| Course | HD420 Social Determinants of Health and Health Behavior |
|---|---|
| Unit | Unit 2 |
| Paper type | Determinants analysis |
| Length | About 660 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health and Wellness |
| Updated | October 2026 |
Free sample paper for HD420 Unit 2
Pulled, Not Filled: A Unit 2 Determinants Analysis of Losing Every Tooth in a Composite Former Coal County
[Student Name]
Purdue University Global
HD420: Social Determinants of Health and Health Behavior
Unit 2 Determinants Analysis
[Instructor Name]
[Date]
The county, its dentists and every figure are composite; the review of oral health access, the social determinants review and the conceptual framework cited are real.
The Outcome
In the composite county, about [24] percent of adults aged 65 and older have lost all their natural teeth, compared with about [13] percent statewide. Complete tooth loss affects chewing, diet, speech, employment and self-image. It also clusters: neighbors, parents and grandparents share it.
Working Back From the Outcome
The analysis follows a chain of causes, starting with the most immediate and moving upstream, in the way the social determinants framework separates the circumstances of daily life from the structural forces that shape them (Solar & Irwin, 2010).
Immediate cause: extraction rather than restoration. When a tooth is decayed or infected, it can be filled, crowned or treated with a root canal, or it can be pulled. In the county, most adults with a painful tooth have it pulled, often at an emergency visit.
Why extraction: cost and coverage. Adult dental coverage in the composite state's Medicaid program pays for extractions but not for root canals or crowns on back teeth. Many working adults have no dental coverage at all. A filling costs about [$180] out of pocket and a root canal and crown more than [$1,500]; an extraction costs about [$150]. For a family living on a disability check or seasonal work, the choice makes itself.
Why late: access. The county has two general dentists for about [22,000] people, and only one accepts Medicaid. Appointments wait weeks. When a tooth hurts, the emergency department, which cannot do dental work, gives antibiotics and pain medicine, and the tooth is pulled when it finally can be.
Why decay to begin with: water and diet. Most rural households draw from private wells, which are not fluoridated, so the protection community water fluoridation provides never reaches them. Sugary drinks are cheap and widely sold at gas stations that double as grocery stores.
Structural layer: the end of mining. When the mines closed, many families lost employer health and dental coverage at the same time as their income. Younger adults left; those who stayed are older and poorer. Dental practices followed the population and the insurance out of the county.
Each link in the chain makes the next one more likely, so that by the time a person sits in a dentist's chair with a painful tooth, coverage, cost and distance have already decided the treatment.
What the Analysis Rules Out
It does not rule out individual habits; brushing and diet matter. But habits cannot explain why the rate is nearly double the state's, or why it rises with age and poverty in the same way across families. A review of oral health access found that disparities follow insurance, income, rurality and the dental workforce more than any single behavior (Northridge et al., 2020).
Points Where Change Could Start
1. Coverage: adult Medicaid dental benefits that include restorative care would change the immediate choice.
2. Workforce: dental therapists or visiting clinics could add capacity where dentists will not settle.
3. Prevention: well water testing and fluoride varnish or supplements for children could reduce decay before it starts.
4. Emergency care: a referral link from the emergency department to the Medicaid dentist could catch infections earlier.
Conclusion
Losing every tooth in this county is the end of a chain that starts with mine closures and runs through coverage rules and distance. A program that only teaches brushing would treat the last link and leave the rest intact. The causes of the causes, as the social determinants literature puts it, are where change has the most reach (Braveman & Gottlieb, 2014).
References
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It's time to consider the causes of the causes. Public Health Reports, 129(Suppl. 2), 19-31. https://doi.org/10.1177/00333549141291S206
Northridge, M. E., Kumar, A., & Kaur, R. (2020). Disparities in access to oral health care. Annual Review of Public Health, 41, 513-535. https://doi.org/10.1146/annurev-publhealth-040119-094318
Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health (Social Determinants of Health Discussion Paper 2). World Health Organization.
