CASE: Huan Zhao

Huan Zhao lives with relatives close to Humber College and presents at the Student Massage
Therapy Clinic reporting right sided knee pain. You are the massage therapy student assigned to
work with her.

Ms. Zhao, a 24-year-old university student, has never had massage therapy before and is new to
Canada. Last September, she moved to Toronto to attend York University for biotechnology.
This summer, she was unable to return home to China to visit her mother and father because her
family could not afford it. The only way she is able to pursue her degree in Canada is through a
substantial scholarship. She is staying in Toronto with relatives in a crowded high rise apartment
complex. Huans first language is Mandarin and she has English as an added language. Her
English language skills are good but she is shy to speak to others. She doesnt know a lot of
people other than her relatives, who speak only Mandarin, and a few classmates. She began
playing tennis at a local community centre three months ago.

Identify the social determinants of health present in this case and explain how those the
social determinants of health could influence Ms. Zhaos overall health and wellness.
Social Determinants

Immigration is an important determinant of health. It can affect ones way of social

interaction. People who face the difficulties that come with immigration can face many barriers

that can exclude them from society. This can can increase the likelihood of someone developing
diabetes and other health conditions due to lack of resources and information or living in poverty
(Mikkonen, J, 2010, pg 33). Huan has travelled from China to take part of her education at York
University which is one of the top university in the Greater Toronto area and has gained a
sustained scholarship to continue her education in Toronto. Haun is an immigrant but, Canadian
Universities and Colleges have great support groups for international students and Scholarships
Canada offers multiple scholarships for students that are international students. While being an
immigrant, language barriers can be a big influence for social interactions and may affect Huans
way of learning if her classes are taught in English and finds it difficult to understand concepts.
Social exclusion due to language barriers are more likely to be unemployed or have low income
(Mikkonen, J, 2010, pg 32).

Income is an important determinant as it shapes a person's overall lifestyle. This can

affect the quality and amount of food an individual has access to as well as housing and living
conditions. Also, having an income can help keep the structure of someones day-to-day life
(Mikkonen, J, 2010, pg 17). Since Huan is unemployed she is prone to material and social
deprivation, stress, and poverty (Mikkonen, J, 2010, pg 17). Huan is currently living in a
crowded living conditions because her family cannot afford to pay for her to travel back home.
This may cause her to be stressed or overwhelmed because she is not able to see her family.
Housing, in Canada, is a necessity for living a healthy life (Mikkonen, J, 2010, pg 29). Huan is
currently living in a crowded apartment with many of her relatives. This can create many issues
such as lack of privacy and quiet areas for studying. Although she is in this type of living

situation, it may be what she is used to in China. A positive of living in this type of situation is
that she would have her family and relatives there that she can talk to. She is often too shy to
others, so this may help her with feeling comfortable.
A persons gender plays a huge role in how they are treated. There is a large gender gap
in Canada and inequality shows itself in jobs, lifestyle, and the responsibilities they have. Being
a female does impact ones overall income within and more discrimination within the workplace
(Mikkonen, J, 2010, pg 44). Women have a life expectancy of 79 years comparing to mens
76.3 years. However, the higher mortality rate and lower life expectancy of men does not mean
that women enjoy superior health. (Mikkonen, J, 2010, pg 44). These are all negative impacts of
being a female compared to being a male because without having a health care plan set out for
Huan then she might have issues because she will not have enough money put aside in order to
treat any ongoing issues. A positive about being a female is that the suicide rate, substance abuse
and prison population is not as high in women than it is in men. Haun is a female, but she is not
subject to the difficulties that come with being female. She does not have any children to care for
and she does not have a job where she experienced discrimination or unfairness.
Educated individuals are, on average, healthier due to the fact that they have better access
to resources and services that can help them remain healthy and reach out when they are in need.
More educated individuals gain more understanding and literacy. Many schools require students
to take courses along with their programs that educate them on nutrition and mental health.
Because Haun is in school, she has access to the services, information, insurance, and resources
that the school offers. This also may help her understand the importance of health and help her
become more active in seeking out ways to improve it in herself.

There are many factors that influence wellbeing and health care that an individual
receives. In Huans case, following are some of the barriers that she is faced with.
Language plays a role in her overall health and wellness because she feels too shy to
speak to others in English and only feels comfortable speaking Mandarin and with relatives and
some classmates. A combination of this shyness and language barrier will prevent her from
reaching out to receive health care and information about resources available to her. She may
also not be able to give enough information about her health history or conditions because she
wouldn't know how to properly explain herself. This could result in her not knowing who to go
to for specific issues and may result in her not reaching out or going to see a doctor at all because
she feels too overwhelmed.
Huan is a full time student at York University and is completing her education in
biotechnology. Huan is under a sustained scholarship and her parents dont have enough money
to have her visit. A lack of money and limited amount of benefits that are provided from school,
Huan may have a restricted amount of income to cover her schooling and basic health care.
Income can also determine other social determinants such as quality of food, housing, and and
access to basic necessities (Mikkonen, J, 2010, pg 12). Income can determine ones health in
two ways; how much income the family or individual makes, and secondly, how the
family/individual distributes their money (Mikkonen, J, 2010, pg 12). A family that makes a
small income, the majority of the money would be designated for monthly bills which leaves
them with limited money to spend on healthy foods or to address health concerns.

References

Mikkonen, J. & Raphael, D. (May, 2010). Social Determinants of Health: The Canadian
Facts. Social Determinants of Health: The Canadian Facts. Toronto. York University School of
Health Policy and Management.

MARKING RUBRIC
Social Determinants: Excellent submission will include at least four (4) social determinants of health;
including a clear description of the social determinants effect on health outcomes (at both the negative and
positive end of the spectrum) and potential effects on Ms. Zhaos health and wellness. Responses should
include a link to why the social determinants were chosen for Ms. Zhao. Submissions will be written in the
groups own words and will be supported by credible resources.
Cannot
mark

Poor

Average
2

Excellent
5

Barriers: Excellent submission will include at least two (2) potential barriers to accessing health care for
Ms. Zhao that are clearly articulated including a detailed description of the barriers that may be faced, how
they relate to her situation, and may prevent her from receiving optimal care. Submissions will be written in
the groups own words and will be supported by credible resources.
Cannot
mark

Poor

Average
2

Excellent
5