Case Study Norma James

Norma James is a socially isolated 65 year-old widow. She has limited contact with her two adult sons. Norma has no interest engaging in social interaction. She has a history of Type 2 diabetes mellitus and hypertension. Norma has many physicians and takes various medications. She is unemployed, has limited savings, and depends on Old Age Security benefits for income. She smokes cigarettes daily and has been smoking for about forty years. She likes to indulge in alcohol a few times a year. Norma has no driver’s license and depends on friends, neighbours, or the city bus for transportation. Most of the time, she prefers to be at home alone doing personal hobbies.
The first determinant of health relevant to Norma’s situation is social exclusion. This means that certain groups, including Aboriginal and disabled people, women, new immigrants, and visual minorities, lack the opportunity to participate in Canadian life (Kozier, 2014). Socially excluded people cannot participate in civil affairs and social production, and cannot access social goods and economic resources
Firstly, she is excluded from social production because she rarely contributes to societal and cultural activities. For instance, she spends most of her time at home doing hobbies because she lacks the financial resources that facilitate community involvement. Secondly, Norma is economically excluded because she has no access to economic resources and opportunities, such as paid work (Mikkonen, 2010). Lastly, Norma has health complications caused by social exclusion. Social isolation causes long term stress, and those affected are prone to diabetes and high blood pressure (CNA, 2005). It is possible that Norma is stressed because she smokes every day, drinks alcohol, and is diabetic and hypertensive. Overall, insufficient social support and economic resources, along with stress, can impact Norma’s health and decrease her abilities to living a fulfilling