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L3: Vulnerable Populations (final population health lecture)

Terms in this set (68)

___________________ is susceptibility to actual or potential stressors that may lead to an adverse effect.
vulnerability
________________ ____________________ are groups of people that are typically considered to be at greater risk for poor health status and poor access to healthcare.
vulnerable populations
________________ ______________ __________ are a subgroup of the population that is more likely to develop health problems as a result of exposure to risk and to have worse outcomes than the rest of the populations.
vulnerable population groups
___________________ ________________ are wide variations in health services and health status among certain population groups.
health disparities
Why are vulnerable populations more sensitive to risk factors and more likely to suffer from health disparities ?
they are often exposed to multiple cumulative risks
___________________ results from the combined effects of limitations in physical environment, personal resources, and biopsychosocial resources.
vulnerable
What are the social determinants of health by the WHO?
-income and social status
-education
-physical environment
-social support network
-genetics
-health services
-gender
True or False:
Vulnerable populations often have worse health outcomes than that of other people in terms of morbidity and mortality.
True
What is the cycle of vulnerability?
-poor health creates stress as individuals and families try to manage health problems with inadequate resources
-sometimes when one problem is solved, another quickly emerges
-leads to feelings of hopelessness
What did the social security act of 1935 do?
-largest federal support program for elderly and poor
-Created the largest federal support program for elder and poor Americans in history. It was intended to ensure a minimal level of support for people at risk for problems resulting from inadequate financial resources. This was accomplished by direct payments to individuals.
What did the social security act amendment of 1965, Medicare & Medicaid do?
added elderly care and the disabled
-Medicare, and Medicaid provided for the health care needs of elderly, poor, and disabled people who might be vulnerable to impoverishment resulting from high medical bills or to poor health status from inadequate access to health care. These acts created third-party health care payers at the federal and state levels.
What did the Title XXI for the SSA in 1997 do?
-Provides for the State Children's Health Insurance Program (SCHIP) to provide funds to insure currently uninsured children.
What did the affordable care act do?
-Made affordable health insurance available to more people.
What did the balanced budget act of 1997 do?
-Influenced the use of resources for providing health services. To curb the rapid growth in spending on home health and fraud in that industry, the Health Care Financing Administration moved toward prospective payment for home health services. The goal is to ensure that care is appropriate, rather than limited to access.
What did the health insurance portability & accountability act (HIPPA) of 1996 do?
intended to help people keep their insurance when moving
What did the patient protection and affordable care act of 2010 do?
...
True or False:
There is a trend toward providing more comprehensive, family-centered services when treating vulnerable populations groups.
True `
There is a trend toward providing more comprehensive, family-centered services when treating vulnerable populations groups. What is this trend called?
-wrap around services
What objectives emphasize improving health by modifying the individual, social, and environmental determinants of health?
health people 2020
True or False:
Individual perception of poverty and poor persons are deeply rooted in social, political, cultural, and environmental factors.
True
True or False:
It is not important, as a nurse, to understand your own beliefs about poor and homeless persons. Just take what you know and that is enough.
False
_____________ refers to having insufficient financial resources to meet basic living expenses.
poverty
________________ poverty are individuals and families who remain poor for long periods of time. (multigenerational)
persistent
_______________ poverty is a geographically defined area of high poverty, characterized by rundown housing, high unemployment rates.
neighborhood
What is the definition of poverty for a family of 4?
income level of $24,000
Most of those in poverty are ages ____-_____.
18-64
Where geographically is poverty the heaviest?
south
True or False:
Those in poverty have higher rates of chronic illness, higher infant morbidity and mortality, and shorter life expectancy.
True
Poverty can lead to ________________.
homelessness
What are the two predominant ways to determine the number of homeless people?
1) point-in-time counts (counting the number of persons who are homeless on a given day)
2) period prevalent counts (examines the number of people who are homeless over a given period of time)

*These methods typically undercount those who are homeless because they fail to visit many locations where those who are homeless stay
What are the two broad categories of homelessness?
Crisis poverty (transient or episodic)
-stay in shelters
-tend to be younger
-represent the majority of the homeless

