vulnerable populations Flashcards
vulnerability
susceptibility to actual/potential stressors that lead to adverse effect
phys, env, biopsychosocial (illness, genetic predisposition) resources and human capital
human capital
personal resources
strengths, knowledge, skills that enable one to live happy and productive life
resilience
factors that help to resist effects of vulnerability
vulnerability: cycle and additive
predisposing factors -> poor health, exacerbate predisposing factors
insight to possible interventions
marginalization
invisible to society, forgotten about when social planning
occurs when people/pop are relegated to position on periphery of society with diminished importance, influence, power
weak social power and connections
cause and outcome of vulnerability
increased likelihood of developing health problems and worse outcomes, increased exposure to R
not personal or moral failing, not intrinsic; result of extrinsic factors
vulnerable pops
pop grounds that are at greater R than others for poor health outcomes
based on combo and interaction of rf
individual v pop vulnerability -> recognize but dont stereotype
socioeconomic status
social standing or class, combo of edu, income, occupation
differ in access to resources, privilege, power, control
poverty
primary driver of vulnerability
determined by household income, # of people in house, cost of living
different types - depend on level of deprivation present
crisis poverty
situational, short term
persistent poverty
chronic, long term, generational
neighborhood poverty
lack of businesses/revenue, most people in community are at poverty level
groups at increased risk for poverty
low education
low earnings
single mom
F
elderly
inadequate programs for education, job skills, functioning with disabilities
poverty: impact on health
nutrition, higher rates of chronic illness, more comp, higher mortality
poverty: stigma
leads to poor health outcomes
blamess deserve assistance: widowed women, children, injured laborers, elderly
not blameless = illicit drug users, addiction, homeless, young adults, lazy
homeless
lacks fixed, reg, adequate nighttime residence
episodic homelessness
hardship and struggle, chronic unemployment, young, mental health abuse, substance
transitional homelessness
catastrophic event, short shelter stay -> perm housing
chronic homelessness
older, chronically unemployed, disability, substance abuse issue, emergency shelter becomes long term, smallest %
homelessness: factors
poverty: lack of affordable housing, insuff assistance, high unemployment, economy
shortage of substance use treatment facilities
domestic/interpersonal violence
homelessness: vulnerable
unemployed, migrant workers, MI or SUD, no safety net (liquid asset poor), vets, victims of violence, LGBTQ+
homelessness: impacts of health
cause and outcome of homelessness
adequate rest, nutrition, exercise, stress, exposure, infectious disease, acute and chronic illness, infestations, mental health
homelessness: preventative services
nursing intervention
crisis/emergency shelter, federal assistance
housing first solutions: housing to long term homeless -> mental health and SUD tm
permanent supportive housing: long term housing with supportive services for those with long hx of homelessness and persistent obstacles
homelessness: preventative services - primary
decrease poverty, early childhood support, affordable housing, old age pensions
homelessness: preventative services - secondary
rapid rehousing, case management, shelter services
homelessness: preventative services - tertiary
minimize impact of homelessness, never experience another episode
lesbian
a woman who is emotionally, romantically or sexually attracted to other women
gay
a person who is emotionally, romantically or sexually attracted to members of the same gender
bisexual
a person emotionally, romantically or sexually attracted to more than one sex, gender, or gender identity though not necessarily simultaneously, in the same way or to the same degree
transgender
an umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth
queer
a term people often use to express fluid identities and orientations
cisgender
a term used to describe a person whose gender identity aligns with those typically associated with the sex assigned to them at birth
non binary
gender identity is not exclusively male or female
persons who identify outside the male-female sex binary
intersex
a combination of chromosomes, gonads, hormones, internal sex organs, and genitals that differs from the two expected patterns of male and female
sex
biological status
male, female, intersex
indicators: sex chromosomes, gonads, reproductive organs, external genitalia
sexual orientation
inherent or immutable enduring emotional romantic or sexual attraction to other people
gender identity
innermost concept of self as male, female, blend, neither
how individuals perceive themselves and what they call themselves
sex v gender v sexual orientations
sexual orientation does not = gender identity
LGBTQ+: impact on health
heterosexual hc workers implicitly favor heterosexual pts
internalized homophobia: members of comm also favor straight people
fight by educating and gathering more data
LGBTQ+: health disparities
decreased knowledge, culturally humble, legal discrimination, youth -> increased r/o suicide, victimization, bullying, homeless
disparities due to decreased understanding -> in and out of community
elderly = isolation, decreased social services
higher rates of tobacco, OH, substance abuse
LGBTQ+: reality in healthcare setting
traditionally segregated spaces, anx of coming out (isolate, mistrust), less respectful and safe restrooms and hospital assignments, staff dont recognize/respect identities, insuff records
pronouns: ask, can change with or without change to appearance, mess up? - correct, brief apology
LGBTQ+: body part terminology
life may differ from exam room, pt pref may differ
ask, offer explantation if other terms needed, use gender and sex affirming lang, be aware of using slang terms
LGBTQ+: interventions
focus on pt experience, ask all pts (dont assume), be sensitive and aware, inclusive lang always evolve
race, ethnicity, culture
social constructs, not biological
race: black or african american, american indian or alaska native, asian, native hawaiian or other pacific islander, white
ethnicity: hispanic, latinx
cultural characteristics: personal space, time, comm, beliefs about aging, death, dying
extrinsic: system have created these disparities
race, ethnicity, culture: health disparities
higher sx mortality among marginalized groups
decreased likelihood of receiving
implicit bias favoring white patients and an unconscious perception of black patients being less cooperative with medical procedures
black patients less likely than white patients to: receive kidney transplants, be given appropriate cardiac care, receive state-appropriate care or guidelines concordant cancer care
biased tech and algorithms create care differences -> pulse ox
race, ethnicity, culture: addressing disparities
interventions need to address social determinants of health policies and systems bias in hcp, culturally tailored health promo
acknowledge historic untrustworthy, result in hesitancy from affected pops
advocate for pts
rurality
subjective, defined by geographic location, pop density, distance/time to commute
unique features
rurality: impact on health
poor perception of overall health in functional status, less likely to engage in health behaviors
seek care less frequently
higher rates of chronic illness
less providers
disabilities
most people experience at some point
largest minority group
umbrella term -> impairments, activity limit, participation restriction
impairment
problem in body function/structure
handicap
disadvantage from impairment or disability that prevents fulfillment of expected role
disabilities: models
medical: defect, need intervention
rehab: defect treated with rehab
moral: sin and shame
disability: social construct, whether or not inability to perform a function is seen as disability depends on socioenv barriers
disabilities: experience
largest minority group in US
differ depending on: temp, perm, progressive
impact on health: access, biases, comm, health lit, cause disparities
more chronic illness and secondary issues
disabilities: victimization
more likely, kids abused, sexual assault, usually know the perp
