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Community Health > Vulnerable Populations > Flashcards

Vulnerable Populations Flashcards

1
Q

Vulnerable.

A
  • “to wound”
  • capable of being physically or emotionally wounded
  • open to attack or damage
  • SUSCEPTIBLE TO NEGATIVE EVENTS (results from interacting factors of which people have LIMITED or NO CONTROL
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2
Q

Vulnerable Population

A

is a SUBGROUP of the population who is MORE LIKELY TO DEVELOP HEALTH PROBLEMS as a result of EXPOSURE TO RISK or have worse outcomes form those problems than the population as a whole

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3
Q

Cumulative risk.

A

a COMBINATION OF RISK factors that make them MORE SENSITIVE to adverse effect of individual risk factors that others might be able to overcome

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4
Q

Vulnerable population group.

A
  1. a PARTICULAR SOCIAL GROUP
  2. has INCREASED SUSCEPTIBILITY or higher than the national average RISK OF HEALTH RELATED PROBLEMS
  3. Susceptibility is related to FEWER RESOURCES
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5
Q

3 Aspects of Vulnerabildy

A
  1. RESOURCES AVAILABLE
  2. RELATIVE RISK
  3. HEALTH STATUS
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6
Q

Types of risk vulnerable populations experience.

A
  • INDIVIDUAL
  • SOCIETAL
  • PROGRAM
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7
Q

Individual vulnerabilities.

A
  • Risks r/t person and his situation

- Risks are cumulative

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8
Q

What causes individual risk?

A

Low SES

Economic status

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9
Q

What does low SES cause?

A

MORE POOR HEALTH OUTCOMES (health status) because of decreased access to nutrition, poor housing and exposure to toxins, decreased education, lack of job skills/vocation, lack of knowledge to avoid risks and minimize consequences of disease, decreased access to resources required to manage issues, and often use inappropriate coping mechanisms (substance abuse)

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10
Q

Low SES is related to competing ___

A

COMPETING PRIORITIES, due to multiple things that need being paid for and all are important

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11
Q

Social vulnerabilities.

A
  • UNDERSERVED and socially disadvantaged r/t low SES
  • Lack of power and control and resources needed to function effectively = DECREASED AUTONOMY
  • DEPENDENT on others
  • STIGMATIZED
  • DISCRIMINATED (unjust or different treatment)
  • STEREOTYPED (fixed and over simplified image)
  • VICTOMIZED (blamed for their situation)
  • DISENFRANCHISEMENT (invidible to society, feelings of separation from mainstream
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12
Q

Program Vulnerabilities.

A
  • DISADVANTAGED STATUS= fewer resources and lack of access to resources r/t low SES
  • Life in a NON SUPORTIVE ENVIRONMENTS (lack economic, social, physical resources in their community)
  • Increased BARRIERS to access resources (Ex. knowledge of resources, lack of community resources, lack of financial resources)
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13
Q

Examples of vulnerable populations.

A
  • poor
  • homeless
  • immigrant and refugees
  • aboriginal peoples
  • disabled persons
  • persons with stigmatizing condition
  • elderly
  • children/youth in disadvantaged conditions
  • persons with low literacy
  • woman
  • single parent families
  • LGBTQ
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14
Q

Outcomes of vulnerable populations.

A

NEGATIVE- poor physical and MH outcomes/death; chronic stress; hopelessness; increased risk behaviours; continuation of the cycle of vulnerability
POSITIVE- resilience, self reliance, improved health outcomes; peer relationships/community-building; decrease in judgement of providers and deepening understanding of struggles of these populations; change in policies to improve circumstances such as increased financial support and culturally appropriate series

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15
Q

Cycle of vulnerability.

A

individuals are unable to get off the circle of vulnerability with out environmental or community support

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16
Q

What is an issue regarding poverty and politics?

A

no universal definition

- societal values are r/t statistics and measurement and if there is no measure it is like it doesn’t exist

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17
Q

Poverty is not natural, it is ____ _____.

A

man made

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18
Q

Stating that poverty is man made implies what?

A

that it can be eradicated by actions of human beings

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19
Q

Poverty.

A

a human condition characterized by sustained or chronic deprivation of the resources, capabilities, choices, security and power necessary for the enjoyment of a adequate standard of living and other civil, cultural, economic, political and social rights
- - UN committee on economic, social and cultural rights - -

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20
Q

Poverty is a violation of ___ ______.

A

human dignity

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21
Q

Tools for measuring poverty

A

a. BASIC NEEDS: lacking food, clothing shelter and necessities to maintain physical well-being
b. MARKET BASKET MEASURE (MBM): cannot afford basic physical needs and non defined category of essentials such as education, transportation, extracurricular activities
c. LOW INCOME MEASURE (LIM): based on family income (those who make less than average Canadian)

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22
Q

What is the BASIC NEEDS tool for measuring poverty?

