Jay and Sue Kim, ages 29 and 26 years and married for 2 years, immigrated from South Korea and settled in Los Angeles. They have lived in a small one-bedroom apartment since their arrival. Both graduated from the same Korean university with baccalaureate degrees in English literature. They have one child, Joseph, age 1 year. When they arrived in the United States, Jay was unable to find a job because of his poor proficiency in English, despite his major in English literature. He eventually obtained a job with a moving company through a church friend. Sue is not working because of their son. Although the Kim’s did not attend a church before immigration, they are now regularly attending a Korean Protestant church in their neighborhood. Sue is pregnant again, determined by a home pregnancy kit, with their second child and concerned about the medical costs. They did not use any contraceptives because she was breastfeeding. Because of financial limitations, Sue did not initially have prenatal care with her first pregnancy. However, she did keep up with the Korean traditional prenatal practice, tae-kyo. Eventually, she received help from her church and delivered a healthy son. She is not sure whether she can get financial help from her church again but is confident that her second child will be healthy if she follows the Korean traditional prenatal practices. Jay is concerned about job security because he recently heard from colleagues that the moving company might soon go bankrupt. Although Jay has not been satisfied with his current job (he thinks that he is overqualified), this news is still a cause for concern. Moreover, Sue’s recent pregnancy has made Jay more stressed, and he has started drinking alcohol. Joseph cannot stand up by himself and still wants to be breastfed. Although Sue has tried to give foods such as oranges, apples, steamed rice, and milk (because she is now pregnant), Joseph refuses to eat them and cries for breastfeeding. Joseph’s weight is low-normal for same-age babies.


The case study presented revolves around a Korean immigrant couple, Jay and Sue Kim, and their current situation in Los Angeles. The couple faces a series of challenges including language proficiency barriers, limited financial resources, lack of job security, and concerns about pregnancy and childcare. This analysis aims to assess the various social determinants of health that may affect the Kims’ well-being and provide recommendations for addressing their needs.

Social Determinants of Health:

Social determinants of health refer to the social, economic, and environmental conditions that shape individuals’ overall health and well-being. Understanding how these factors interact is crucial in addressing health disparities and promoting equitable access to healthcare services.

1. Language Proficiency and Employment Opportunities:
Jay’s struggle to find employment reflects the impact of language proficiency on job prospects for immigrants. Despite holding a degree in English literature, Jay’s poor English skills limit his employment opportunities, leading him to accept a job below his qualifications. This situation highlights the connection between language proficiency and socioeconomic status, with individuals facing barriers to better job prospects and career growth due to language limitations.


To address this issue, Jay could consider enrolling in English language courses or seeking out job training programs that focus on language improvement. These initiatives would enhance his job prospects and potentially lead to better career opportunities, reducing financial constraints and job insecurity.

2. Financial Limitations and Access to Prenatal Care:
Sue’s lack of prenatal care during her first pregnancy indicates the impact of financial limitations on healthcare access. Financial constraints may limit individuals’ ability to afford essential prenatal and healthcare services, leading to potential adverse outcomes for both the mother and the child.


The Kims can explore options such as applying for government assistance programs or seeking financial support from community organizations. These resources may provide access to affordable or free prenatal care, ensuring proper monitoring of Sue’s health during her pregnancy and reducing the risk of complications.

3. Cultural Beliefs and Traditional Prenatal Practices:
Sue’s adherence to Korean traditional prenatal practices, such as tae-kyo, showcases the influence of cultural beliefs on healthcare decisions. While cultural practices may have value, it is important to ensure that they align with evidence-based medical practices and do not compromise the health of the mother or child.


Encouraging open communication and collaboration between Sue and her healthcare provider can help bridge the gap between cultural traditions and modern medical practices. Healthcare providers should be knowledgeable about cultural practices and respectfully discuss the potential benefits and risks, ensuring that Sue makes informed decisions regarding her prenatal care.

4. Job Insecurity and Coping Mechanisms:
Jay’s concerns about job security have led to increased stress, as evidenced by his recent alcohol consumption. Job insecurity has been linked to various negative health outcomes, including mental health issues, substance abuse, and relationship problems.


It is crucial for Jay to seek support and coping mechanisms to manage his stress and anxiety related to job insecurity. This may involve reaching out to support groups, counseling services, or seeking assistance from community organizations that provide resources for individuals facing employment-related challenges.

5. Breastfeeding and Child Nutritional Needs:
Joseph’s refusal to eat solid foods and his continued desire for breastfeeding raises concerns about his nutritional intake and development. Sue’s pregnancy and the potential strain on her own nutritional needs further complicate the situation.


A multidisciplinary approach involving healthcare providers, nutritionists, and lactation consultants can help address Joseph’s feeding challenges. Providing education and support to Sue regarding appropriate infant nutrition and methods to transition Joseph to solid foods can promote his healthy growth and development. Additionally, addressing Sue’s own nutrition needs during pregnancy is crucial to ensure both her and the baby’s well-being.


The case study of the Kim family highlights several social determinants of health that influence their overall well-being. By addressing key factors such as language proficiency, financial limitations, cultural beliefs, job insecurity, and child nutritional needs, we can work towards promoting equitable access to healthcare services and enhancing the health outcomes of immigrant families like the Kims.