Blog 3 Social Determinants of Health: Adolescents. Socio-Cultural Perception of Addiction and Population Health

 

                 Picture retrieved from: https://www.cdc.gov/healthy-youth/mental-health/index.html

                                 

     Part A

What are some of the determinants that make marginalized populations more at risk for chronic disease, substance use and mental illness?  

Adolescents are at risk of developing mental health disorders such as anxiety, depression, social anxiety, dissociation, post-traumatic stress disorder [PTSD], substance abuse, alcohol dependency, suicidal ideation, and non-suicidal behaviors related to financial stressors, home insecurities, food insecurities, unsafe home environments [second-hand smoking, abuse, neglect, and trauma], lack of access to healthcare services including mental health, and stigma (Kirkbride et al., 2024), According to CDC (2023), 40% of high school students experienced persistence sadness, worthlessness, and hopelessness (CDC, 2024). In addition, 20% of high school students contemplated suicide and approximately 9% attempted suicide (CDC, 2024).

Picture retrieved from: https://www.va.gov

How do Veterans, Homeless and Incarcerated populations intersect? 

According to Kelton et al. (2025), criminal legal system among military veterans in the U.S increases risks for homelessness (Kelton et al., 2025). In the year 2024, 32,000 veterans experienced homelessness in the U.S, which is equivalent to approximately 5% (de Sousa & Henry, 2024 & Kelton et al., 2025).  The Veterans Health Administration [VHA] focuses on reducing homelessness and enhancing the health of veterans with criminal legal involvement via Veteran Justice Programs [VJP] (Kelton et al., 2025). VJP staff members provide outreach programs for veterans following release, including clinical and housing services, contact law enforcement, courts, jails, and community supervision such as probation or parole (Blue-Howells et al., 2013 & Kelton et al., 2025).

However, veterans may experience significant challenges related to housing. According to Kelton et al. (2025), the U.S Housing and Urban Development’s definition of homelessness omits individuals with extended periods of incarceration [90 days or greater] (Kelton et al., 2025). Consequently, upon release, veterans may not qualify for housing as they may not meet the qualifications for homelessness; increasing risks for mental health concerns such as anxiety, depression, substance misuse, post-traumatic stress disorder, and suicide (Blue-Howells et al., 2019 & Kelton et al., 2025).

 For the future to moving forward, it is imperative that the U.S Housing and Urban Development reevaluate their services for veterans experiencing homelessness. It would be prudent to provide housing services such as housing subsidies, funding assistance, Section 8, and assistance in-housing services to prevent mental health concerns [suicide and substance abuse] and homelessness (Kelton et al., 2024).

Picture retrieved: https://www.pfeifferlaw.com/entertainment-law-blog/mark-laita-soft-white-underbelly

Please take a moment to view and comment on one of the short interviews on the website Soft White Underbellies.  These offer powerful insight into the lives of the most marginalized.  

          I enjoyed watching ‘Soft White Underbelly’ by Mark Laita for several reasons: it presents a

 meaningful discussion on events that individuals experience in their childhood and how it impacts their

 quality of life. For instance, traumatic events [trauma, neglect, abuse] and mental health concerns

 [anxiety, depression, substance use disorder, post-traumatic stress disorder, and alcohol dependency]

 and their significant impact on individuals’ physical, mental, and spiritual health (Laita, 2020). 

            In addition, Laita discusses concerns such as alcohol, use, drug dependency, diet choice, choice

 of partners [in our lives], prioritizing health, career choices, and having belief in ourselves significantly

 impacts our daily lives. This video is sentimental for me, as it reminded me of a time during my

 childhood when I experienced home insecurity. At the time, my mom was a single parent raising me

 and my two younger brothers. I saw how my mom struggled with raising me and siblings and working

 several jobs to prevent home insecurity. Nevertheless, my mother never showed my siblings and I that

 we were struggling financially.

Currently, whenever I see homeless individuals in my community (Bath, Maine), I always try to donate what I can. I note that this small portion of philanthropy embeds empathy, support, kindness, and humbleness in my community; other community members begin to provide what they can to enhance community involvement and support.

What action can we take to address the health disparities experienced by these groups?  

Primary action to prevent health disparities in social determinants of health particularly adolescents, is to be empathetic, supportive and provide validation; as individuals we all seek to be validated and supported during our quality of care (CDC, 2024). In addition, as healthcare professionals we must collaborate with each other and incorporate kindness, respect, diversity, and cultural competence to enhance respect, foster trust, and innovation to improve quality of patient care, enhance medication compliance, and improve quality of life (CDC, 2024).

            Picture retrieved from: https://www.cdc.gov/healthy-youth/mental-health/index.html

According to CDC (2022), 46% of healthcare workers reported experiencing burnout (CDC, 2023). Furthermore, in 2022, 44% of healthcare workers experienced decreased job satisfaction and intended to seek new work positions (CDC, 2023). Addressing health disparities not only supports individuals during their personalized care, it reduces healthcare costs, prevents health disparities [stigma, inequality, racial discrimination, and lack of access to healthcare services], prevents burnout, workplace conflict, turnover rates, and enhances workplace productivity and job satisfaction (CDC, 2023). 