A

when the person is lacking food, clothing, shelter and NECESSITIES to maintain physical well-being

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23
Q

What is the MARKET BASKET MEASURE (MBM) tool for measuring poverty?

A

Cannot afford BASIC needs and NON DEFINED CATEGORY (education, sports, transportation, etc.)

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24
Q

What is the LOVE INCoME MEASURE (LIM) tool for measuring poverty?

A

based on family INCOME (those who make less then community average)

25
Q

Factors that increase the risk of poverty.

A
  1. Lone parent of at least one child under the age of 18
  2. Unattached individuals 45-64
  3. People with physical and mental disabilities/chronic illness and unable to work
  4. Recent immigrants to Canada
  5. Aboriginals living off the reserve
  6. Urban/rural living
26
Q

Types of homelessness.

A

a. EPISODIC (moves often, has periods of no housing)
b. SITUATIONAL (no housing r/t significant life change)
c. RELATIVE (some housing but inadequate)
d. ABSOLUTE (lives on the street the majority of the time

27
Q

Episodic homelessness.

A

moves often, has periods of no housing

28
Q

Situational homelessness.

A

no housing r/t significant life changes (natural disaster, kicked of home)

29
Q

Relative homelessness.

A

some housing however it is inadequate

30
Q

Absolute homelessness.

A

lives on the street the majority of the time

31
Q

Crisis poverty.

A

includes episodic (moves often with periods of no housing) and situational (no housing r/t life change)

32
Q

Persistent poverty.

A

Chronic homelessness (disabled who likely have mental and physical disabilities that exist along with alcohol and drug use, family estrangement, poor skills, etc.)

33
Q

What is the poverty cycle?

A

Family in poverty > child grows up in poverty > significantly disadvantaged in education and skills > struggles to get a job > fail to escape the poverty cycle

34
Q

12 Determinants of health

A
  1. Income and social status
  2. Education and literacy
  3. Social support networks
  4. Employment and working conditions
  5. Physical environments
  6. Social Environment/ Social connectedness
  7. Personal Health and Coping Skills
  8. Healthy Child Development
  9. Biology and genetic endowment
  10. Culture
  11. Health services
  12. Gender
35
Q

Barriers to health care.

A
  • competing priorities
  • difficulty following txt regime/ keeping appointments
  • lack of transportation and money for it
  • no fixed address, uninsured, lost HC
  • immigration issues
  • may lack telephone
  • alienated from society, health care system
  • have nee refused care
  • feel stigmatized and experience victimization
36
Q

Poverty/homelessness increased health risks such as …

A
  • substance abuse
  • depression, despair, homelessness
  • mental illness
  • less positive/spiritual lives
  • suicide thoughts, paranoia, hallucinations
  • seizures
  • hypertension, CVD, DM, infant mortality, caner, HIV, STIs, trauma by violence, renal disease
  • foot problems (poor footwear, pregnancy, overuse, no socks, etc)
  • TB
  • Unintended injury (fall, OD, struck by vehicle, exposure to elements,etc.)
  • Chronic pulmonary disease
37
Q

Who does homelessness effect most?

A

developing children

38
Q

Health care issues with homelessness.

A
  • conditions hit homeless or poor first
  • difficult to manage chronic illness in homeless population
  • receive care in ER/clinic for symptom management only
  • admitted to hospital 5x more often then general public
  • longer visits to hospitals
  • need to go to them through outreach and identification in community (best-use mobile van staffed with NPs to provide primary health services
39
Q

Primary health services.

A

BP, glucose monitoring, chronic disease management, wound care, STIs treatment, follow up

40
Q

CHN strategies to work with homeless or poor.

A
  • take time and exercise patience/ understand barriers to care
  • listen to their stories
  • develop a trusting, non judgemental relationship/avoid stereotyping
  • use open ended questions
  • let the client set the pace
  • show respect, compassion and concern
  • follow up with promises
  • coordinate services and providers/have issues addressed in ONE VISIT
  • focus on housing and other needs, dental, bathing facilities
41
Q

CHN assessment of the homeless and poor.

A
  • signs of malnutrition, infectious disease, individual self esteem
  • talents and strengths
  • coping skills (effective/ineffective)
  • Adequate housing (hit, rodents, phone
  • daily routine
  • sleeping patterns (where they sleep)
  • food
  • support
  • income
42
Q

Identify priorities.

A

acute or chronic, needing social support, housing, food, legal issues

43
Q

Plan interventions together.

A
  • treat acute illness with treatment plan, prescribed medication
  • coordinate care with “one stop shopping” (all in one place, with one visit)
  • avoid fragmentation (splitting the intervention up)
  • Investigate and network with various disciplines and social services agencies
  • refer clientes to appropriate services
  • learn about education and job training programs, free legal services
  • assist with access to medical card
  • may do education (safer sex, screening for diseases)
44
Q

Social service agencies.

