HWSC4005 Health Across the Life Course Assignment Sample

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Introduction to Biological, Psychological, and Social Determinants of Health Across the Life Course Assignment

The purpose of this report is to identify the main biological determinants of health and wellbeing and explore the main psychosocial determinants of health and wellbeing. To meet this purpose, Sarah's case scenario has been considered. Sarah, a 43-year-old black African woman living in a deprived area of Blackpool, is at high risk of developing obesity-related disorders due to her significant increase in weight to 220 pounds and sedentary livelihood. The case scenario also stated that with a BMI of 30 and an apple-shaped fat distribution, she faced an increased risk of conditions like Type 2 diabetes, cardiovascular disorders and certain cancers. Understanding risk factors of Sarah through the biopsychosocial model is considered to be important for providing her holistic care and interventions. This model considered both the biological factors like genetic predisposition and obesity and psychological aspects like motivation, mental health, and self-efficacy, along with social determinants, to indicate the root cause of health and well-being for an individual. In contrast, the biomedical model focuses on Sarah’s obesity and metabolic dysfunction as the physiological issues related to her declining health and well-being. While the biomedical model is important to diagnose and manage disease, it does not identify the social and psychological barriers that may contribute to Sarah’s condition. On the other hand, by adopting the biopsychosocial approach, healthcare providers can offer tailored interventions, such as community-based support for healthy eating, mental health resources, and exercise programmes designed for specific health needs (Card, 2022). Therefore, this report, supported by insights commonly explored through Online Assignment Help UK, emphasises the use of the biopsychosocial model to develop a comprehensive understanding of Sarah’s case scenario and improve patient-centred care outcomes.

Biological factors

Genetic Predisposition to Lifestyle Disease:

Genetic predisposition refers to the individual’s inherited likelihood of developing a particular disease due to their genetic makeup (Rebuzzi et al., 2023). In Sarah’s case, her family history of significant obesity suggests that genetic components may influence her metabolism, fat storage, and insulin sensitivity. This predisposition arises from specific genetic variations that can be inherited from parents. While these genetic factors do not directly cause diseases, they can influence how a person responds to lifestyle choices and environmental factors. For example, individuals with a family history of obesity or Type 2 Diabetes may have a higher risk of developing these conditions, even if they maintain healthy habits. This concept highlights the multifactorial nature of diseases, where genetics interacts with lifestyle and environmental influences to determine the overall health outcomes (Chiarella et al., 2023). In the case of Sarah, her significant obesity and sedentary lifestyle may be exacerbated by genetic factors that predispose her to weight gain and metabolic disorders. More specifically, Sarah’s struggle with weight management, despite dieting attempts, could be partly attributed to genetic influences. Furthermore, genetic factors may contribute to insulin resistance, which can increase her likelihood of developing type 2 diabetes, especially when combined with her sedentary lifestyle and high waist-hip ratio.

HWSC4005 Health Across the Life Course Assignment Sample

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Stefan Bell 5 Years | MPhil

Biological changes caused by Type 2 Diabetes:

If Sarah develops type 2 diabetes, several biological changes will occur in her body:

• Insulin resistance: Over time, the cells of her body may become less responsive to insulin, requiring the pancreas to produce more insulin to maintain normal blood glucose levels. Eventually, this leads to high blood sugar or hyperglycaemia.

Insulin is a hormone that helps in regulating blood sugar levels by allowing glucose to enter into cells for energy production. When insulin resistance develops, the pancreas compensates by producing more insulin to maintain normal blood sugar levels (Rahman et al., 2021). Over time, as the body struggles to keep up with the increased demand, glucose begins to accumulate in the bloodstream and leads to hyperglycaemia. The prolonged persistence of insulin resistance contributes to prediabetes and, eventually, type 2 diabetes.

