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Introduction

Hong Kong's aging population has become a public health concern. The increase in

population of the elderly brings challenges that the city must confront. Within the elderly

community, the correlation with health-related factors is complex, which include factors like

financial status and social networks (Domènech-Abella et al., 2019).

The various challenges experienced by this demographic makes them receptive to the

effects of social determinants of health. The elderly face difficulties including limited social

interactions, financial constraints, and limited access to healthcare services (Douthit et al.,

2015). Isolation is further aggravated by cultural and societal factors, including family

dynamics and urbanization trends. These challenges usually leads to poor quality of life.

By focusing on isolated older adults, this paper aims to draw attention to the intricate

web of SDH that underlies their health issues. It seeks to illuminate the importance of

addressing these determinants to enhance the well-being of this vulnerable group and, by

extension, contribute to the broader discourse on public health nursing and geriatric care in

Hong Kong.

Social Determinants of Health

Social Determinants of Health are conditions in which people are born, live, learn,

work, play, and age (Braveman & Gottlieb, 2014). These factors directly affect their well-

being, resulting in varied health outcomes. Nurses play a central role in sensing and

responding to key factors. SDH recognizes that health outcomes go beyond individual

choices and genetics. Determinants range from economic factors including income to social

dimensions such as social support networks (Daniel et al., 2018). Other factors play a role

too, such as access to clean water and safe housing, as well access to quality education.
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Nurses have an intimate understanding of the interplay between health outcomes and

numerous determinants, being healthcare professionals entrusted with their care. They are the

frontline advocates for health equity and the architects of interventions that address the root

causes of health disparities. A person's life outside of medical facilities is just as important to

nurses, who understand that leading a healthy life is about more than clinic or hospital walls.

All of these things are included when you think about their living situation: access to good

food, support networks, education, and job chances. Understanding the role of SDH, nurses

can stray from traditional clinical care walls and adopt a more holistic approach, factoring in

broader societal and environmental factors on health. They serve as change agents, treating

illness while also preventing it.

Social Support Networks

Robust social support networks are crucial for the elderly. As individuals grow older,

they may experience feelings of solitude, yet possessing a robust circle of companions can

serve as a protective barrier. A study conducted by Steinman et al. (2020) highlights the

significance of interpersonal relationships and empathy in relation to the well-being of senior

citizens. According to the study, when older adults encounter social seclusion, they become

susceptible to depression, decline in cognitive abilities, and various other health issues. The

impact of social support goes far beyond the realm of emotional welfare. It has the ability to

exert a positive influence on conduct and preferences in life. Elderly individuals with strong

interpersonal connections are more inclined to partake in physical exercises, uphold a well-

rounded dietary regimen, and comply with medical interventions, all of which lead to

improved health consequences (Contrady, 2020). Hence, it is crucial to prioritize tackling

social seclusion and encouraging the development of supportive social networks when
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addressing the healthcare requirements of isolated older adults.

Housing

The health and well-being of the elderly are greatly influenced by their state living. In

Hong Kong, older adults who are isolated often face a complex set of difficulties when it

comes to housing. Many of them reside in overcrowded places, which can worsen various

health issues. Overcrowding, for example, increases the chances of respiratory ailments and

infectious diseases due to limited space and compromised airflow (Liu et al., 2021).

Inadequate housing possess safety risks that increases the falls and injuries, particularly for

those with limited mobility (Ambrose et al., 2013). These housing challenges are closely

intertwined with social isolation, as subpar living conditions may deter social visits and

interactions, further isolating older adults. Housing conditions affects both physical and

mental well-being. Safe housing not only reduces the risk of accidents and illnesses, but also

fosters a feeling of security and comfort, thereby enhancing quality of life.

Income & Social Status

The well-being the elderly in Hong Kong is influenced by their financial stability and

levels of income. Economic gaps and low earnings poses widespread challenges that have

implications for the welfare of the elderly. According to Williams et al. (2016), there

relationship between economic status and health outcomes. Limited finances limits them

from accessing healthy meals and healthcare services. Lack of enough income forces them to

decide between purchasing medications and affording healthy meals.

Health Services

Access to healthcare is needed to enhance the health of the elderly. However, those

who live in isolation encounter challenges that hinder access to healthcare. These hindrances
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include restricted mobility and communication challenges. Lack of healthcare access result in

poor health conditions or worsening of chronic conditions (Syed et al., 2013).

