Chapter 23 Working w/ Vulnerable People

Question 1

Vulnerable Populations

Answer 1

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

Question 2

Vulnerability

Answer 2

Increases one’s susceptibility to poor health

Question 3

Vulnerable Populations Conceptual Model

Answer 3

Provides evidence of the link between poor health status & socioeconomic resource availability via loss of income, jobs, & health insure

Question 5

Lack of resources (socioeconomic & environmental) ____ a population’s exposure to risk factors & ____ an individual’s ability to avoid illness

Answer 5

increase; reduce

Question 6

What do socioeconomic resources include?

Answer 6

Human capital, integration (and lack = marginalization), & social status

Question 7

Human Capital

Answer 7

Jobs, income, housing, & education

Question 8

Social Integration

Answer 8

Social networks/ties, social support (or lack- characterized by marginalization)

Question 9

Social Status

Answer 9

Position, power, role

Question 10

Environmental resources mainly deal with, what?

Answer 10

Deals mostly w/ access to healthcare & quality of care

Question 11

Sources of Limited Access/Lack of Access to Healthcare

Answer 11

Crime-ridden neighborhoods
Insufficient transportation
Lack of adequate numbers & providers
Limited choices of health care plans
No insurance

Question 12

Relative Risk

Answer 12

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

Question 13

The Behavioral Model for Vulnerable Populations

Answer 13

Looks at population characteristics (predisposing & enabling factors, needs) as an explanation for health behaviors & eventual health outcomes

Question 14

Predisposing Factors

Answer 14

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

Question 15

Enabling Factors

Answer 15

Family & personal resources

Community resources:
- Income
- Insurance
- Social support
- Region
- Health service resources
- Public benefits
- Transportation
- Telephone
- Crime rates
- Social services resources

Question 16

Kessler’s Differential Vulnerability Hypothesis

Answer 16

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

Question 17

Racism

Answer 17

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

Question 18

Healthy People 2030 Objectives

Answer 18

Attain higher quality & long life

Achieve health equity & eliminate disparities

Create social-physical environments that promote health

Promote health across life span

Question 19

What is the prevalence of vulnerable populations?

Answer 19

Difficult to measure due to overlapping of populations

Question 20

Root Causes of Vulnerability

Answer 20

1) Socioeconomic status/poverty
2) Insurance coverage: uninsured or underinsured
3) Race & Ethnicity: Racism & discrimination

Question 21

How does poverty make one vulnerable to poor health outcomes?

Answer 21

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

Question 22

How does having inadequate or no health insurance make one vulnerable to poor health outcomes?

Answer 22

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

Question 23

Why does being a member of a racial or ethnic minority make someone vulnerable to poor health outcomes?

Answer 23

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

Question 24

Social Determinants of Health

Answer 24

Acknowledged conditions associated w/health outcomes
- Economic
- Social
- Environmental
- Genetic

Question 25

Socioeconomic Gradient

Answer 25

Direct relationship between social class or income and health

Question 26

Health Disparities

Answer 26

Differences in quantity and burden of disease and access to health care between groups

Question 27

Causes of Health Disparities

Answer 27

1) Low socioeconomic/income level
2) Poor access to and quality of care
3) Race/ethnicity, overt discrimination

Question 28

Role of Public Health Nurses

Answer 28

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