1. Pancreatic Beta-Cell Dysfunction: The pancreas, which produces insulin, may become overworked and eventually lose its ability to produce sufficient insulin, which can lead to the worsening of diabetes symptoms. In the early stage of insulin resistance, these beta cells work harder to produce additional insulin to compensate for the body’s reduced sensitivity (Shelton et al., 2022). However, over time, they become overworked and begin to lose their ability to produce sufficient insulin. This leads to progressively worsening blood sugar control, making it difficult for Sarah’s body to regulate glucose levels effectively. Beta-cell dysfunction is a key factor in the transition from insulin resistance to full-blown type 2 diabetes, ultimately leading to a dependence on external insulin or medication to manage blood sugar.
2. Increased Fat storage and inflammation: excess visceral fat, particularly in the abdominal area, releases inflammatory chemicals (cytokines) that contribute to insulin resistance and cardiovascular disease. Sarah’s apple-shaped fat distribution indicates a high level of visceral fat, which is stored around vital cell organs like the liver and pancreas. Unlike subcutaneous fat, visceral fat is metabolically active and releases inflammatory chemicals known as cytokines. These inflammatory markers contribute to insulin resistance by interfering with normal glucose metabolism and insulin signalling (Li et al., 2022). Chronic low-grade inflammation caused by excess visceral fat also increases the risk of cardiovascular disease, such as high blood pressure and atherosclerosis (narrowing of the arteries due to plaque buildup).
3. Damage to blood vessels: Chronic high blood sugar can damage the lining of blood vessels, increasing the risk of hypertension, heart disease, and stroke. The combination of diabetes and hypertension significantly increases her risk of heart disease and circulatory problems, which can narrow the blood vessels and reduce the oxygen and nutrient delivery to tissues, leading to complications like poor wound healing and increased risk of infection (Petrie et al., 2018).
4. Nerve Damage or Neuropathy: Prolonged hyperglycaemia can cause nerve damage, leading to tingling, numbness or pain in the hands and feet (Bodman & Varacallo, 2024). For Sarah, as the neuropathy progresses, she might experience a loss of sensation, which can increase the risk of injury infection, and this further can lead to foot ulcers. If infections spread because of poor circulation and hindered healing, severe instances of diabetic neuropathy may require amputation.
5. Kidney and Eye Complications: Uncontrolled diabetes can lead to kidney disease (diabetic nephropathy) and damage to the small blood vessels in the eyes (diabetic retinopathy), potentially causing vision problems and blindness.

Psychosocial impact

The psychosocial impact of obesity involves a range of mental and emotional challenges that significantly affect an individual's well-being and quality of life. These challenges often include heightened risks of depression, anxiety, and other mental health conditions3. Factors such as weight bias, discrimination, poor body image, and physiological issues contribute to these psychological difficulties.

Psychological Challenges Associated with Obesity:

Low Self-esteem and Body Image Issue: Obesity is often stigmatised in society, leading to negative self-perception and low self-esteem (Westbury et al., 2023). Sarah’s apple-shaped fat distribution may make her more self-conscious about her body, and a potential diabetes diagnosis could further reinforce feelings of inadequacy. The psychological impact of being overweight and living with a chronic illness could make her feel socially isolated and discouraged from engaging in social activities.

Diabetes-related distress: Managing diabetes requires ongoing monitoring of blood sugar levels, dietary changes, and possible medication use (National Institute of Diabetes and Digestive and Kidney Diseases, 2019). This can lead to diabetes-related distress, a condition where individuals feel burdened by the constant demands of the disease. Given Sarah’s history of unsuccessful dieting, she may struggle with the pressure of maintaining strict dietary control, leading to feelings of failure and hopelessness.

Emotional Distress and Depression: According to research by Jena et al. (2018) and Tareen and Tareen (2017), People who receive a type 2 diabetes diagnosis may experience emotional discomfort because they may feel overburdened by the requirement for long-term lifestyle modifications and medical supervision. Sarah may already be experiencing irritation and low self-esteem as a result of her battle with obesity and her incapacity to keep up a balanced diet. She can feel more stressed and anxious about possible problems, including heart disease, neurological damage, or even early death if she has diabetes. Depression, which is prevalent in people with chronic conditions, can also result from the worry of deteriorating health.

Sarah's Case Scenario:

Sarah, a 43-year-old Black African woman living in a deprived area of Blackpool, exemplifies the psychosocial challenges linked to obesity2. Her lifelong struggle with weight, combined with a family history of obesity and lack of qualifications, contributes to her vulnerability. Sarah's "apple-shaped" fat distribution, sedentary lifestyle, and BMI over 30 exacerbate these issues.
The psychosocial factors significantly impacting Sarah's health and overall quality of life include:
Social Isolation and Loneliness: Sarah's inability to participate in activities she enjoys due to her weight and related physical limitations can lead to social isolation and difficulty coping with life's hardships. More specifically, living in a deprived area of Blackpool (IMD decile 1) means Sarah may have limited access to healthcare services, healthy food options, and community support (Aveyard et al., 2023). Socioeconomic disadvantages can lead to feelings of isolation, as financial struggles may prevent her from joining exercise programs, seeking therapy, or affording nutritious food. Additionally, the stigma surrounding obesity and diabetes could make Sarah hesitant to seek medical advice, fearing judgment from healthcare providers or society.

