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Compare vulnerable populations NRS 428 Topic 3 DQ 1

Compare vulnerable populations NRS 428 Topic 3 DQ 1

Several circumstances can make an individual or group vulnerable like disease, disability, limited resources personal and environmental conditions. This paper Identifies a vulnerable population, challenges, and how their issues are advocated.

Comparison of Vulnerable Population

Vulnerable groups often include children, ethnic groups/minorities, persons with a disability, abusers of drugs and alcohol, the elderly, malnourished, pregnant women, and ill or immunocompromised people. These groups are exposed to poor health and malnutrition and low income.

Ethnic minorities are among vulnerable groups in America. They face multiple forms of

Compare vulnerable populations NRS 428 Topic 3 DQ 1
Compare vulnerable populations NRS 428 Topic 3 DQ 1

discrimination resulting in marginalization and exclusions. They include African American, American Indians, Alaska natives Asia and Hispanic. Among the group, African Americans are more vulnerable, especially in healthcare services. Lack of effective participation in political and economic life leads to poor living standards and health (De Chesnay & Anderson 2019). The health care quality gap is evident in the provision of cardiac care; they are less likely to receive than their white counterpart’s evidence-based procedure following hospitalization for heart failure (Richard et al., 2016). Severe underrepresentation makes it difficult for minorities to advocate for themselves. Besides, the lack of access to adequate insurance has consequences related to a person’s health status ability to receive preventive care and manage health problems. Historically minority professions have faced systematic discrimination that placed significant barriers.

Ethical issues to be considered in Health facilities are the culture of clients. Health profession ensures that all patients receive high–quality, effective services irrespective of cultural background, language proficiency, socioeconomic status, and other factors that may be informed by a patient’s race or ethnicity. Cultural competency is a part of delivering patient-centered care. It enhances respect shared decision making and building nurse-patient relationships (Richard et al., 2016).

Conclusion

From the findings, discrimination in health care, genetic, unequal education opportunities, cultural beliefs, and community system affect the vulnerable. Diversifying the healthcare workforce and improving inequities socioeconomic status of the vulnerable population would dramatically improve the lives of all people and the future of America.

References

De Chesnay, M., & Anderson, B. (2019). Caring for the Vulnerable. Jones & Bartlett Learning.

Richard, L., Furler, J., Densley, K., Haggerty, J., Russell, G., Levesque, J. F., & Gunn, J. (2016). Equity of access to primary healthcare for vulnerable populations: the IMPACT international online survey of innovations. International journal for equity in health15(1), 64.

Replies

Vulnerable populations are groups of people who require special attention related to well-being and safety, including persons who cannot advocate for their own needs such as children, prisoners, and the cognitively, emotionally, and physically impaired (Falkner, 2018). Immigrants are considered one of the most vulnerable populations in the United States These individuals are new to the environment and have little or no understanding of the new culture and will require support to acclimatize to the new environment.

In working with the Hispanic and Latino populations it is very important to provide primary prevention and screening for metabolic syndrome. Not only is there a high correlation of the syndrome within the population but new genetic research, the Insulin Resistance Atherosclerosis Study (IRAS) Family Study, has provided evidence for linkage of metabolic syndrome to 1q23-q31, and evidence linkage to this region (LOD 1.2) (Langefeld et al., 2004). This research contributes to the growing evidence that chromosome 1q harbors at least one locus related to the metabolic precursors of diabetes. Linkage of diabetes to the 1q21-25 regions has previously been reported in European-Caucasian, Amerindian, and Chinese populations. Genetic research provides exciting possibilities for the future of DM treatment, but it does not negate the powerful influence that lifestyle and behavioral choices have on the prevention and minimization of the detrimental effects of this predisposition.

This genetic predisposition hopefully can be used to motivate Hispanics to proactively modify diet and activity levels. Studies in Mexico show similar rates of metabolic syndrome and lack of activity that are seen in the Hispanic American population. In one study in an industrialized Northeastern Mexican city, the prevalence of obesity for men was 32%, women 7% (Gilson, 2007). Elevated levels of cholesterol were 44%M and 10% F, and healthy exercise rates were low, with 76% of women and 70% of men identified as inactive. They concluded much like American researchers that there is a need to increase healthy physical activity.

