Vulnerable & Homeless (8)

Question 1

What factors determine vulnerability?

Answer 1

• Income and education
• Age and gender
• Race and ethnicity
• Chronic illness and disability
• HIV/AIDS
• Mental illness and disability
• Alcohol and substance abuse
• Familial abuse
• Homelessness
• Suicide and homicide risk
• High-risk mothers and infants
• Immigrants and refugee

Question 2

What are the health ramifications for vulnerable populations?

Answer 2

• Heightened risk of adverse health outcomes
• Higher mortality rates
• Less access to health care; disparities in quality of care
• Uninsured or underinsured
• Lower life expectancy
• Overall diminished quality of life

Question 3

What is human capital?

Answer 3

one’s investments in personal capabilities and skills

Question 4

What are examples of human capital?

Answer 4

• Education
• Job training
  Comprises
• Jobs
• Income
• Housing

Question 5

What is social capital?

Answer 5

• Marital status
• Family structure
• Social ties and networks
• Membership in voluntary organizations

Question 6

What is differential vulnerability?

Answer 6

• “Negative or stressful events (such as unemployment, divorce, or death of a loved one) hurt some people more than others.”
• Early chronic stressors can induce physiological changes that lead to later negative health outcomes.

Question 7

Describe the prevalence of vulnerable populations and causative factors.

Answer 7

• Difficulty in measuring due to overlapping of populations
• Root causes
• Socioeconomic status/poverty
• Insurance coverage: uninsured and underinsured
• Race and ethnicity

Question 8

What do the social determinants of health have to do with vulnerability and inequality in health care?

Answer 8

• Acknowledged conditions associated with health outcomes (economic, social, environmental, and genetic)
• Socioeconomic gradient: inverse relationship between social class or income and health

Question 9

Describe types of health disparities.

Answer 9

• Poor access to care; quality of care
• Overt discrimination
• Levels and types of care and care settings

Question 10

Describe the impact of American with Disabilities Act (ADA) of 1990.

Answer 10

…prohibits discrimination on the basis of disability in employment, state and local government, public accommodations, commercial facilities, transportation, and telecommunications [and] also applies to the United States Congress”

Question 11

Describe the role of the public health nurse with vulnerable populations.

Answer 11

• Effective caring: assisting clients to develop capabilities to take charge of life and make own choices: “Opening the door” difficult because clients often the most disenfranchised and fearful of others
• Engagement and rapport are essential.
• Empowerment: client-centered approach, trust, advocacy, teaching and role modeling, capacity building.
• Making a difference: protective factors; resilience

Question 12

What is the prevalence of substance abuse and substance use disorders?

Answer 12

• Alcohol: highest incidence of use in young adults (18 to 25 years)
• Tobacco: decline over past decade but not consistent across age groups and genders
• Marijuana: most frequently reported illicit drug
• Cocaine: use doubled in last 25 years
• Opiates/heroin: death rates for dependent heroin users are 6 to 20 times higher than for the general population
• Prescription drugs: across all age groups; rise in college-age students

Question 13

Describe substance use and the CHN.

Answer 13

• Promotion, Prevention, Screening, Treatment, and Recovery for Mental and Substance Use Disorders
• Continuum including abstinence, low-risk use, risk/hazardous use, harmful use, and dependence
• CHN: needs basic understanding of issues related to specific substance; clear idea of desired outcomes related to treatment or prevention program
• Trends of substance use across different populations and communities
• Differences between legal and illegal substance use
• Consequences of substance use on community

Question 14

What does it mean to be homeless?

Answer 14

Determined by federal agencies in the US.

• Category 1.Literally Homeless
• Category 2.Imminent Risk of Homelessness
• Category 3.Homeless Under Other Federal Statutes
• Category 4.Fleeing/Attempting to Flee Domestic Violence (DV)

Question 15

What are homeless subpopulations?

Answer 15

• Homeless men (↑ chance of being treated with disdain)
• Homeless women
• Homeless children; homeless youth (<18 without parent, foster, or institutional care)
• Homeless families (majority headed by single mothers)
• Homeless veterans
• Rural homeless
• Older homeless
• Lesbian, gay, bisexual, and transgender homeless