So ɛyɛ nnuru ara kwa na ɛka w’akwahosan? Momma yensua asetra mu nneɛma ho ade? (Asetra mu Nneɛma a Ɛkyerɛ Akwahosan - SDOH)

So woasusuw nea enti a nnipa binom wɔ apɔwmuden sen afoforo ho pɛn? Ɛtɔ da bi a, yesusuw sɛ sɛ yɛnom nnuru pa na yɛkɔ oduruyɛfo nkyɛn a, yebetumi atwe yɛn ho afi nyarewa ho. Nanso nokwarem no, nneɛma afoforo pii wɔ hɔ a ɛka yɛn akwahosan, a ebia yɛremfa yɛn adwene nsi so kɛse wɔ yɛn da biara da asetra mu, nanso ɛho hia yiye. Ɛno ne nea yɛfrɛ no Social Determinants of Health (SDOH).

Dɛn ne asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) yi?

Sɛ yɛbɛka no tiawa a, eyi ne sɛnea w’ankasa, asetra, ne nneɛma a atwa wo ho ahyia no ka w’akwahosan ne wo yiyedi. Eyinom yɛ nneɛma a ɛnyɛ aduruyɛ mu nneɛma. Ɛno kyerɛ nneɛma te sɛ sika a wunya, wo nhomasua, ofie ko a wote mu, ne nneɛma a w’abusua kɛse no wɔ. Ebia worempɛ sɛ wo ne wo duruyɛfo bɛkasa afa saa nneɛma yi ho efisɛ wunsusuw sɛ ɛne w’akwahosan wɔ abusuabɔ.

Nanso, nhwehwɛmu ada no adi sɛ saa asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) yi nyɛ nea ɛfa w’akwahosan ho nko, na mmom ebetumi akyerɛ w’akwahosan ankasa. Ɛne sɛ, ɛka asiane a ɛwɔ hɔ sɛ wubenya nyarewa bi, ayaresa a wonya, ne sɛnea wote nka sɛ wo ho ye da biara da.

Fa no sɛ, sɛ wowɔ sika a ɛkɔ so daa, adwuma pa a, wubetumi atua ka adi nnuan a ahoɔden wom, ayɛ akwahosan ho nhwehwɛmu daa. Sɛ wowɔ kar a, ɛnyɛ den sɛ wobɛkɔ oduruyɛfo nkyɛn, na woakɔfa nnuru bi afi nnurutɔnbea hɔ.

Nanso, wɔ obi a ɔyɛ adwuma wɔ adwuma bi a onni akwamma a wotua ho ka, anaasɛ ɔte akyirikyiri a onni kar a ɛfata nkɔ sotɔɔ mu fam no, hokwan a ɛwɔ hɔ sɛ obedi nnuaba ne nhabannuru a ahoɔden wom na wakɔ oduruyɛfo nkyɛn daa no sua koraa, ɛnte saa?

Dɛn ne saa asetra mu nneɛma yi ho nhwɛso ahorow (SDOH)?

Nneɛma a ɛkyerɛ akwahosan wɔ asetra mu (SDOH) ho nhwɛso ahorow bi ni:

• Wo sika a wonya no dodow .
• Wo nhomasua gyinabea .
• W’adwuma ne mfasoɔ a ɛde ma – sɛ nhwɛsoɔ no, akwahosan ho insurance, akwamma a wotua ho ka.
• Nneɛma a ɛwɔ wo mpɔtam hɔ – nneɛma te sɛ mmeae a wodidi a ahoɔden wom, ɔmanfo kar, ne mmeae a wɔhwɛ mmofra.
• Ahobammɔ ne ahobammɔ a wote nka wɔ wo mpɔtam hɔ .
• Aduruyɛ ho nnwuma a wobenya .
• Mframa a wohome ne nsu a wonom no su .
• Wo fekubɔ ne wo fekubɔfo .

