Chapter 23 Working w/ Vulnerable People Flashcards
Vulnerable Populations
Usually subpopulations
- Ethnic/racial minorities
- Uninsured
- People w/HIV or AIDS
- Children
- Older adults
- Poor
- Homeless
Higher morbidity/mortality rates
Less access to healthcare
Shorter life expectancy
Overall diminished quality of life compared to the general pop
Vulnerability
Increases one’s susceptibility to poor health
Vulnerable Populations Conceptual Model
Provides evidence of the link between poor health status & socioeconomic resource availability via loss of income, jobs, & health insure
Lack of resources (socioeconomic & environmental) ____ a population’s exposure to risk factors & ____ an individual’s ability to avoid illness
increase; reduce
What do socioeconomic resources include?
Human capital, integration (and lack = marginalization), & social status
Human Capital
Jobs, income, housing, & education
Social Integration
Social networks/ties, social support (or lack- characterized by marginalization)
Social Status
Position, power, role
Environmental resources mainly deal with, what?
Deals mostly w/ access to healthcare & quality of care
Sources of Limited Access/Lack of Access to Healthcare
Crime-ridden neighborhoods
Insufficient transportation
Lack of adequate numbers & providers
Limited choices of health care plans
No insurance
Relative Risk
Refers to exposure to risk factors identified by a substantial body of research as lifestyle, behaviors and choices, use of health screening services, & stressful events
The Behavioral Model for Vulnerable Populations
Looks at population characteristics (predisposing & enabling factors, needs) as an explanation for health behaviors & eventual health outcomes
Predisposing Factors
Demographic: Sex, age, marital status
Social Variables: Education, employment, ethnicity, social networks
Health Beliefs: Attitudes/values toward health & healthcare services, knowledge of disease
Social structures
Sexual orientation
Childhood Characteristics: Mobility, living conditions, hx of substance abuse, victimization, criminal behavior, or mental illness
Enabling Factors
Family & personal resources
Community resources:
- Income
- Insurance
- Social support
- Region
- Health service resources
- Public benefits
- Transportation
- Telephone
- Crime rates
- Social services resources
Kessler’s Differential Vulnerability Hypothesis
States that there is a relationship between social status & psychological distress
Psychological distress is determined by impact of the stressor event as influenced by social status
Racism
Largely defined as believing that race is the primary factor of our capacities & traits as humans & that any racial differences result in feelings of either superiority or inferiority
Healthy People 2030 Objectives
Attain higher quality & long life
Achieve health equity & eliminate disparities
Create social-physical environments that promote health
Promote health across life span
What is the prevalence of vulnerable populations?
Difficult to measure due to overlapping of populations
Root Causes of Vulnerability
1) Socioeconomic status/poverty
2) Insurance coverage: uninsured or underinsured
3) Race & Ethnicity: Racism & discrimination
How does poverty make one vulnerable to poor health outcomes?
Having less money means being less able to afford most aspects of a quality of life (safe housing)
- May lead to fewer opportunities to exercise, especially if going outside is risky to one’s safety
Fewer community resources are available (grocery stores, quality schools, recreation facilities, and providers)
Lower level income is associated w/ lower quality education that forces a person to:
- Take a job with high occupational hazards
- Need to work more than 1 job to make ends meet
- w/out insurance
How does having inadequate or no health insurance make one vulnerable to poor health outcomes?
Those w/few or no resources in the area do NOT use early screening & preventive measures & delay getting care to save money
- No regular visits
- May be inadequately immunized
Those w/out insurance receive care for the current issue & not underlying causes
Elevated risk for poorer health & may die early from cancer or cardiovascular diseases due to late interventions
Why does being a member of a racial or ethnic minority make someone vulnerable to poor health outcomes?
Institutional racism in policies procedures reduced:
- Access to housing
- Neighborhood & educational quality
- Employment opportunities
Creates a policy environment adverse to equal policies
Experiences of racism are a type of psychosocial stressor that contributes to increased health risks
Social Determinants of Health
Acknowledged conditions associated w/health outcomes
- Economic
- Social
- Environmental
- Genetic
Socioeconomic Gradient
Direct relationship between social class or income and health
Health Disparities
Differences in quantity and burden of disease and access to health care between groups
Causes of Health Disparities
1) Low socioeconomic/income level
2) Poor access to and quality of care
3) Race/ethnicity, overt discrimination
Role of Public Health Nurses
Empowerment: client-centered approach, trust, advocacy, teaching and role modeling, capacity building
Facilitating external support: family members, neighbors, friends, teachers, or others
Using evidence to reduce vulnerability
- Research, expert opinion, and best practices
- Specific agency documentation for nursing practice
- Prevention and health promotion