Despite the critical need for support, the elderly in Hong Kong often encounter

service gaps. The mental welfare of the elderly in Hong Kong is a pressing issue that requires

attention. There have been increase in levels of depression and anxiety among the elderly in

Hong Kong. These is due to the lack of mental health facilities and support systems

accessible to the elderly. Having access to mental health services is a crucial in tackling the

emotional difficulties experienced by the elderly (Kontoangelos et al., 2020).

Social seclusion and solitude are widespread concerns among the elderly in Hong

Kong. Regrettably, the Killam (2022) has brought to light the inadequacy of the existing

social provisions in the area to adequately cater to the requirements of this particular

demographic. Societal reinforcement initiatives and community-based provisions are

indispensable in combatting social seclusion and enhancing the overall standard of living for

solitary elderly individuals. These initiatives may encompass day centers that offer communal

activities and companionship, support groups where individuals can exchange their

encounters and discover emotional solace, and home care provisions that extend aid with

everyday tasks.

Nurses play a vital role in providing support for elderly individuals who are

experiencing seclusion, by conducting thorough assessments to determine their unique health

and social requirements. This extensive evaluation involves carefully examining their

physical state, mental well-being, the strength of their social networks, and their living

conditions. Moreover, nurses play a crucial role in championing the cause of fostering

healthy aging, actively participating in endeavors to boost health and wellness (He & Tang,

2021). They equip them with knowledge to appropriate nutrition, regular exercising, and
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efficient medication administration. All these endeavors are directed towards augmenting

their holistic life experience.

In Hong Kong, a diverse array of community resources has been established to

provide essential support to isolated older adults. These resources include community centers,

which serve as hubs for combating social isolation through a plethora of activities, health

talks, and recreational opportunities. Elderly Health Centers offer tailored healthcare services

aimed at preventive care, chronic disease management, and comprehensive health

assessments. Non-Governmental Organizations (NGOs) contribute significantly by offering

various programs like meal delivery, home visits, and counseling, ensuring older adults

receive holistic support. Moreover, specialized transportation services are available to assist

older adults with mobility challenges in accessing healthcare appointments and participating

in community events, thus promoting their overall well-being and engagement in the

community.

Expanding social services is paramount to addressing the various needs of isolated

older adults in Hong Kong. It necessitates a robust commitment to increasing funding and

allocating additional resources to bolster social programs and community-based initiatives

tailored to this vulnerable demographic. Among the critical components of this expansion are

day centers, which provide older adults with vital social interactions and engaging activities

that counteract isolation, loneliness, and mental health challenges. Moreover, enhancing

home care services is pivotal in ensuring that older adults can age in the comfort and

familiarity of their homes while receiving essential assistance with daily tasks, healthcare

management, and emotional support. By dedicating resources to these programs, Hong Kong

can foster a more inclusive and supportive environment for its isolated older adults,

ultimately promoting their well-being and improving their overall quality of life.
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It important to establish and implement policies and initiatives that focus on the

advancement of aging-in-place practices in order to effectively cater to the changing

requirements of Hong Kong's elderly population. These policies must adopt a comprehensive

approach that encourages the idea of growing old in one's desired surroundings, primarily

one's own home, for as extended a period. Critical aspects of these policies entail the creation

of easily accessible housing alternatives that not only meet the physical demands of older

individuals but also prioritize their safety and well-being. This may necessitate the

incorporation of universal design principles to ensure that housing is suitable for individuals

with varying levels of mobility.

Conclusion

This research has illuminated the complex connection between the aging population

in Hong Kong and the factors that influence health, specifically concentrating on older adults

who are isolated. The senior citizens in Hong Kong encounter numerous difficulties that are

affected by these factors, such as restricted networks of social assistance, inequalities in

housing, financial limitations, and obstacles to accessing healthcare. These difficulties

combine to create unfavorable health consequences, varying from problems with mental well-

being to long-term illnesses, ultimately affecting the overall quality of their lives.

To improve the well-being of isolated older adults, Hong Kong must expand and

enhance its social services, bolstering support programs and community-based initiatives.

Additionally, the development of aging-in-place policies and accessible housing options is

essential to cater to the evolving needs of the elderly population. In essence, by

acknowledging and addressing the SDH affecting isolated older adults, Hong Kong can pave

the way for a healthier, more equitable, and inclusive future for its aging population.
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