Vulnerable populations Flashcards
vulnerable pop
sus to actual or potentials stressors that may lead to an adverse effect
- limitations in phys resources, enviro, human capital PLUS BPS resources
- unfavorable health outcomes compared to others
Human capital
personal resources
- all strength, knowledge, and skills that enable a person to live a prod, happy life
If you have less education, you have less…
Human capital
BLANK helps ppl to resist factors of vulnerability
Resilience
Vulnerability cycle
predisposing fx that lead to poor health outcomes can exac other predisposting fx
- create additive and cyclical effects
- adds to stress load
marginalization
ppl or pops are relegated to a position on the periphery of society where they have less influence, power, importance
- cause and outcome of vul
- assoc with inc change of dev health prob and worse health outcomes
Examples of vulnerable pops
Poverty, homeless, queer, minoritized racial, ethnic, and cultural, rural, disabled
What is a primary driver of vulnerability?
Poverty
SES
social standing measured as combo of education, income, and occupation
- often leads to inequities to resources and issues r/t privilege, power, and control
How is poverty measured?
- income
- # people living in a household
- cost of living
Crisis poverty
- situational
- short term
- ex: college students
Persistent poverty
- chronic
- long term
- ex: gen pov
Neighborhood pov
area where lack businesses and resources
Who is more at risk for poverty?
Kentuckians, lack education, single moms, elderly, poor job skills training, disabled
Impact of poverty on health
- inadequate nutrition
- high rates of chronic illness
- more complications
- higher mortality (incl infants)
“blameless poverty” pops
- determines stigma and deservance of assistance
- old, widowed women, kids, laborers injured on the job
impoverished pops that are not blameless
Lazy, young adults, drug addicts, homeless
Homelessness
Lack a fixed, regular, adequate nighttime residence
episodic homelessness
often in and out, often younger and mentally ill/substance abusers
transitional homelessness
often from catastrophes and temporary
- eventually get to permanent housing
Chronic homelessness
- older often, unemployed, and sub abuse/AMI
- smallest percent overall
Factors that affect homelessness
Poverty, shortage of sub abuse facilities, domestic/interpersonal violence, unemployment, economy
- insufficient housing assistance
Who is vulnerable to homelessness?
unemployed, migrants, sub use and mentally ill, vets, victims of violence, no safety net, queer
Impact of homelessness on health
can’t rest, can’t get food, stress, exposure, infection, disease, chronic/acute ill, infestations, mental health
Nursing interventions for housing
- crisis/emergency shelters
- federal housing asst
- “housing first”
- permanent supportive housing
Housing first policy
provide long-term housing then link it to mental health treatment
Permanent supportive housing
long term housing assistance with supportive services for ppl with long histories of homelessness and persistent obstacles
Primary interventions for homelessness
Prevent homeless
Secondary interventions for homelessness
for people on the verge or newly homeless
- case management and edu
- policies
Tertiary interventions for homelessness
Permanent supportive housing, understanding BPS functioning that lead to that
Intersex
combo of chromosomes, gonads, hormones, int sex organs, genitals that differ from expected patterns of male and female
sex
biological male or female, intersex
gender identity
Innermost concept of male, female, both, neither
health disparity in queer pops
- internalized homophobia; queer pops prefer hetero physicians
- lack knowledge, legal discrim, more suicide, bully, homeless
- more tobacco, alc, sub use
Organ inventory
method of inventorying body parts to allow for document of alterations or artificial
Important NC for queer pops
- Ask all pt about sex orientation, gender ID, pronouns
- constant evolution of inclusive lang
- focus on pts lived experiences
Queer considerations in HC setting
- being in spaces segregated by binary sex
- anxiety about coming out; fear iso or mistx
- lack safe/respectful restrooms and hospital assignment
- staff not recognize or respect IDs
- insuff records systems
Race and ethnicity
Socially constructed external systems used to classify people
Federally recognized races
Black, AfAm, Am indian, white, Native Hawaiian or Pacific islander
Federally recognized ethnicity
Hispanic or Latino OR not
Hispanic/Latino
Spanish origin regardless of race
Cultural characteristics that differ
- belief of age, death, dying
- time
- communication (non-verbal too)
- personal space - trauma, gender influence
Health disparities for race and ethnicity
- inc surg mortality with marg groups
- unconscious bias of Black pt being less cooperative with medical procedures
- biased technology and algorithms (ex: pulse ox)
Black pts are less likely to…
- get kidney transplant
- get good cardiac care
- receive stage appropriate cancer care
Focus of interventions for race and ethnicity
SDH, policy/sys, bias, tailored health promo
What can the nurse do to support patients with race/ethnic disparities?
Advocate
- acknowledge HC sys historically untrustworthy
Rural
subjective term; defined by geographic location, population density, distance/time to get to urban centers
- each rural location has unique features
Impact of rural on health
- perceived poorer perception of health status, less likely to engage in health bx
- less likely to seek health services
- inc rate chronic illness (CVD, COPD, HTN, DM, cancer)
Disability
umbrella term covering impairments, activity limitations, and participation restriction (ind)
Impairement
problem in body fxn or structure - activity limitation or participation restriction (micro)
Handicap
disadv resulting from an impairment or disability that prevents fulfillment of an expected role (macro level)
Medical model of disability
defect in need of cure thru medical intervention
rehab model of disability
defect tx by rehab professional
moral model of disability
connection with sin and shame
Disability model of disability
Socially constructed
Whether the inability to perform a certain fxn is seen as disabling depends on…
socio-environmental barriers
- attitudinal, architectural, sensory, cog, econ, inadequate support services, other fx
What is the biggest minority group in the US?
Disabled population
Experience of disability depends on…
- temporary
- permanent
- prog decline of chronic illness
Health disparities for disabled populations
inc chronic illness, inc risk for med, phys, social, emo, spiritual probs, inc anx/dep
T/F People with disabilities are more likely to be victimized
True - often by people who know them well (HC worker, fam, intimate partner)