Eyinom yɛ nhwɛso kakraa bi pɛ. Saa asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) yi wɔ baabiara a wote, woyɛ adwuma, na wobɔ fekuw. Nhwehwɛmufo akyekyɛ mu akuw atitiriw anum na ama wɔate ase yiye. Sɛnea U.S. Akwahosan ne Nnipa Nnwuma Dwumadibea kyerɛ no, saa akuw anum yi ne:

1. Sikasɛm mu ahotɔ: Nsɛm a ɛfa sika dodow a wunya ne sɛ ebia saa sika no betumi adi w’abusua akwahosan ne ahiade afoforo ho dwuma anaa.

2. 2. .Nhomasua a wobenya ne nea ɛyɛ papa: Nsɛm a ɛfa nhomasua a wunya ne sɛnea edi w’adesua ahiade ho dwuma yiye ho. Nea ɛka eyi ho ne adesua ahiade ahorow a ɛfa ɔkwan a w’amemene no yɛ adwuma ho.

3. Akwahosan ho nhyehyɛe a wobenya ne nea ɛyɛ papa: Nsɛm a ɛfa ayaresa a wunya ne baabi a edi wo nipadua ne adwene mu akwahosan ahiade ho dwuma.

4. Mpɔtam ne nneɛma a wɔasisi: Nsɛm a ɛfa beaeɛ a wote, kyerɛ sɛ, w’akuraa anaa kuropɔn, ne sɛdeɛ nneɛma a ɛwɔ hɔ boa wɔ w’akwahosan ne ahobanbɔ mu.

5. Asetra ne mpɔtam hɔ nsɛm: Nsɛm a ɛfa wo ne w’abusua, wo nnamfo, w’adwumayɛfo, ne afoforo a wɔwɔ mpɔtam hɔ ntam abusuabɔ ho.

Susuw ho hwɛ, saa nneɛma yi nyinaa wɔ abusuabɔ na ɛka wɔn ho wɔn ho. Sɛ nhwɛso no, ohia ka w’asetra fã biara – efi nea wudi, kosi baabi a wote, kosi nneɛma a wubetumi anya so. Sɛ wowɔ mma a, mmofra hwɛ a ne bo nyɛ den a wunnya no betumi ayɛ akwanside a ɛbɛma woatumi akɔ adwuma. Ebetumi ayɛ den sɛ wobɛkɔ sotɔɔ mu anaa wobɛkɔ oduruyɛfo nkyɛn wɔ beae a ɔmanfo kar anaa akwan a wɔfa so nantew nni hɔ.

Sɛ yɛbɛka no tiawa a, asetena mu nneɛma a ɛkyerɛ akwahosan (SDOH) nni hɔ wɔ baabi a ɛyɛ soronko – akwanside biako anaa abien mpo betumi anya nkɛntɛnso kɛse wɔ w’asetra ne w’akwahosan so.

Enti, dɛn na eyi nyinaa ka kyerɛ wo? Wobɛyɛ dɛn ahu nea ɛyɛ asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) a ɛreka w’asetra? Susuw nsɛmmisa a ɛwɔ aseɛ ha yi ho – wɔahyehyɛ no atwa mmeaeɛ titire anum a yɛadi kan aka ho asɛm no ho ahyia. Ɛsɛ sɛ wutumi bua nsɛmmisa yi nyinaa sɛ “yiw.” Kyerɛw nsɛmmisa a wubetumi abua “dabi” no nsow. Eyinom yɛ nsɛmti a ebia wobɛpɛ sɛ wo ne w’adamfo, ɔfotufo, anaa oduruyɛfo susuw ho.