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In recent years, there has been an increase in the refugee and immigrant population seen in America and other countries worldwide. According to the U.S. Census Bureau (2019), about 40 million people, or 13% of the total population are immigrants. Immigrants are more likely to live in poverty (19% overall to 15% immigrant) and lack health insurance (87% to 66%) than native born Americans.  In addition to these basic inequalities, immigrants have long faced barriers at every level of healthcare, including discrimination, financial, and policy barriers, language barrier, stigma and marginalization.

Ethical consideration for this population includes cultural differences and linguistics. Limited English proficiency is related to poorer access to and lower quality of health care, Undocumented immigrants as well as those who are not proficient in English are often at the mercy of their employers and depend on them for their livelihood (Bloch & Mckay, 2015). An immigrant’s first language may be an intervening factor. In addition to using interpreters, nurses need to self-evaluate their understanding of racial and cultural biases.

It is imperative for nurses to address their needs with compassion and patience and advocate for their needs to the best of their ability. This includes accounting for language barriers, lack of insurance, and provision of resources such as clothing, food and water, and possibly housing needs. They can also benefit from legal representations and health counselling. For example, nurses may encounter girls and women who have suffered from female genital mutilation; immigrant victims of domestic violence; and immigrant survivors of other traumas. Nurse must speak up when witnessing prejudices and discrimination among these population.

Reference

Bloch, A., & McKay, S. (2015). Employment, social networks and undocumented migrants: The employer perspective. Sociology49(1), 38-55.

Falkner, A (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1

U.S. Census Bureau. (2019). Quick facts. Retrieved from https://www.census.gov/quickfacts/fact/table/US/PST045216

While vulnerable populations are usually minority groups based on their age, race, and social status, an emerging vulnerable population in the US comprises of veterans. According to Murphy,Busuttil andTurgoose (2018), after coming home from war, many soldiers experience social, physical, and mental challenges that make them vulnerable. Some of the major challenges are brain damage, trouble adjusting to civilian life, depression, interpersonal and family problems, post-traumatic stress disorder, unemployment, anxiety, homelessness, substance abuse, of loss of limbs.

Currently, there are around 17.1 million of veterans with around 34% from minority populations. In 2017, the largest groups of veterans were African Americans at 11% and Hispanics at 7%. In addition, women comprised of 8.7% with 34.4% being from minority groups (Africa-American women at 19.5% and Hispanics at 8.3%)(Finlay et al., 2019).

It is unfortunate that apart from the challenges faced by veterans in general, the issues are more severe for veterans who come from minority populations. According to Oster et al. (2017),with American veterans coming more from populations regarded by the federal government as ‘potentially vulnerable’, the risk of receiving poor quality care and having worse medical issues increases. People from minority groups have higher rates of chronic health issues like high blood pressure, diabetes, and many cancers.Compare vulnerable populations NRS 428 Topic 3 DQ 1

Most of these people are unable to advocate for themselves because of high levels of discrimination, poor life experiences, lack of social support, and low level of education and income. Nurses should therefore advocate for these patients by ensuring that their health needs are heard and addressed. When advocating for veterans, nurses should address the perceive discrimination, address the suffered mental health issues, and be concerned with the veterans’ life experiences (Duan-Porter et al., 2018).

ALSO READ: NRS 428 Topic 3 DQ 2 How does the community health nurse recognize bias, stereotypes, and implicit bias within the community?

References

Duan-Porter, W., et al. (2018). Evidence review: Social determinants of health for veterans. Journal of General Internal Medicine, 33, 1785-1795. https://doi.org/10.1007/s11606-018-4566-8

Finlay, A. K., et al. (2019). A scoping review of military veterans involved in the criminal justice system and their health and healthcare. Health & Justice, 7(6). https://doi.org/10.1186/s40352-019-0086-9

Murphy, D. M., Busuttil, W., &Turgoose, D. (2018).Understanding the needs of veterans with PTSD.Healthcare, 6(3), 100. https://doi.org/10.3390/healthcare6030100

Oster, C., Morello, A., Venning, A., Redpath, P., & Lawn, S. (2017). The health and wellbeing needs of veterans: A rapid review. BMC Psychiatry, 17, 414.doi: 10.1186/s12888-017-1547-0

It’s critical to understand the overlap and distinction between the terms “vulnerability” and “at-risk” when talking about these concepts. Even if they may have risk factors that make them more likely to contract a disease or disorder, a community or individual who is at risk may not necessarily belong to a particularly vulnerable group. Because of their age, physical or mental handicaps, poverty, or ethnicity, vulnerable groups need additional care and advocacy (Falkner, 2018).