Internalised Stigma: Facing societal negativity and stereotypes about obesity, Sarah may internalise these biases, leading to feelings of shame, embarrassment, and low self-worth. This internalised stigma can further contribute to depression and anxiety (Bury and Gabe, 2013). Additionally, as per the case scenario of Sarah, as a mother of three young children, she has caregiving responsibility that needs physical and emotional energy. If she develops diabetes, managing the disease alongside her role as a mother could be overwhelming. Fatigue, stress, and potential diabetes complications may limit her ability to engage with her children, leading to feelings of guilt and emotional strain.

Barriers to employment and financial stress: Since graduating from college, Sarah has not held full-time work, which could already be a factor in her financial instability. The expenses of medical treatment, prescription drugs, and healthier diet options could further tax her already meagre financial resources if she gets diabetes. Finding a job can also be more difficult if you have a chronic condition, particularly if diabetes-related health issues and exhaustion affect your ability to do your job.

Barriers to Healthcare: Negative attitudes and stereotypes about obesity among healthcare providers may affect the quality-of-care Sarah receives, potentially impacting her self-esteem and access to appropriate medical and mental health support.

Coping mechanism and mental resilience: Without a proper support system, Sarah may turn to unhealthy coping mechanisms, like emotional eating and avoidance of medical care, which could worsen her condition. However, without appropriate interventions like counselling, peer support groups, and education about diabetes management, she could develop healthier coping strategies to improve her well-being and self-efficacy to manage her health.

Demographic factor

Impact of Socioeconomic Status (SES) on Disease Risk and Progression:

Socioeconomic status (SES) significantly affects health outcomes, especially regarding lifestyle-related diseases like obesity and type 2 diabetes. Sarah has spent her entire life in a deprived area of Blackpool (IMD decile 1), which means she has encountered economic difficulties, limited access to healthcare, and fewer chances to engage in health-promoting activities. People from low SES backgrounds often face higher rates of obesity and diabetes due to factors such as poor nutrition, food insecurity, insufficient health education, and limited access to recreational facilities. Furthermore, Sarah has not had full-time employment since leaving school without qualifications, which may have hindered her ability to afford healthier food choices or seek medical advice promptly. Over time, these challenges elevate her risk of developing type 2 diabetes and complicate disease management.

Demographic Factors that Contribute to Increased Disease Risk:

Age: 43 years old: As Sarah is in her early 40s, she is at an age where metabolic changes slow down, making weight loss more difficult. The risk of type 2 diabetes also rises with age as insulin resistance becomes more pronounced, particularly in individuals with long-lasting obesity and a sedentary lifestyle.

Gender (Female): Women with central (apple-shaped) obesity, like Sarah, have a higher risk of developing metabolic syndrome, a cluster of conditions that can increase the likelihood of diabetes and cardiovascular disease. Hormonal fluctuations, particularly after childbirth and approaching perimenopause, may further contribute to weight gain and insulin resistance.

Ethnicity (Black African): Ethnicity plays a significant role in diabetes risk. Black African individuals are genetically predisposed to insulin resistance and have higher rates of Type 2 diabetes than the White population. As per estimation, 70 per cent of the people in Blackpool are overweight or obese, which is equivalent to 77,000 compared to the national figure of 63%. In 2022/23, the obesity rate in Blackpool was 65.7%, and 72.1% of the black population in Blackpool region were overweight in comparison to a total of 64% of the population in England.