1. Susuw sikasɛm mu ahotɔ ho

• So wowɔ sika a ɛdɔɔso a wode bɛtɔ nnuan ne anonne a ahoɔden wom?
• So wubetumi atua ayaresa, akɔ oduruyɛfo nkyɛn, na woatɔ nnuru?
• So wowɔ sika a ɛdɔɔso a wode bɛhwɛ wo fie so na woatua dan ka?
• So wowɔ sika a wode betua ka afoforo te sɛ anyinam ahoɔden ne nsu?
• So wubetumi anya mmofra hwɛ a ne bo nyɛ den?
• Wosusu sɛ w'adwuma no gyina hɔ pintinn ?
• So w'adwumam ma wonya akwahosan ho insurance ?
• So w’adwumam ma wonya akwamma a wotua ho ka anaasɛ akwamma a wɔde yare ?
• Sɛ wunni adwuma a, so wubetumi de wo ho ahyɛ nhyehyɛe ahorow a ɛboa wo ma wunya adwuma mu?
• So wowɔ hokwan sɛ wubenya adwuma ho afotu?

2. Susuw nhomasua a wobenya ne nea ɛyɛ papa ho

Sɛ woredwen ɔfã yi ho a, ebetumi aboa kɛse sɛ wubesusuw nneɛma a wo ba no wɔ (mprempren ne daakye nyinaa) ho, nanso wubetumi asusuw w’ankasa wo bere a atwam anaa mprempren nhomasua mu osuahu ahorow nso ho.

• So wo ba no nya hokwan nya sukuu nhomasua a ɛkorɔn ?
• So wubetumi asusuw sɛ wo ba no besua ade akodu A-level ?
• So nneɛma bi wɔ hɔ a ɛbɛboa wo ba no adesua ahiadeɛ soronko – sɛ nhwɛsoɔ no, adesua mu dɛmdi anaa adwene mu dɛmdi?
• So w’abusua wɔ sika a wɔde bɛma wo ba akɔ sukuupɔn anaa adwumayɛ ho ntetee sukuu?
• So wo ba no ne mmofra afoforo wɔ adamfofa pa wɔ sukuu mu?

3. Susuw akwahosan ho nhyehyɛe a wobenya ne nea ɛyɛ papa ho

• So wowɔ akwahosan ho insurance ?
• So wowɔ insurance soronko ma nnuru a wɔkyerɛw ma wo?
• So wowɔ sẽ ho insurance?
• So wowɔ abusua oduruyɛfo (`primary care provider`) a wokɔ ne nkyɛn daa?
• So wubetumi ate nea wo duruyɛfo reka no ase ?
• So wote nka sɛ wo ho tɔ wo sɛ wo ne wo duruyɛfo bɛkasa ?
• So wubetumi anya nsɛm a ɛfa akwahosan ho na woate ase ?
• So wubetumi anya w’aduruyɛ ho kyerɛwtohɔ?
• So wubetumi anya nhwehwɛmu a wɔde siw nyarewa te sɛ nna mu nyarewa (STI) ne kokoram ano?
• So wubetumi anya ayaresa a wuhia ma wo nyarewa no?
• So wowɔ ɔkwan a wobɛfa so akɔ oduruyɛfo nkyɛn (e.g., kar, ɔmanfo kar)?

4. Susuw mpɔtam hɔ ne nneɛma a atwa yɛn ho ahyia a wɔasisi no ho

• So ɛnyɛ den sɛ wobɛkɔ sotɔɔ a wɔtɔn nnuan a nneɛma pii wom mu?
• So wubetumi akɔ akuraa bi ase gua anaa baabi foforo akɔtotɔ nnuaba ne nhabannuru a wɔayɛ no foforo?
• So wowɔ intanɛt ?
• So wote nka sɛ wowɔ ahobammɔ wɔ wo fie ?
• So wote nka sɛ wowɔ ahobammɔ wɔ wo mpɔtam hɔ ?
• So akwan a wɔfa so nantew wɔ wo mpɔtam hɔ?
• So sakre akwan a ɛsono emu biara wɔ hɔ a wɔde sakre tu?
• So fluoride wɔ wo tap nsu mu ?
• So wo dan ka/dan ka a wotua no yɛ nea wotumi tua ? (Affordable kyerɛ sɛ ɛnboro wo sika a wonya no mu 30%.)
• So nneɛma a awuduru wom te sɛ kɔbere nni wo fie?
• Wɔ wo kwan so.So dede no sua dodo sɛ wobɛda?
• So wo dan no wɔ nneɛma a ɛboa wo ma wokɔ baabiara brɛoo (e.g., akwan a wɔfa so kɔ soro anaa mfiri a wɔde foro mmubuafo akongua)?

