Addressing the Effects of Psychological Trauma in a Community Using a Social Determinants of Health Approach: A Case Study
This teaching case study examines psychological trauma in a community context and the relevance, both positive and negative, of social determinants of health. Healthy People 2020 views people residing in communities with large-scale psychological trauma as an emerging issue in mental health and mental health disorders (Healthy People, 2016). The case study, which focuses on Newark, New Jersey, addresses three of the five key determinants of health: social and community context, health and health care, and neighborhood and built environment. The three key determinants are addressed using psychological trauma as an exemplar in the context of trauma-informed systems. The social and community context is addressed using concepts of social cohesion, civic participation, and discrimination. Access to health and health care are addressed with discussion of access to mental health and primary care services, health literacy, and the medical home model. Neighborhood and built environment are viewed through the lens of available government and NGO programs and resources to improve the physical environment with a focus on quality of housing, crime and violence, and environmental conditions. Upstream interventions designed to improve mental health and well-being that support trauma-informed systems are analyzed. The use of Newark as the case study setting allows a real-life exploration of each of these three key determinants of health.
This case study has four sections – introduction, case study, side bar, and vignettes. Learners should work through the case, access appropriate resources, and work in a team for successful completion.
Learning Objectives
Upon completion of the case study, the student will be able to:
This case study has four sections – introduction, case study, side bar, and vignettes. Learners should work through the case, access appropriate resources, and work in a team for successful completion.
Learning Objectives
Upon completion of the case study, the student will be able to:
- Recognize the symptoms of psychological trauma.
- Assess for adverse experiences that may precede psychological trauma.
- Analyze the relationship among psychological trauma, physical and mental health, and social determinants of health.
- Examine the prevalence of psychological trauma in a community context.
a. Analyze the social and community context of adverse experiences and psychological trauma.
b. Analyze access to health and health care for those with adverse experiences and psychological trauma
c. Analyze neighborhood conditions and the built environment in relationship to adverse experiences and
psychological trauma. - Identify how adverse experiences may contribute to health issues over the life course and adversely impact multiple generations of a family and community.
- Discuss the institutional relationships in a community that may impact mental health and well-being and points for improvement.
- Discuss available federal, state, and local resources to improve the physical and mental health of community residents.
- Develop a strategy to address social determinants of health to improve mental health and well-being in individuals residing in a community with wide-spread psychological trauma.
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Step 3: Side BarStep 4: VignettesBelow are four vignettes to read and discuss. These vignettes are to be viewed within the context of the Newark case study. There are discussion questions provided after vignette 4 that you may wish to refer to while reading to guide your learning.
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Instructor Materials:
This project was made possible through Cooperative Agreement #5 ATPHP120007-05 between the Association for Prevention Teaching and Research (APTR) and the the Office of Disease Prevention and Health Promotion (ODPHP), Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. The findings and conclusions are those of the author(s) and do not necessarily represent the views of ODPHP and APTR.