Health Equity & Care of Vulnerable Populations

population health

an approach to health that aims to improve health of an entire population and decrease inequities among population groups

-considers broad, upstream determinants of health

-outcomes-focused, attempts to reduce disparities and promote health equity

population

group of individuals who have one or more personal or environmental characteristic in common

aggregate

small parts of a population defined by a specific characteristic

health determinants

a range of factors that influence health and health outcomes

-includes morbidity, mortality, life expectancy, health care expenditures, health status, and functional limitations

community health rankings model

health outcomes are more influenced by contextual factors than individual choices or access to and use of health care

social determinants

conditions in the environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks

upstream

improve community conditions

-laws, policies, and regulations that create community conditions supporting health for all people

midstream

addressing individual social needs

-includes pt screening, questions about social factors like housing and food access, use data to inform care and provide resources

3 determinants of health

-social and economic environment

-physical environment

-person’s individual characteristics and behaviors

socioeconomic status (SES)

a measure of social status, standing, or class of an individual or group based on income, education, occupation

-most important determinant of health

education

higher levels of _ lead to better human capital (skills, personal control, problem-solving ability), and increase social and economic resources

health disparities

differences, inequalities, or incongruences in health status or outcomes between people or populations closely linked with social and economic disadvantage

social justice

recognizes the dignity of every human being or group irrespective of ethnicity, gender, sexual orientation, economic status, education level, possessions, race, religion, or other characteristics and treating every person or group without prejudice

vulnerable populations

those considered to be at increase risk for poor health status and those that have poor access to healthcare

-often have multiple illnesses

-protective factors:

• social support, age, confidence, ability to feel in control

causes of vulnerable populations

-presence of chronic illness

-poverty

-limited social support

-working in hazardous environment

-lack of education/knowledge skills

-stigmatizing diseases (HIV)

-mental illness

-unemployment

-abused individuals

marginalization

occurs when people or populations are relegated to a position on the periphery of society where they have diminished importance, influence, or power

-a cause and outcome of vulnerability

-groups are disconnected from mainstream society and lack ties to strong social supports

-tend to be forgotten in health and social planning leading to disenfranchisment, or a feeling of invisible and powerless

advancing health equity

-increase resilience of vulnerable population through advocacy

-work for the passage and implementation of policies to improve PH services for those populations

-provide comprehensive services to bridge gaps in health care

-educate pt

-culture and linguistically appropriate health care

planning and implementing care for vulnerable populations

-create a trusting environment

-show respect, compassion, and concern

-don’t make assumptions

-coordinate services and providers

-advocate for accessible health care services

-focus on prevention

-know when to “walk beside” the pt and when to “walk ahead”

-know what resources are available

-develop a support network

-help break the cycle of vulnerability