Vulnerable populations include many different groups of people, such as low-income older adults, people with cognitive disabilities, recently migrated refugees, minority immigrants, pregnant women, neonates, fetuses, the poor, sick, homeless veterans, and many more. One of the groups in the United States that I would like to discuss is the homeless, retired veterans, and low-income elderly. If we compare them with general populations, these vulnerable populations always have low socioeconomic status, lack of resources, lack of support systems, are financially exploited or abused by caregivers, are helpless, and have healthcare inequalities due to being uninsured.

The current and future trends in homelessness among veterans are based on age demographics and the general veteran population. Recent calculations suggest that the number will rise between 2010 and 2020. Between 2010 and 2020, as predicted, the number of senior homeless veterans rose by a total of 14%, from 24,100 to 27,524 (Schinka, & Byrne, 2018). The Supplemental Poverty Measure (SPM) and the Official Poverty Measure are the two separate measures of poverty that the U.S. Census Bureau provides. The official poverty measure, as well as the SPM, show that poverty rates increase with age, and they are higher among women, Africans, and Hispanics, and among people with relatively poor health.

In 2017, more than 15 million older adults had incomes below 200% of poverty, a number that increases to more than 21 million (42.0%) when based on the SPM. The official poverty measure identifies nearly 3 million women over 65 with incomes below poverty, but the SPM reports more than 4 million (based on three-year averages for 2015–2017). According to official poverty estimates, 1.6 million older men are poor, but 2.7 million are poor according to the SPM (Cubanski et al., 2018). Vulnerable populations face challenges and are unable to advocate for themselves because they are socially isolated, unable to afford healthcare services due to financial hardship, face family disruption due to poverty, and do not have support from society. It is more likely that they have been abused and violated by their caregivers and family members. Moreover, vulnerable populations are unable to speak for themselves because of mental health issues such as post-traumatic stress disorder (PTSD).

Nurses encounter ethical issues while working with vulnerable populations because of their low socioeconomic status, economically unstable, and healthcare inequalities. Poor Americans have worse access to care than wealthy Americans, partly because many remain uninsured and unable to afford insurance premiums due to their low-income status. As registered nurses (RN), we should provide service with respect, and honesty. However, it is not appropriate to treat and respect people based on their economic situation, health, ethnicity, gender orientation, or cultural beliefs if they are poor, sick, or of a different origin.

Advocacy is beneficial to this population because it is the action of supporting or pleading for a cause or proposal. Primarily, the nurse uses critical thinking, knowledge, and nursing judgment to care for the client and coordinate care for the client. A person can be their advocate, or they can advocate for a particular group, or a specific individual can be their advocate (Helbig, 2018). Moreover, advocacy involves speaking for the client because he or she is unable to do so alone. Also, advocacy may involve translating or expressing the client’s intent when, in a nurse’s view, it is not being acknowledged, perceived, or understood accurately (Harrington, & Terry, 2018). At this level of nursing, as an RN, I will have the ultimate career responsibility and accountability in advocating for the client or populations to ensure their desires are understood and to protect the client’s rights because of freedom of choice. As an RN, the nurse should stand up for the patient or population to protect their rights because, ultimately, the nurse is all sense for their clients.

References:

Cubanski, J., Wyatt, K., Damico, A., & Neuman, T. (2018, November 19). How many seniors live in poverty? Kaiser Family Foundation.

How Many Seniors Live in Poverty?

Falkner, A. (2018). Community as client. In Grand Canyon University (Ed.), Community & public health: The future of health care. 

https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/3

Harrington, N., & Terry, C. L. (2018). Lpn to rn transitions: achieving success in your new role. (Edition 5th.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Helbig, J. (2018). Advancing Professional Standards. Dynamic in nursing: Art & science of professional practice. Retrieved July 4th, 2022, from https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and-science-of-professional-practice/v1.1/#/home

Shinka, J. A., & Byrne, T. H. (2018). Aging and life expectancy in homeless veterans: Nine questions. Va National Center On Homelessness Among Veterans.

https://www.va.gov/HOMELESS/nchav/docs/Schinka_Byrne_AgingLifeExpectancyHomelessVeterans_Sept2018.pdf

A vulnerable population is a group of individuals who are devoid of getting basic needs fulfilled due to their race or ethnicity. They are even deprived of getting good healthcare. The most common vulnerable population are immigrants, prisoners, families of patients who are incompatible with life LGBT community, uninsured or underinsured

Nearly 27.3 million people are not insured in the US (Maskell, 2020). This may be because of low socioeconomic status, or an immigrant of fewer than 5 years, not holding a green card.