5. Susuw asetra ne mpɔtam hɔ tebea ho

• So wowɔ abusuafo ne/anaasɛ nnamfo a wɔhyɛ wo nkuran na wɔboa wo ?
• So woka ayɔnkofa kuw bi, te sɛ asɔrefie, atuhoama kuw, anaa mmepɔw so foro kuw bi ho ?
• So wowɔ obi a wo ne no bɛkasa bere a woadi awerɛhow anaasɛ woahyia ɔhaw no ?
• So obi wɔ hɔ a ɔbɛboa wo wɔ ahiade atitiriw ho bere a wo ho retɔ wo wɔ ayaresabea a wobɛtra anaasɛ wo oprehyɛn akyi no?
• So wowɔ nneɛma a wode bɛhwɛ wo mma anaa afoforo a wɔhwɛ wo?
• So wote nka sɛ wɔagye wo atom wɔ w’adwumam ?
• So wote nka sɛ wɔagye wo fɛw so wɔ wo mpɔtam hɔ ?
• So wote nka sɛ wo ne afoforo wɔ abusuabɔ mpɛn pii sen sɛ wote nka sɛ woyɛ ankonam ?

Dɛn nti na saa asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) yi ho hia saa?

Saa asetra mu nneɛma (SDOH) yi ho hia efisɛ ebetumi ama asiane a ɛwɔ hɔ sɛ wubenya nyarewa ahorow no ayɛ kɛse anaasɛ ɛso atew. Wɔ saa kwan yi so no, wobetumi aka wo nkwa nna nso. Saa asetra mu nneɛma yi wɔ tumi a ɛte saa efisɛ ɛka sɛnea w’awosu mu nkwaadɔm yɛ adwuma ne gyinaesi ahorow a wusi da biara da no. Momma yɛnhwɛ eyi mu nkɔ akyiri kakra.

Asetra mu nneɛma (SDOH) ne w’awosu mu nneɛma

Wo awosu mu nkwaadɔm betumi aka asiane a ɛwɔ hɔ sɛ wubenya yare bi. Sɛ nhwɛso no, ebia wubenya awosu mu nsakrae – te sɛ nsakrae a ɛba BRCA1 anaa BRCA2 awosu mu nkwaadɔm mu – a ɛma asiane a ɛwɔ hɔ sɛ wubenya yare te sɛ kokoram no yɛ kɛse. Anaasɛ ebia ɛbɛyɛ mmerɛw sɛ wubenya komayare esiane sɛ w’abusua anya komayare dedaw nti.

Nanso awosu mu nsakrae a wonya fi awo mu no yɛ asɛm no fã biako pɛ. Nhwehwɛmufo a wɔwɔ ``Epigenetics'' mu no da so ara rehu sɛnea nneɛma a atwa wo ho ahyia a wote mu no ka sɛnea w'awosu mu nkwaadɔm yɛ adwuma. Yɛrehu sɛ biribiara fi ɔkwan a wɔfaa so tetee wo sɛ abofra so kosi mframa a wohome no yiye so no betumi ama awosu mu nkwaadɔm bi ``asɔ'' na ama afoforo ``adum''.

Saa ``epigenetic`` nsakraeɛ yi ne ``genetic mutations`` nyɛ pɛ – wo ``DNA`` ntoatoasoɔ no yɛ pɛ. Nanso w’awosu ntumi nyɛ adwuma yiye. Ɛte sɛ nea kanea bi wɔ kanea mu nanso obiara nni hɔ a ɔbɛsɔ.

