At-Risk and Vulnerable Populations and Related Effects on Health

Vulnerability

From Individual/Social factors
—Individual: Pre-existing illness, age
—Social: Education, employment, housing, etc.
High risk developing health problems
High risk of health disparities

What is their biggest need?

Social Determinants of Health (SDOH)

• Contribute to health Inequities/Disparities
• Socioeconomic status major factor to disparities

Education SDOH

• Early childhood influence school readiness
• Low-income children lack resources needed for success

Poverty #1 SDOH

• Poor health
• Hazardous environment
• High-risk jobs
• Low health care access

Housing SDOH

• Exposure to elements
• Contaminated water supply
• Overcrowding
• Long-term stress
• Homelessness

Race Inequity

• Associated with vulnerability
• Higher illness and death rates

Nurse’s Role with Vulnerable Groups

• Patient advocacy
• Equal treatment
• Culturally sensitive
• Address SDOH

Veterans

• Depression, PTSD, anxiety common
• High risk
- Substance abuse
- Physical diseases
- Somatic complaints
• Veterans Affairs (VA) health system access

Adolescent Pregnancy (Highest Priority)

• Health risks to mother and baby
- Lack of prenatal care common
- HTN- Preeclampsia
- Premature birth
- Low-birth-weight infants
• Mothers in foster care
• Nurses should prepare to discuss all options (termination, adoption, parenthood)

Incarceration

• Mental health disorders common
• Other risk factors
- Violence
- Crowded living conditions
- Limited Tx options
• Nurses maintain Professionalism/Care without unconscious bias

Homelessness

High rates —
• HIV
• Alcohol/drug use
• Mental illness
• TB
• Chronic illness

Rural Populations

• Often Poor perception of health/functional status
• High incidence of chronic illness
• Less likely to seek health care
- Telehealth an option
• Nurses should advocate for access

Migrant Populations

Risk factors
• Poverty
• Limited access
• Hazardous occupation
• Lack of regulations
Focus on infection prevention (often live in crowded spaces)

Nursing Process Application

• Assessment of community
- Windshield survey
• Planning population-focused care
- Include community in planning process
• Collaborative interventions to address SDOH