At-Risk and Vulnerable Populations and Related Effects on Health

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At-Risk and Vulnerable Populations

Learning Objectives

  • Analyze individual and social factors contributing to vulnerability.

  • Explain the nursing role in caring for at-risk and vulnerable populations.

  • Apply the nursing process using clinical judgment functions when caring for at-risk and vulnerable populations.

Definition of Vulnerability

  • Vulnerability arises from a combination of individual and social factors:

    • Individual Factors:

      • Pre-existing illnesses

      • Age

    • Social Factors:

      • Education

      • Employment

      • Housing

  • Vulnerability increases the likelihood of developing health problems and consequently leads to health disparities (CDC, n.d.).

Social Determinants of Health (SDOH)

  • Social determinants contribute significantly to health inequities and disparities.

  • Socioeconomic Status:

    • Identified as a major factor linked to health disparities (ODPHP, n.d.).

Key Social Determinants of Health

  1. Education:

    • Early childhood experiences influence school readiness.

    • Low-income children may lack essential skills for success.

  2. Poverty:

    • Associated with poor health outcomes.

    • Contributes to hazardous living environments, high-risk jobs, and lack of health care access (Pianta et al., 2017; Xafis, 2020).

  3. Housing:

    • Poor living conditions can lead to:

      • Exposure to harmful environmental elements

      • Contaminated water supply

      • Overcrowding leading to long-term stress

      • Homelessness (Xafis, 2020).

  4. Racial Inequalities:

    • Higher rates of illness and death associated with racial disparities (Hicken et al., 2018).

Nurse’s Role with Vulnerable Groups

  • Nurses take on various roles including:

    • Patient Advocacy:

      • Ensuring equal treatment irrespective of social factors.

    • Culturally Sensitive Care:

      • Providing care that respects diverse cultural backgrounds

    • Addressing Social Determinants of Health:

      • Incorporating awareness of social determinants in treatment plans (Fowler, 2015).

Specific Vulnerable Populations

Veterans

  • Common mental health issues among veterans include:

    • Depression

    • Post-Traumatic Stress Disorder (PTSD)

    • Anxiety

  • Increased risk for other issues:

    • Substance abuse

    • Physical diseases

    • Somatic complaints

  • Access to necessary care through Veterans Affairs (VA) health system is critical (Gaddy, 2018; Possemato et al., 2018).

LGBTQIA+ Populations

  • High prevalence of:

    • Depression

    • Anxiety

  • Additional risks include:

    • Substance abuse

    • Sexually Transmitted Infections (STIs)

    • Suicide

  • Emphasis on the need for improved sensitivity in treatment for this demographic (Gnan et al., 2019; Rossman et al., 2017).

Adolescent Pregnancy

  • Associated health risks for both mother and baby:

    • Lack of prenatal care common in this group.

    • Health complications that may arise:

      • High blood pressure

      • Premature birth

      • Low-birth-weight infants.

    • Consideration for special cases, such as young mothers in the foster care system, emphasizing the importance of discussing all options including termination, adoption, and parenthood (U.S. National Library of Medicine, n.d.).

Incarceration

  • High incidence of mental health disorders within prison populations.

  • Associated difficulties include:

    • Violence

    • Overcrowded living conditions

    • Limited treatment options available.

  • Nurses face the challenge of maintaining professionalism and care while avoiding unconscious bias (Grosholz & Semenza, 2021; Ashton, 2017).

Homelessness

  • Increased prevalence of:

    • HIV

    • Substance abuse (alcohol and drugs)

    • Mental health issues

    • Tuberculosis

    • Chronic illnesses (CDC, n.d.).

Rural Populations

  • Often exhibit a poor perception of their health and functional status.

  • High incidence of chronic illnesses observed.

  • Less likely to seek healthcare services.

  • Utilization of telehealth as a viable option for better access.

  • Nurses should advocate for improved healthcare access in rural communities (Stanhope & Lancaster, 2015).

Migrant Populations

  • Increased vulnerability due to:

    • Poverty

    • Limited access to healthcare

    • Hazardous working conditions

    • Insufficient regulations protecting workers.

  • Focus on infection prevention is crucial as crowded living conditions are common (MCN, 2017).

Nursing Process Application

  • Assessment of the community's health through:

    • Windshield surveys assessing the community's needs.

  • Planning population-focused care by:

    • Including community members in the planning process.

  • Engaging in collaborative interventions aimed at addressing social determinants of health effectively.