Awosu mu nkwaadɔm a wɔadan anaasɛ wodum bere a ɛsɛ sɛ wɔyɛ no betumi de nsakrae ahorow a epira nyinaa aba wo nipadua mu. Akisikuru yɛ nhwɛso biako. Wei kyerɛ sɛ asetena mu nneɛma a ɛkyerɛ akwahosan (SDOH), te sɛ asetena mu nkitahodi ne nneɛma a atwa yɛn ho ahyia mu awuduru, betumi aka wo awosu mu nkwaadɔm – wo afã horow a yesusuwii sɛ ɛrensesa da mpo.

Asetra mu nneɛma (SDOH) ne nea wopaw

Wɔ w’awosu akyi no, nneɛma a wopaw no nso ka asiane a ɛwɔ hɔ sɛ wubenya yare no. Worentumi nsakra asiane ahorow a wunya fi awo mu no. Nanso nim a wunim sɛ wowɔ asiane mu no betumi aboa wo ma woapaw nneɛma bi te sɛ kokoram ho nhwehwɛmu a wobɛyɛ, Mediterranea aduan a wubedi akyi, anaasɛ wobɛhwɛ wo mogya mmoroso daa. Saa nneɛma yi a wobɛyɛ no betumi aboa wo ma woatew asiane a ɛwɔ hɔ sɛ wubenya nyarewa bi so anaasɛ ɛbɛma hokwan a wowɔ sɛ wubenya ayaresa ntɛm na wo ho atɔ wo no ayɛ kɛse.

Nanso so nea wobɛpaw no wɔ wo nsam ampa? Mpɛn pii no, ɛnte saa. Ebia akwanside ahorow bɛba wo kwan so, te sɛ kar a wunni a wode bɛkɔ oduruyɛfo nkyɛn, sika a wunni a wode bɛtɔ aduan a ahoɔden wom. Worentumi mfa ``apɛde tumi`` nkutoo nyɛ biribiara.

Ade a eye sen biara ne sɛ obiara benya nneɛma a ɛkorɔn ne hokwan ahorow a ɛbɛboa no ma wahwɛ n’akwahosan so. Yɛnnya mmaa hɔ, nanso wo SDOH a wobɛhunu no ne anammɔn a ɛdi kan a wobɛfa so adu saa botaeɛ no ho. Nnuruyɛfo de nnwinnade ahorow a wɔde hwehwɛ nneɛma mu di dwuma de hwehwɛ sɛnea saa SDOH ahorow yi ka wo ne nea wubetumi ayɛ de aboa.

Dɛn ne eyi ``asetra mu nneɛma a ɛkyerɛ akwahosan nhwehwɛmu adwinnade``?

Eyinom yɛ nneɛma te sɛ `nhwehwɛmu anaa nsɛmmisa` a wohyehyɛ ansa na woakɔ oduruyɛfo nkyɛn. Sɛ nhwɛsoɔ no, wobɛtumi ahyehyɛ `digital form` ansa na woakɔ w'abusua oduruyɛfoɔ nkyɛn. Krataa no bisa wo w’asetena mu nneɛma ahodoɔ ho asɛm – te sɛ wo fie, abusuabɔ, ne sɛdeɛ wobɛnya aduane ne anonneɛ. Ebia nsɛmmisa no te sɛ nsɛmmisa a edi kan wɔ asɛm yi mu no. Ebia wobɛka wo mmuae ho asɛm bere a wokɔ wo duruyɛfo nkyɛn no.

Dodow a wubetumi aka wo dadwen ho asɛm pefee no, dodow no ara na wo duruyɛfo no betumi aboa wo. Ebia wobetumi aka wo haw ano aduru ho asɛm anaasɛ wɔde wo bɛka mpɔtam hɔ nneɛma ho. Ebia biribi wɔ w’asetra mu a kratasin no nka ho asɛm. Sɛ saa a, wo ne wo duruyɛfo nka ho asɛm bere a woahu no no. Sɛ oduruyɛfo no ntumi mmoa wo wɔ asɛm pɔtee bi ho a, ɔde wo bɛkɔ obi a obetumi nkyɛn.