HD420 Unit 2 instructions, in plain terms
Unit 2 typically asks you to choose a health outcome in a population and analyze the determinants behind it, moving from immediate causes to structural ones. Analyses often run three to four pages. Graders reward a clearly defined outcome with figures, a chain of causes in a logical order, each link supported by evidence or local detail, and an analysis that reaches a structural condition someone could change. Many sections expect a named framework, such as the WHO conceptual framework or Healthy People's domains. Address individual behavior honestly rather than ignoring it. Close with points of intervention that follow from the chain. Use local data where possible and cite a review on the outcome itself as well as a framework.
How the HD 420 Unit 2 example is put together
The analysis defines the outcome with county and state figures and explains why tooth loss matters beyond the mouth. It then works upstream link by link, citing a determinants framework: extraction over restoration, coverage and cost with sample prices, access through the dentist count, water and diet, and the structural layer of mine closures. The highlighted sentence describes the links as a sequence in which each makes the next more likely. A section explains what the analysis does not rule out, citing an oral health access review. Four points where change could start follow, covering coverage, workforce, prevention and emergency referral, and a short conclusion returns to the causes of the causes.
Reading the HD420 Unit 2 grading rubric
Determinants analyses tend to be graded on clarity of the outcome, logic of the causal chain, evidence for each link, the structural reach of the analysis and the quality of the intervention points. The chain's logic and its structural reach usually decide the grade, since the unit tests whether a student can move past immediate causes. Evidence credit rewards local figures, prices or counts for each link. Outcome clarity rewards a defined measure and a comparison. Intervention points earn marks when each follows from a named link. Use of a framework and a topic-specific review completes the support most graders expect. An analysis that treats individual behavior fairly, then explains why it is insufficient, tends to persuade more than one that skips it.
Common HD420 Unit 2 mistakes, and how to avoid them
The commonest problem is a list of determinants without any order, so the reader cannot see how one leads to another. Another is stopping at access or cost without asking why access is limited or prices are what they are. Some students pick an outcome too broad to trace, such as poor health. Others assert links without any figures. Recommendations that do not match a link in the chain look borrowed from elsewhere. If you are analyzing another outcome, perhaps amputations, low birth weight or overdose deaths, gather the local numbers you have, and the chain can be followed back link by link.
Get an HD420 Unit 2 example written to your instructions
Send the outcome your HD420 section assigned, or the one you chose, along with the Unit 2 instructions and rubric. Your free first custom sample arrives in 24-48h and traces that outcome through whichever determinants framework the prompt names, with a sourced figure at every layer and a closing condition the chain actually supports. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More HD420 papers and BS in Health and Wellness samples
- HD420 Unit 1: Social Determinants Discussion Post
- HD420 Unit 3: Behavior Theory Application
- HD420 Unit 4: Community Profile
- HD420 Unit 5: Access Barrier Study
- HD420 Unit 6: Seminar Reflection
- HD420 Unit 7: Health Equity Paper
- HD420 Unit 8: Policy Influence Analysis
- HD420 Unit 9: Intervention Level Proposal
- HD420 Unit 10: Determinants Report
HD420 Unit 2 questions, answered
Which determinants framework should the analysis use?
Whichever your prompt names, if it names one. Healthy People 2030's five domains, the Dahlgren-Whitehead layers and the Bay Area Regional Health Inequities Initiative framework are all common choices. The example uses the last because its rows run from institutions down to mortality, which suits a trace. What matters more is that the framework is actually used in the argument, not just pictured.
How far upstream does the trace need to go?
Far enough to reach a condition someone could change, which usually means an institution, a rule or a resource rather than a behavior. Stopping at a behavior leaves the analysis unfinished by this course's standard. Reaching back into history or economics is fine when each link is supported, but a vague chain ending at society in general earns less than a precise one ending at a benefit rule.
Can I analyze an outcome from my own community?
Usually yes, and it tends to produce a stronger paper because local figures are available to anchor each layer. County Health Rankings, CDC PLACES and your state health department's data portal cover most outcomes. If county data is suppressed for small numbers, a multi-year average or the regional figure, labeled as such, is the accepted workaround in many sections.
Where can I find a free HD420 Unit 2 sample paper?
You can read the complete Unit 2 analysis here, tracing complete tooth loss in a composite former coal county back to its structural causes.
Why does dental coverage that pays only for extractions matter?
Because when saving a tooth costs far more than pulling it, people with low incomes choose extraction, so the coverage rule shapes the outcome directly.