Vulnerable Populations; Occupational Justice

What are occupational rights?

Enabling meaningful occupations

Inclusion/participation

Autonomy of choice

Diverse participation/balance

Occupational injustice

Occupational apartheid

Occupational deprivation

Occupational marginalization

Occupational alienation

Occupational imbalance

Occupational apartheid

Occurs in situations where opportunities for occupation are afforded to some individuals and restricted to others based on personal characteristics such as race, disability, gender, age, nationality, religion, social status, sexuality and so on

Occupational deprivation

A state of preclusion from engagement in occupations of necessity and/or meaning due to factors that stand outside the immediate control of the individual

Occupational marginalization

Exclusion from participation in occupations based on ‘invisible’ norms and expectations about who should participate in what occupations, how, when, where and why

Occupational alienation

A prolonged experience of disconnectedness, isolation, emptiness, lack of a sense of identity, a limited or confined expression of spirit, or a sense of meaninglessness

Occupational imbalance

When when the timing of occupations is out of alignment with personal or physiological needs or routines

What needs are met by occupational justice?

Exerting citizen empowerment

Choice and control

Nourishment of the human spirit and spirituality

Health and quality of life

Sustenance of families and communities

 Looking after the self or others

Enjoying life, or doing something that feels or is acknowledged by others to be productive

What is the significance of July 3, 1946?

President Harry S. Truman signed the National Mental Health Act. Resulted in National Institute of Mental Health

What is the significance of 1963?

JFK signed The Community Mental Health Act. Goals was for care in community centers than institutions. Change in mentality of care

What happened in the 1960s?

Independent living movement-creation of centers run by and for people with disabilities

The Rehabilitation Act of 1973, Section 504

The United States’ first major federal disability rights law. Regulations not truly implemented. Served as model for ADA.

Significance of July 25, 1990?

Americans with Disabilities Act was signed

Americans with Disabilities Act Title I

Employers must provide people with disabilities an equal opportunity to benefit from the employment-related opportunities available to others. This includes things like recruitment, hiring, promotions, training, pay, and social activities.

Americans with Disabilities Act Title II Subtitle A

State and local governments must provide people with disabilities an equal opportunity to benefit from all of their programs, services, and activities

Examples of equal opportunity in Americans with Disabilities Act Title II Subtitle A

Public education, transportation, recreation, health care, social services, courts, voting, emergency services, town meetings

Americans with Disabilities Act Title III

Businesses must provide people with disabilities an equal opportunity to access the goods or services that they offer

Americans with Disabilities Act Title IV

Telephone companies must provide services to allow callers with hearing and speech disabilities to communicate

Lois Curtis and Elaine Wilson

Experienced mental health conditions. Forced to stay in mental hospitals due to lack of community health supports

The Supreme Court held that people with disabilities have a qualified right to receive state funded supports and services in the community rather than institutions when

The person's treatment professionals determine that community supports are appropriate; 

The person does not object to living in the community; and 

The provision of services in the community would be a reasonable accommodation when balanced with other similarly situated individuals with disabilities.”

Vulnerable populations

Groups and communities at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability

Highly vulnerable populations

Those with complex medical problems exacerbated by social needs, are one of the fastest growing segments within the US and includes racial and ethnic minorities who have complex chronic illnesses and multiple chronic comorbidities

Vulnerable populations’ health and healthcare issues may be exacerbated by social factors and they may experience

Greater risk factors

Worse access to care

Increased morbidity and mortality compared with the general population.

How must the complex need of these populations be addressed?

Healthcare practitioners must understand social determinants of health and utilize a comprehensive health definition, including biological, social, and psychological dimensions