A

churches, volunteer groups, health departments, social services (emergency shelter, food, hygiene products, clothing)

45
Q

Upstream interventions for poor/homeless.

A
  • advocate with political leaders, general public about the needs of the poor/homeless
  • create mobile clinics
  • build street clinics (accessible in neighbourhood)
  • use research to prove that housing with supportive care saves money
46
Q

CHN Evaluation of poor/homeless.

A
  • measure progress
  • provide positive feedback
  • adjust goals when necessary
47
Q

Discuss income and social status.

A
  • income dictates where we can afford to live
  • people i low income neighbourhoods, increased risk of poor health outcomes, less leisure time and increased risky behaviours
  • some provincial governments have social support networks
  • early kindergarten, subsidized housing, child tax benefits (no fixed address, difficulty accessing)
  • LOW SES have LESS POWER, left out of decision making of communities and have decreased influence
48
Q

Discuss education and literacy.

A
  • Poorly educated less likely to qualify for high paying jobs
  • Increase in tech= increased literacy requirements
  • People with LD less likely to graduate unless treated, decreases opportunity
  • Even if upgrading classes available and subsidized, poor may not be able to afford supplies, or day care or transportation
49
Q

Discuss social support.

A
  • poor and homeless less able to meet this determinant
  • many networks of family and friends may already be exhausted in providing support which creates strain and withdrawal
  • difficulty in obtaining money or travel or long distance communication
  • not have a fixed address, makes it difficult to receive mail or other communication
  • perception of little to offer in relationships
  • honour relationships with each other and tend to share resources among themselves
50
Q

Discuss employment and working conditions.

A
  • poor may not have fixed address, no identification , which makes if difficult to apply and maintain a job
  • jobs they get may be transitory, hourly wage, with few benefits
  • low paying jobs may increase risk of injuries (poor working environment, long distance travel)
  • history of chronic unemployment
51
Q

Discuss physical environment.

A

housing may be substandard, unsafe, overcrowded

  • low income housing seems to be unsafe neighbourhoods (high pollution, ^injury, ^ disease, ^ violence, fewer supports like police)
  • housing is not usually subsidized
  • increase in environmental issues within the house (poor heating/cooling, told, rodents, overcrowding, poor hygiene)
  • Hwang et al. (2009) suggests that mortality is impacted more by ‘where a person lives’ is a factor than by ‘income’
52
Q

Discuss personal health and coping skills.

A
  • increase substance abuse, family disfunction, difficulties in school, legal problems, suicide attempts
  • many attempting to escape physical/sexual abusive home environments
  • less parental support for youth, greater depressive states, less effective coping skills
  • facilities for basic hygiene practices are less optimal
  • no consistent access to nutritious food, shelter, warm clothing
  • may exchange sex for clothing, shelter, drugs resulting in increased risk of STIs and unwanted pregnancies
53
Q

Discuss healthy child development.

A
  • poverty and homelessness impacts health status of children
  • have food insecurity or lack of access to nutritional food creates difficulties in memory, concentration, energy, problem solving
  • other issues: lack of safety, poor hygiene, increased exposure to hazards and violence in housing and communities = decreased life expectancy
  • children will have less/no opportunity for organized sports activities, access to books, library, different types of clothing which are not stylish
  • constant moving interferes with education
  • feeling more bullied and ostracized
54
Q

Discuss biology and genetic endowment.

A
  • poor may delay seeking help with vision, hearing, dental problems
  • inability to pay for medication/treatment
  • uninsured (lost health care, no fixed address, no transportation, no money to buy supplies for treatments)
  • mortality and morbidity rates higher than general population
55
Q

Discuss culture.

A
  • encompasses neighbourhood, ethnic, work, clubs, religions, etc
  • poverty and homelessness increase barriers to meeting one’s cultural expectations
  • decrease feelings of self worth and increased risky behaviours
56
Q

Discuss health services.

A
  • may lack access r/t geography, financial barriers, culture, no fixed address
  • health care often provided where there are shelters, streets, store front clinics, churches, mobile vans
  • Care often fragmented (r/t reduced access, attitudes, no follow up appointment by client, can’t access equipment for treatment)
  • Appointments should have multi disciplinary team (not always practical)
  • Often stigmatized, victimized, turned away by HCP who do not understand
57
Q

Discuss gender.

A
  • women live longer but for poor/homeless
  • experience greater depression, stress overload, risk of increased chronic illness and violence
  • increased risk of lower employment more often than men
  • lone parent families headed by women experience lowest levels of income and usually more poverty
  • continues the cycle of poverty
58
Q

What are the 12 determinants of health.

A
  • Education & literacy
  • Social support networks
  • Employment/work conditions
  • Physical environment
  • Social environment= social connectedness
  • Personal health and coping skills
  • Healthy child development
  • Biology and genetic endowment
  • Culture
  • Health services
  • Gender

Community Health (5 decks)

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