Caring for Vulnerable Populations Final Exam

SDOH (housing incarcerated - general)

Difficulty finding housing due to record

SDOH (housing incarcerated - mental illness)

Difficulty finding “supportive housing” that manages meds

SDOH (employment incarcerated - general)

Limited to manual labor/entry level

SDOH (employment incarcerated - mental illness)

Limited by stigma and potential "symptom flare-ups"

SDOH (healthcare incarcerated - general)

General “distrust” of healthcare system

SDOH (healthcare incarcerated - mental illness)

Critical need for immediate, continuous medication/therapy

SDOH (social incarcerated - general)

Loss of community standing (“Shadow of Stigma”)

SDOH (social incarcerated - mental illness)

Total isolationd; higher risk of “crisis” without support system

Gender differences in incarceration

Iowa: (males - 91.8%, females - 8.2%)

Men v Women in prison

Women have higher % of any mental illness (twice the rate!)

How many people make up the carceral system in the US?

2 million

How many people are under correctional control in the US?

5.5 million

World population % vs prisoner % (US)

4.2% of world population, 20% of world prisoners

What % of the land in the US is considered to be rural?

84% (Iowa is 12th most rural state)

What percent of US population lives in rural areas?

20%

What % of people living in rural environments are people of color?

25%

Access to care in rural populations

• <8% of physicians choose rural populations

• 64% of rural providers have trouble finding specialists for their patients

Veteran suicide statistics

1.5x more likely than civilian population, women veterans 2.5x more likely

MST (military sexual trauma) stats

• 1/3 females

• 1/100 males

Barriers to communication - veterans

• Confirmation bias from veteran - “I’ve never had a good experience with the VA”

• Lack of empathy from nurses - “They don’t have to pay for health care”

• Unclear goals in treatment

Healthcare advocacy

Influences public policy to improve individual and community health, which reduces health disparities

Advocacy

Strategic approach to influencing outcomes and driving change on behalf of your community. It involves representing your community’s rights and needs to the level of government best able to respond.

Politics

• Political parties

• Candidates

• Elections

What is advocacy

• Educating, influencing, organizing

• Building relationships

• Advancing solutions

Trauma informed lens

The profound understanding of how a patient’s past trauma can affect an individual’s current behaviors and future mental and physical health

How common are ACEs?

• ¾ high schoolers experienced 1 or more

• 1/5 experienced 4 or more

• 2/3 of adults experienced 1 or more

SAMHSA’s 6 key principles of TIC

• Empowerment, voice, and choice

• Collaboration and mutuality

• Cultural, historical, and gender issues

• Peer support

• Safety

• Trustworthiness and transparency