Strategies to improve health status

The Health Belief Model (HBM) is a valuable framework for understanding Sarah’s views on her health risks and for creating effective interventions (Jones et al., 2015). The Health Belief Model consists of:

• Perceived Susceptibility – Sarah might not fully grasp her significant risk of developing type 2 diabetes, given her obesity, lack of physical activity, and family history. Raising her awareness through education about genetic factors and lifestyle choices could inspire her to make changes.
• Perceived Severity – She may not be aware of the serious complications associated with diabetes, such as heart disease, kidney failure, and nerve damage. Sharing real-life stories or connecting her with healthcare professionals could help her understand the gravity of the condition.
• Perceived Benefits – Helping Sarah recognise the advantages of a healthier lifestyle, like increased energy, improved mobility, and disease prevention, can motivate her to adopt weight management strategies.
• Perceived Barriers – Sarah’s limited financial resources might lead her to think that healthy eating and exercise are too expensive or out of reach. By suggesting affordable healthy food options and local exercise programs, we can help her overcome these obstacles.
• Cues to Action – Regular health check-ups, reminders from healthcare providers, and support from community groups can act as external motivators for Sarah to take action.
• Self-Efficacy – Enhancing Sarah’s confidence in making lasting lifestyle changes, such as setting small, attainable goals, can empower her to take charge of her health.

Comparison of Health Intervention Methods:

Dietary and Lifestyle Interventions

Strengths: Tackles the underlying causes of obesity and diabetes, non-invasive and cost-effective over time.

Limitations: Demands a long-term commitment; Sarah may face challenges in staying motivated due to her socioeconomic situation.

Pharmacological Interventions (e.g., Metformin for insulin resistance)

Strengths: Effective in managing blood sugar levels.

Limitation: It does not address the underlying lifestyle factors and may have side effects.

Community-based Programs (e.g. NHS weight management support groups, local fitness classes)

Strengths: It provides peer support, affordability, and accessibility.

Limitation: Effectiveness depends on Sarah’s participation and willingness to engage.

Tailored Recommendation for Sarah:

A biopsychosocial approach is crucial for enhancing Sarah’s health by addressing the biological, psychological, and social factors that increase her risk of developing type 2 diabetes. On the biological front, Sarah should have regular health screenings, including blood glucose checks, lipid profile evaluations, and BMI monitoring, to catch any early signs of metabolic issues. Considering her genetic background and family history of obesity, a healthcare provider might explore pharmacological options, like metformin, if she exhibits signs of insulin resistance (NHS and Cleminson, 2020). However, relying solely on medication isn't a sustainable long-term strategy; lifestyle changes must take precedence. Encouraging Sarah to embrace a balanced diet that includes portion control, whole grains, lean proteins, and fibre-rich foods while reducing processed and sugary items will aid in managing her weight and metabolic health. Additionally, incorporating physical activity, even in small doses like walking or doing household chores, will enhance her insulin sensitivity and cardiovascular well-being. From a psychological perspective, Sarah may face challenges with motivation, self-esteem, and emotional eating due to years of failed dieting and her socioeconomic situation. Offering counselling or motivational coaching can empower her to build self-efficacy and tackle emotional obstacles related to her weight and health. A cognitive-behavioural therapy (CBT)-based approach could be particularly effective in helping her shift negative perceptions about food, exercise, and self-worth (Nakao et al., 2021). Moreover, stress management strategies, such as mindfulness practices, relaxation techniques, or support groups, could assist Sarah in managing emotional distress that might otherwise lead to unhealthy behaviours.

Socially, Sarah’s environment plays a significant role in her ability to adopt healthier habits. As she lives in deprived areas with limited access to health-promoting resources, it is important to connect her with community-based programs that can offer her affordable and subsidised gym membership, group fitness sessions, and nutritional workshops (Sumner, 2023). Local Government and NHS-funded weight management initiatives could provide structured support tailored to her financial situation. Additionally, engaging her family in health education sessions could encourage a household-wide shift towards healthier eating and physical activity, ensuring long-term success.

Conclusion

This report analysed Sarah's situation using a biopsychosocial approach, emphasising how biological factors (like genetic predisposition and the risk of Type 2 diabetes), psychosocial elements (such as low self-esteem and social isolation), and demographic aspects (including socioeconomic status, ethnicity, and age) all contribute to her health risks. The Health Belief Model serves as a valuable framework for intervention, focusing on Sarah's views regarding her susceptibility, the severity of her condition, the benefits of making changes, and the obstacles she faces. By raising awareness, offering affordable resources, and encouraging social support, this approach can help Sarah embrace healthier habits, ultimately enhancing her health outcomes and quality of life.

References

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