3 - Social Determinants of Health

Summary

Janae is a smart and capable twenty-one-year-old black woman who has lived in the same low-income urban neighborhood all her life. She graduated from the local public high school and received grants to take a few community college classes, but after dealing with the frustrations of unreliable transportation to campus and trying to manage many more urgent priorities, she decided to put classes on hold and focus on making money. She shares an apartment with her mother, who suffers from lupus and is on long-term disability, and her younger brother and sister, and works as a part-time cashier at a discount store down the street from their apartment. Janae sometimes dates men from the neighborhood, but is cautious about letting anyone in. Her father has been gone since she was a small child, and her mother has had a number of boyfriends, a few who were violent with her, one who was violent with Janae and her siblings, and one who touched Janae inappropriately. Most of the time, Janae feels responsible for taking care of her mother, brother, and sister – she uses her mother’s Supplemental Nutrition Assistance Plan (SNAP) card to buy groceries at the discount store where she works or at the corner grocery, and she makes sure there is always food at home. She promises her family that she will always be there when they need her, but she dreams of going back to school and having new experiences and a career that makes her feel proud. Janae worries a lot about what she’s missing, and the worrying sometimes makes her tired and depressed, and at other times it makes her want to go out and party and forget about all her responsibilities.