present and requires the assistance of the supporting agencies as well as local and state authorities. The revealed requirement is persistent as such aspects as durations of poverty and early experience of poverty increase the chance of adverse outcomes in children (Gifford & Nilsson, 2014). However, poverty is not the only problem in Donna’s family.

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An additional aspect that aggravates the health outcomes of Donna and her siblings is insufficient knowledge of their basic bio-psycho-social needs in the parents. The presented evidence indicates Donna’s mother attempts to mitigate the evolving psychological conflicts. However, the woman lacks awareness of the aspects related to the psychology of children and adolescents as well as their psychological and social needs, which a public nurse approves after the consultation. For example, Donna requested her mother to remove a television set from her room as it interfered with her need for sleep and asked for additional communication with different people (“Journeyman Film Company,” 2010). According to this evidence, it is possible to state that even the 10-year-old girl recognized the threats to her development and well-being, whereas the mother initially failed to realize the problem. Moreover, the scholars indicate that, in addition to the income, parents’ education and knowledge affect the well-being of their children having a stronger effect on daughters (Chevalier, Harmon, O’Sullivan & Walker, 2013). Consequently, Donna’s parents require undergoing the relevant program reviewed by Dollahite, Pijai, Scott-Pierce, Parker, and Trochim (2014), which promotes nutrition education for low-income parents. However, the proposed program should combine the educational aspects that target knowledge of the biological, psychological, and social needs of children and the strategies to meet them accordingly.


Summarizing the above-presented information, the analysis of the case of Donna and her family demonstrates that due to partial poverty and lack of the appropriate education of the parents, the child suffers from insufficient attention to their critical and bio-psycho-social needs. The endangered needs include the need for sleep, proper nutrition, and fitness, physical activity, proper psychic development, family support, socialization, and the development of socialization-associated skills. The review of relevant scholarly literature proved that the lack of meeting these needs leads to different short and long-perspective disparities in the development of the child. For these reasons, the research assumes that the family should receive financial support from local and state authorities. In addition, the parents require undergoing a theoretical and practical course that would increase their competence in the bio-psycho-social needs of their children.

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