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Now consider that the patient:
Now consider that the patient:
Has few family members or friends to provide emotional support
Has few family members or friends to provide emotional support
Loneliness and social isolation are correlated with a higher risk of coronary heart disease and stroke (Valtorta et al., 2016).
Has no support for care of an elderly family member or childcare
Has no support for care of an elderly family member or childcare
Caregiver stress can lead to declines in physical health, depression/anxiety, and overall decreased quality of life (Broxson et al., 2020).
Has experienced discrimination throughout their life
Has experienced discrimination throughout their life
Greater lifetime discrimination* is associated with a higher incidence of hypertension (Forde et al., 2020).
*It's important to specifically note that race, ethnicity, gender identity and sexual orientation are also social determinants of health. (Hill-Briggs et al., 2021, Golden et al., 2021)
Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart (British Cardiac Society), 102(13), 1009–1016. https://doi.org/10.1136/heartjnl-2015-308790
Forde, A. T., Sims, M., Muntner, P., Lewis, T., Onwuka, A., Moore, K., & Diez Roux, A. V. (2020). Discrimination and Hypertension Risk Among African Americans in the Jackson Heart Study. Hypertension (Dallas, Tex. : 1979), 76(3), 715–723. https://doi.org/10.1161/HYPERTENSIONAHA.119.14492
Broxson J, Feliciano L. Understanding the impacts of caregiver stress. Professional Case Management. 2020 Jul 1;25(4):213-9.
Hill-Briggs F, Adler NE, Berkowitz SA, Chin MH, Gary-Webb TL, Navas-Acien A, Thornton PL, Haire-Joshu D. Social determinants of health and diabetes: a scientific review. Diabetes care. 2021 Jan 1;44(1):258-79. https://doi.org/10.2337/dci20-0053
Golden SH, Joseph JJ, Hill-Briggs F. Casting a health equity lens on endocrinology and diabetes. The Journal of Clinical Endocrinology & Metabolism. 2021 Apr;106(4):e1909-16. https://doi.org/10.1210/clinem/dgaa938
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