Social Determinants of Health in Elderly Chronic Disease Management
This literature review examines three key social determinants of health — access to health services, income and social status, and physical environment — and their influence on chronic disease management among Canada's elderly population. Drawing on Canadian and international research, the paper explores how geographic remoteness, socioeconomic disadvantage, and inadequate housing conditions compound health vulnerabilities for seniors. It highlights systemic barriers such as fragmented care delivery, rural isolation, poverty cycles, and overcrowded housing that impede early diagnosis and effective disease management. The review concludes with recommendations for research investment, policy reform, and theoretically grounded interventions tailored to the socio-demographic realities of Canada's aging population.
- Introduction: Scope of chronic disease burden among Canadian seniors
- Access to Health Services: Rural barriers, wait times, and care fragmentation
- Income and Social Status: Income levels, employment, and disease risk links
- Physical Environment: Housing quality, overcrowding, and medication access
- Conclusion: Policy recommendations and future research directions
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What makes this paper effective
- Organizes a complex multi-factor topic into three clearly defined determinants, making the argument easy to follow across sections.
- Consistently grounds claims in peer-reviewed sources, including epidemiological data (e.g., death rates 30% higher in deprived locales) that lend empirical weight to the analysis.
- Uses concrete examples — such as Inuit Nunaat communities and the Non-Insured Health Benefit drug approval process — to illustrate abstract systemic barriers.
- Demonstrates awareness of the interconnected nature of the determinants, showing how poverty reinforces poor physical environments and restricted healthcare access in a compounding cycle.
Key academic technique demonstrated
The paper employs a thematic literature review structure, synthesizing multiple sources under each determinant rather than summarizing studies one by one. This approach allows the author to build a coherent argument about causation and interaction among determinants, which is more analytically sophisticated than a simple annotated bibliography.
Structure breakdown
The paper opens with a contextual introduction establishing the scope of the problem, then devotes a section each to the three determinants: access to health services (the longest and most detailed), income and social status, and physical environment. A concluding section ties findings together and advances policy and research recommendations. Citations follow APA format throughout.
Introduction
While the health of Canada's population compares favorably to many other developed economies, the prevention and management of chronic diseases among the elderly present the greatest challenge to the country's healthcare system. Today, seniors tend to live longer, as they are healthier and economically better off compared to previous generations. However, as they age, studies reveal that the elderly suffer increasingly from chronic diseases that place extra burdens on the healthcare system. Canada's elderly population is highly prone to poverty and has the greatest demands for community, home, and acute care services (Belanger, Gosselin, Valois, & Abdous, 2014). The lack of government support and the shortage of home care nurses mean that most seniors are confronting the health challenges of aging largely on their own. As a result, the only healthcare alternatives for many are emergency ambulance transport and hospital admission (Belanger, Gosselin, Valois, & Abdous, 2014).
Little is known about the distinct impact of social determinants of health on chronic disease management for the elderly in Canada. However, it is evident that the spiritual, emotional, and physical dimensions of chronic disease management among this population are influenced by a variety of social determinants. This literature review focuses on three major social determinants: access to health services, physical environment, and income and social status. These factors influence the management of chronic diseases among the elderly along a continuum from excellent to poor health. As Cott, Gignac, and Badley (1999) observed, "illness-related variables were associated with poor health, with smaller but significant contributions from demographic and lifestyle factors" (p. 731).
Access to health services, physical environment, and income and social status all influence the health vulnerability and chronic disease management of the elderly. This population is not only a burden on the national healthcare system but is often restricted from access to resources that could ameliorate their problems. The three determinants not only influence the diverse health outcomes of seniors but also trigger health complications that reflect and reinforce subsequent health determinants (Mery, Wodchis, & Laporte, 2015). For example, living in low-income households is associated with high levels of illness and disability, which in turn diminishes opportunities for gainful employment, thereby aggravating poverty and chronic disease among the elderly.
Researchers in this area have reached tentative agreement regarding these three determinants of health as they relate to chronic disease management of the elderly in Canada (Belanger, Gosselin, Valois, & Abdous, 2014). The contexts and mechanisms through which these determinants influence the health of this group have been articulated clearly, and for decades researchers have been mapping the complex interconnections among them, demonstrating these linkages in empirical formats (Belanger, Gosselin, Valois, & Abdous, 2014).
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