Population and Community Final

vulnerability

degree to which an individual, population, or organization is unable to anticipate or recover from disasters or illness

--pre-existing illness, unemployment increases this

Stigma

person possesses or is believed to possess something that is not valued in the social context

-can lead to loss of status and discrimination

marginilization

person/group is on the "outside" of society because of their identify, beliefs, environment, associates

-limits opportunities and access to care

disenfranchiesement

depriving someone of basic civil rights (voting) based on factors such as race or history of crime

Population determinations by number

frontier = less than 6 people per square mile

rural = 20,000 residents (15% of Americans)

urban = 20,000-49,000

city/metro = 1 million or more

rural population behaviors

-decreased health access

-decreased health-seeking behavior

-decreased overall health status

**Nurse focus should be teaching prevention/protection and advocate for healthcare access in rural areas

Immigrant

legally emigrate from another country

migrant

move from one place to another; follow seasonal jobs

refugee/asylee

refugee is a person outside USA seeking to enter, asylee is already in USA and applying for asylum

undocumented immigrant/worker

entered a country w/o permission with intent of become resident

-only eligible for school lunch immunizations, communicable disease and emergency care

Refugees health impact

-mental health issue

-food insecurity

-poor sanitation

-violence and disease exposure

-eligible for SSI and temporary assistance for needy families

Modern slavery

labor extracted through coercion, force, threats

-migrant workers at high risk (risk of human trafficking)

-46 million people worldwide

migrant workers risk

-exposure to pesticides

-lack of regulations

-no permanent residence (struggle to get support like food stamps)

-dangerous work environments

-poor living conditions

Migrant farm workers laws

not covered under

-Fair Labor Acts

-OSHA

-Child Labor Act once 12 years old

-Migrant Health act funds centers serving 1/5 of migrant workers

risks of transgender youth/teens

-risk of bullying and family strain if unaccepting of identify

-risk of suicide, risk taking behavior, substance abuse, homelessness

-health care access may not be available

risk for older LGBTQ adults

-distrust main medical services

-unlikely to share identity with medical team; past negative experiences

levels of homelessness

Primary homelessness - lack of adequate shelter; living in cars, the park, squatting in abandoned buildings, the street

Secondary homelessness - staying in temporary housing because they have nowhere else to go

Tertiary homelessness - renting single rooms on long-term basis without permanent residence

homelessness risks

-lower life expectancy

-high risk of chronic conditions

-substance abuse, HIV, TB, mental illness

-trouble self-managing disease

*will consume health materials more than others once receive care

Nursing interventions for homelessness

Primary - prevent homelessness for families and individuals

Housing First Model - give housing, food, improved access to care for homeless

Tertiary - prevent recurrence of poverty, homelessness, adverse health conditions

incarceration risk factors

crowded environment

violence

limited access to care options

vulnerabilities of incarceration

-mental health, substance abuse, decreased care access

-poverty

-HIV, HTN, diabetes exasperation

Veterans

-PTSD, anxiety, depression

-somatic complaints, substance abuse, TBI, orthopedic injury

Veteran Affairs (VA) health care

Disabilities

1/5 of Americans are "differently abled"

-increased risk of abuse, need more care

-Americans with Disabilities Act prohibits discrimination

-Individuals with Disabilities Education Act ensures children with disabilities get education access

Omaha system

generate data following routine client care; used in home-health nursing