 

        Picture retrieved from: https://www.cdc.gov/niosh/healthcare/risk-factors/stress-burnout.html

Part B

Locate ONE example of a local, national or international intervention aimed at addressing social determinants of health issues experienced by Veterans, Homeless, the Incarcerated or another identified vulnerable population.  

Provide a brief background of its origins and the issues it aims to address.   

State of Maine Department of Health and Human Services [DHHS] provides mental health services for individuals including adolescents and military veterans such as Community Integration, Daily living Support Services, Medication Management [consists of psychiatric evaluation, psychoeducation, medication administration, and therapeutic drug monitoring], and Assertive Community Treatment [24/7 intensive community-based mental health services that addresses safety concerns, prevents hospitalization, enhances medication compliance, employment assistance, and enhancement of quality of life] (DHHS, 2023). In addition, DHHS provides ‘Wrap’ grant-funded service for individuals that meet the criteria for Severe and Persistent Mental Illness [SPMI] that cannot be met through the standard medical care (DHHS, 2023). For instance, AngelZ Behavioral Health Services located at Augusta, Maine provides ‘Wrap’ services (DHHS, 2023).

Picture retrieved from: https://www.maine.gov/dhhs/mecdc/population-health

AngelZ Behavioral Health Services initiated its services during 2020 at an outpatient care center, addressing mental health concerns [anxiety, depression, substance use disorder, and alcohol dependency], Family Recovery Skills Program, Behavioral Home Health Services, and Children’s Behavioral Health Home Services [community support based services that aims to provide crisis support, resolving barriers in communication, enhancement of quality of care, development of coping skills and resilience, and therapeutic drug monitoring (AngelZ, 2020).

Picture retrieved from: https://knowyouroptions.me/resource/anglez-behavioral-health-services-abhs/

                Effectiveness of Intervention

According to AngelZ Behavioral Health (2020), 85% of individuals reported satisfaction with staff availability, and responsiveness, calls were returned in a timely manner within 24 hours (AngelZ, 2020). In addition, 83.8% of individuals reported connectedness and a sense of community belonging improving their mental health concerns (AngelZ, 2020). Furthermore, 85.2% of individuals reported personal development, enhancement of safety awareness, prioritization, enhancement of activities of daily living, personal relationship stability, and improvement of housing stability (AngelZ, 2020).

References:

AngelZ Behavioral Health Services (2020). Behavioral Therapist, Family Counselor, and Substance Use Disorder Agency. Retrieved from: https://anglezbhs.com

AngelZ Behavioral Health Services (2020). Data Analysis. Retrieved from: https://anglezbhs.com/wp-content/uploads/2025/11/MH-OPT-Survey-Results.pdf

Blue-Howells J, Clark SC, van den Berk-Clark C, & McGuire JF (2013). The U.S. Department of Veterans Affairs Veterans Justice Programs and the sequential intercept model: Case examples in national dissemination of intervention for justice-involved veterans. Psychological Services, 10(1), 48–53. 10.1037/a0029652

Blue-Howells J, Timko C, Clark S, & Finlay AK (2019). Criminal justice issues among homeless veterans. In Tsai J (Ed.), Homelessness among U.S. veterans: Critical perspectives (pp. 109–137). Oxford University Press. 

CDC (2024). U.S Centers for Disease Control and Prevention. Mental Health. Retrieved from: https://www.cdc.gov/healthy-youth/mental-health/index.html

CDC (2024). U.S Centers for Disease Control and Prevention. Health Disparities. Retrieved from: https://www.cdc.gov/healthy-youth/health-disparities/index.html

CDC (2023). U.S Centers for Disease Control and Prevention. Health Workers Face a Mental Health Crisis. Retrieved from: https://www.cdc.gov/vitalsigns/health-worker-mental-health/index.html

de Sousa T, & Henry M (2024). The 2024 Annual Homelessness Assessment Report (AHAR) to Congress: Part 1: Point-in-Time estimates of homelessness. The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. https://www.huduser.gov/portal/sites/default/files/pdf/2024-AHAR-Part-1.pdf

DHHS (2023). State of Maine Department of Health and Human Services. Mental Health Recovery Support Services & Treatment. Retrieved from: https://www.maine.gov/dhhs/obh/support-services/mental-health-services/recovery-support-services-treatment

Kelton K, Yu M, Singh K, Harris AHS, Blue-Howells J, Stimmel M, Gabrielian S, Finlay AK. (2025). Risk of homelessness among veterans with and without criminal legal system involvement. Psychol Serv. 10.1037/ser0000993. doi: 10.1037/ser0000993. Epub ahead of print. PMID: 40875388; PMCID: PMC12396513.

Kirkbride JB, Anglin DM, Colman I, Dykxhoorn J, Jones PB, Patalay P, Pitman A, Soneson E, Steare T, Wright T, Griffiths SL. (2024). The social determinants of mental health and disorder: Evidence, prevention and recommendations. World Psychiatry. 58-90. doi: 10.1002/wps.21160. PMID: 38214615; PMCID: PMC10786006.

Laita, M. (2020). Soft White Underbelly. Retrieved from: https://www.youtube.com/c/SoftWhiteUnderbelly/featured.