The main challenges faced by them are

  • Denial of health care
  • bias in the treatment on the basis of expense done by a patient
  • Rejected because of having no insurance
  • Care is interrupted in case of under insurance

These populations are unable to advocate for themselves in of fear that the government can fire them and evacuate them to their own countries and which may result in the loss of entire families’ income. The major ethical concerns of working with these people are they should be provided the right type of care and they deserve it. Nurses always act as good patient communicators or on their behalf of them (Maskell, 2020). They can help them by advocating these issues to the concerned authorities or government to intervene and support them economically (e.g., insurance coverage offered by the employers ).

Reference

Maskell, James. (2020). The Community Cure: Transforming Health Outcomes Together. New York: Lioncrest Publishing

Certain populations are vulnerable and at a higher risk for acquiring a disease or disorder. Vulnerable populations are people who require special attention such as age, mental or physical disability, poverty, or ethnicity. Much of the vulnerable population have social determinants of health (SDOH) that can contribute to the individuals’ vulnerabilities. A public health nurse (PHN) can educate and protect people from health risk and vulnerabilities. Many programs such as Medicaid, welfare, and food stamps are available for the vulnerable population. One group of individuals that are vulnerable are people without insurance because they may not always be truthful with healthcare needs due to fear of cost. A (PHN) can educate individuals with no insurance on low cost or free healthcare and screenings.

A PHN can also help uninsured individuals find resources in finding health care coverage. Uninsured Americans were able to get more health coverage over the years, with 44 million in 2013 uninsured to 28 million in 2016 (Falkner, 2018). “Knowing a population’s characteristics, including their vulnerabilities and resources, can help public health professionals determine possible effects of health problems or environmental conditions on disease trends” (CDC, 2022).

References

CDC. (2022, February 22). Populations and Vulnerabilities. Retrieved from https://www.cdc.gov/nceh/tracking/topics/PopulationsVulnerabilities.htm

 

Falkner, A., (2018). Community as Client. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/3

 

Topic 3 DQ 1: Vulnerable Populations

Despite the need for accessible and affordable care, not all populations receive care that matches their needs. Vulnerable populations are at a huge disadvantage, and they comprise individuals (groups and communities) at a high risk of poor health stemming from social, economic, and political barriers. Most barriers that vulnerable populations face can be avoided with a change in cultural mindsets and determination to transform their lives. Populations facing limitations due to illness and disability also comprise the vulnerable populations.

A fitting example of vulnerable populations in the United States is the LGBTQ + people. Due to their sexual minority nature, LGBBTQ+ needs are not comprehensively addressed. They are a vulnerable population since they are socially discriminated against, abused, and stigmatized even in health care settings. Such mistreatment increases the rates of mental disorders among LGBTQ+ individuals (Office of Disease Prevention and Health Promotion, 2022). Demographic statistics indicate that LGBTQ+ comprises about 8% of the USA population. This makes up about 20 million adults (Powell, 2021). Besides mental health problems, substance abuse and suicide are high among LGBTQ+. Stigma deters them from seeking immediate care when in need, and a significant proportion seeks solace in drug abuse.

Discrimination is the main barrier hampering LGBTQ+ individuals’ ability for self-advocacy. Society is yet to fully accept their sexual orientation and gender identity (Office of Disease Prevention and Health Promotion, 2022). As a result, they cannot readily discuss their health problems with family members or visit health care facilities for medical support since fairness is not guaranteed. Ethical issues that must be considered when working with LGBTQ+ individuals and other populations include privacy and respect for their identity, and respect for individual beliefs. Health care providers should primarily focus on health issues and ensure vulnerable populations get the attention they deserve regardless of their beliefs, cultures, and sexual orientation. Nursing advocacy would be beneficial for promoting equality in health care delivery and fighting for the safety of weak groups (Abbasinia et al., 2020). It can also help to promote access to care and the development of policies that protect such populations from abuse and discrimination.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics27(1), 141-151. https://doi.org/10.1177%2F0969733019832950

Office of Disease Prevention and Health Promotion. (2022). Lesbian, gay, bisexual, and transgender health. https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

Powell, L. (2021). We are here: LGBTQ+ adult population in United States reaches at least 20 million, according to human rights campaign foundation report. Human Rights Watch. https://www.hrc.org/press-releases/we-are-here-lgbtq-adult-population-in-united-states-reaches-at-least-20-million-according-to-human-rights-campaign-foundation-report