Nneɛma a ɛkyerɛ akwahosan wɔ asetra mu (SDOH) fi ase ka wo fi bere a wɔwoo wo no, na ɛkɔ so hyehyɛ w’akwahosan bere a worenyin no. Nneɛma bi betumi asesa bere a bere kɔ so no. Sɛ nhwɛso no, ebia na woanya sika a enhinhim bere tiaa bi na afei w’adwuma afi wo nsa mpofirim. Anaasɛ, wobɛtumi afiri beaeɛ a bɔs akwan pa ne akwan a ɛwɔ nkyɛnkyɛn wɔ hɔ akɔ beaeɛ a ahobanbɔ nni mu a worentumi nkɔ baabiara a kar nni hɔ – na ebia worentumi ntɔ bi mpo. Nneɛma a ɛboaa w’akwahosan bere bi a atwam no betumi afi ase apira no mpofirim.

Nanso nneɛma betumi akɔ ɔkwan foforo so nso. Wubetumi akɔ mfe pii a wunni akwahosan ho insurance anaasɛ akwamma a wotua ho ka, na afei woanya adwuma a ɛma abien no nyinaa – na awiei koraa no wubetumi atu akɔtra ofie bi a ɛwɔ abɔnten a ɛhɔ yɛ dinn a wubetumi ada yiye mu. Asetra yɛ beae a ɛsakra, na nneɛma a ɛka w’akwahosan no nkɔ baabiara.

Ɛno kyerɛ sɛ ɛnsɛ sɛ akwanside ahorow a wuhyia mprempren no tra hɔ daa. Sɛ wo nni nneɛma a wode bɛboa w’akwahosan ho a, wo ne oduruyɛfoɔ nkasa anaa wo ne mpɔtam hɔ kuw bi nni nkitaho – te sɛ asɔre anaa ahyehyɛdeɛ a wɔnyɛ adwuma a wɔde hwehwɛ mfasoɔ – a wɔbɛtumi de afotuo ne mmoa ama, na wɔde wo akɔma afoforɔ a wɔbɛtumi aboa.

Nkrasɛm a Wɔde Kɔ Fie

Enti, sɛnea yɛaka ho asɛm no, ebia wobɛte ase sɛ yɛn akwahosan sen nnuru a yɛbɛnom de asa yare bi kɛkɛ.

• Nneɛma a atwa wo ho ahyia ho hia: Nneɛma pii te sɛ ɔkwan a wofa so tra ase, sika a wunya, nhomasua, abusuabɔ a wo ne w’afipamfo wɔ, ne nneɛma a wode gye w’ani no ka w’akwahosan tẽẽ.
• Ɛnyɛ biribiara na ɛwɔ wo nsam: Ɛtɔ da bi a, ɛmfa ho sɛnea yɛpɛ sɛ yedi akwahosan ho su pa akyi no, ebetumi ayɛ den sɛ yɛbɛyɛ saa esiane nneɛma a efi akyi a yentumi nyɛ ho hwee nti.
• Nsuro sɛ wobɛsrɛ mmoa: Sɛ wowɔ nsɛmmisa a ɛte sɛɛ a, wo ne oduruyɛfo, abusua muni, anaa w’adamfo bi nkasa. Mmeae bi wɔ hɔ a wubetumi anya mmoa.
• Wubetumi ama nsakrae aba: Ɛho nhia sɛ wo tebea no tra hɔ daa. Nsakrae nketenkete mpo betumi de nneɛma akɛse aba.

Mma wo werɛ mmfi sɛ, w’akwahosan ne w’agyapade a ɛsom bo sen biara. Bɔ mmɔden sɛ wobɛbɔ ho ban wɔ ɔkwan biara a wubetumi so. Sɛ́ wubehu saa asetra mu nneɛma a ɛkyerɛ akwahosan (SDOH) yi yɛ anammɔn a ɛho hia wɔ saa akwantu no mu!

` Akwahosan, asetena mu nneɛma, sikasɛm, nhomasua, akwahosan ho nhyehyɛe, nneɛma a atwa yɛn ho ahyia, awosu, yiyedi, asetra kwan