Persistent poverty (remain poor for longer periods of time and is often multigenerational)
-chronically homeless
-4 episodes of homelessness in the past 3 years
-typically older population
-smaller proportion of homeless
how many people experience homelessness on any given night in the US?
1/2 million
Homelessness affects which more:
-gender?
-ethnicity?
-males
-whites
What are common diseases related to homelessness?
-hypothermia and hyperthermia
-infestations and poor skin integrity
-peripheral vascular disease and HTN
-diabetes and nutritional deficits
-respiratory infections and COPD
-tuberculosis
-HIV/AIDS
-trauma
-mental illness
-use and abuse of tobacco, alcohol, and illicit drugs
Homelessness can lead to health issues when....
-eat whatever, whenever and mostly simple carbs
-live out in the elements in an unsafe environment
-don't always have access to water
-unable to meet hygiene needs
-no dental care or have supplies for dental hygiene
-crime (sleeping with one eye open)
-walk all day in shoes that were donated to you
-stay in crowded shelters
-have very limited access to healthcare
-many drinks or use drugs
-may have a mental illness
-are surrounded by no green space
A _______________ farmworker is a seasonal farmworker who must travel to do farm work and is unable to return to a permanent residence within the same day.
migrant
A ________________ farmworker returns to his permanent residence, works in agriculture for at least 25 days, and does not work year round only in agriculture.
seasonal
What five states account for 65% of all migrant seasonal farm workers?
-california
-florida
-washington
-oregon
-north carolina
What is the migrant health act (1962)?
provides funds for primary and supplemental health services to migrant seasonal farmworkers and their families
What are barriers to healthcare for migrant workers?
-gender
-immigration status
-migrant status
-english proficiency
-access to transportation
-health status
What are factors that limit adequate provision of health care services?
-lack of knowledge about services
-inability to afford care
-health insurance subsidies
-availability of services
-transportation
-hours of service in hospitals
-mobility & tracking
-discrimination
-documentation
-language
-cultural aspects of healthcare
Why is the national data that is needed to present a clear picture of health of migrant seasonal farmworkers unavailable?
-high annual turnover
-language
-mobility
-concern for immigration status
What health issues are migrant seasonal farmworkers at a high risk for?
-chronic disease
-poor dental health
-mental health problems
-work injuries
-chemical exposures
-food insecurity
__________________ work ranks as one of the most dangerous industries in the US.
agriculture
_____________ exposure can occur from direct spraying, wind drifts, contact with crops, bathing, drinking, and eating.
pesticide
True or False:
worker housing is typically located very close to fields that have been sprayed with pesticides.
true
True or False:
Workers are NOT required to have protective clothing to prevent pesticide exposure.
True
What problems plague the children and youth of migrant farm workers?
-malnutrition
-poor housing
-infectious disease
-dental carries
-inadequate immunization status
-pesticide exposures
-injuries
-disruption of their social and school lives increases anxiety problems
-adolescent farm workers
-older siblings staying home to care for younger siblings
At times because of _____________________ relationships with others, Mexican individuals and families may appear to understand what is being said to them (by nodding their heads) when in actuality they do not understand.
nonconfrontational
True or False:
Mexican patients may not seek health professional care first, instead, they consult with family, friends, or folk healers.
True
True or False:
Mexicans may be more willing to follow advice from another Mexican individual with a similar health problem than the advice of the health professional
True
Socially _______________ people are at an increased risk from almost every cause of disease and death.
isolated
What is the latino paradox?
the good health that many immigrants arrive to the US with comes with an expiration date within a generation
__________________ is the ability to resist the effects of vulnerability. It is important to learn what factors make some people more resistant than others.
resilience
Vulnerable population groups include...
poor and homeless
pregnant adolescents
migrant workers and immigrants
the severely mentally ill
substance abusers
those who have been abused and victims of violence
people with communicable diseases and those at risk
people with HIV or hepatitis B
people with sexually transmitted diseases.
Vulnerability results from the combined effects of limited ____________________: environmental, physical, personal, biopsychosocial, human capital, etc.
resources
What are predisposing factors to vulnerability?
-social and economic (poverty)
-age (very young and very old)
-health (changes in normal physiology- disease processes)
-life experiences (negative experiences)
________________ is the prime cause of vulnerability.
poverty
What are the 2 major outcomes of vulnerability?
poor health outcome
cycle of vulnerability
True or False:
Our perceptions of poverty are rooted in social, political, cultural, and environmental factors.
True
True or False:
Perspectives about individual responsibility for health and well-being are influenced by prevailing cultural attitudes
True
True or False:
The nurse should consider her own personal beliefs and attitudes, clients' perceptions of their condition, and the social, political, cultural, and environmental factors that influence the client's situation
True
What factors have affected the growing numbers of poverty in the US?
-decreased earnings
-increased unemployment rates
-changes in the labor force
-increase in female headed households
-inadequate education and job skills
-inadequate antipoverty programs
-inadequate welfare benefits
-weak enforcement of child support statuses
-dwindling social security payments to children
-increased numbers of children born to single women
-trade deficits, debt, involvement in wars
-outsourcing of american jobs
The Stewart B. McKinney Homeless Assistance Act defines a _______________ person as 1) an individual that lacks a fixed, regular, and adequate nighttime residence; 2) an individual who has a primary nighttime residence that is a) a supervised publicly or privately operated shelter designated to provide temporary living accommodations b) a public or private place not designed for a regular sleeping accommodation for human beings.
homeless
True or false:
poor health is often a cause and an outcome of homelessness.
true
What is a seasonal farmworker?
One who returns to his permanent residence, works in agriculture for at least 25 days or parts, and does not work year round only in agriculture
What is a migrant farmworker?
A seasonal farmworker who must travel to do farm work and is unable to return to a permanent residence within the same day
What problems have plagued rural areas occupied by migrant farm workers?
Scarcity of health professionals, poverty, limited access to services, lack of knowledge, and social isolation
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