Vulnerable Populations

Objectives• Identify populations considered to be

vulnerable• Describe health care disparities• Define and understand the importance of

cultural competency as it relates to self and others

In the USA today:

• As of April 2009,the population is 306,269,974 million people

• Many are considered to be vulnerable and at risk for health disparities

• Health disparities are inequalities in health status due to gender, race/ethnicity, education, disability, geographic location or sexual orientation

Example: Black infants have higher mortality rates than white infants.

• Source: Health Resources & Services Administration-2006

Health Disparities

Why is that? A Look into Health Disparities(Go to You Tube)

Who are the Vulnerable?• Racial & ethnic

minority groups• Uninsured• Underinsured • Low income children• Frail older adults• Mentally/ physically

disabled

• Homeless• Rural Americans • Immigrants/Migrant

Farm workers• People with HIV/AIDS

What Social Factors affect the Vulnerable?

•Poverty- Poverty is defined by family income and the number of people in a family. This determines amount of assistance.•Lack of education- Low literacy, lack of communication skills, and minimal understanding of disease prevention and healthy practices.•Lack of access- No insurance and/or transportation, isolation.

Discussing Specific Vulnerable Populations

Refer to Worksheet

UnderstandingCultural Competency

Culture is the shared values, traditions, norms, customs, art, history, folklore, language of a group of people.

Culture is made up ofmany aspects:• Race • Ethnicity

• Hometown • Religion• Experiences • Spirituality• Talents • Abilities• Disabilities • Languages

Avoid stereotyping:• Individual-two people may be from the

same race but it doesn’t mean they have the same religious beliefs.

• Always changing-as one goes on to college, they leave the high school culture behind

• Multi dimensional- a person can be a student, a sports mate, a sister or an immigrant at the same time

Language Barriers According to the Census Bureau

• A total of 215,423,557 people speak English• A total of 46,951,595 people speak another

language:– 28,101,052 speak Spanish– 2,022,143 speak Chinese – 1,643,838 speak French– 706,242 speak Russian– 614,582 speak Arabic

Source: U.S. Census Bureau, Census 2000 Summary File 3, www.census.gov.

Language statistics• There are more than 100 languages

designated as “official” by governments worldwide. The United Nations has six official languages:

English-French-Spanish-Russian Chinese & Arabic

Did you know? Chinese (Mandarin) -most widely spoken language in the world. English is the second! Source: National Virtual Translation Center; www.NVTR.gov.

A culturallycompetent person:• Is aware of his/her own cultural heritage• Respects the culture of others, clients

and staff• Knows that culture is mulitfacted• Recognizes barriers such as language

differences when communicating• Reflects on experiences with people of

other cultures• Avoids stero-typing individuals

Summary•There are many different types of vulnerable populations.•Poverty, lack of education and lack of access are social factors affecting vulnerable populations.•Culture is the shared values, traditions, norms, customs, art, history, folklore, language of a group of people. •No one has a single culture.

Little or no insurance• More than 47 million people in the U.S. are

“uninsured” because they don’t have or can’t afford health insurance (15.8% of Americans).

• More than 25 million people in the US are “underinsured” because even though they have insurance they can’t afford the co-pay or other out of pocket expenses.

• Social Factor-lack of access.

Low Income Children• There are 28 million

low income children.• Poverty affects

physical/ mental development & school achievement.

• Social Factor-poverty.

Source: National Center for Children in Poverty, 2007 www.nccp.org

Aging Population• Between 2010 and 2015,

those age 65-84 will go from 38.5 million to 43 million! This is an increase of 4.5 million people in just 5 years

• In the last 10 years the number of centenarians (100+) has doubled

• Many face day to day challenges with physical & mental ability

• Many living below the poverty level

• Social Factor- Poverty, Access• Source: 1999 Census Report

The Homeless

• Families make up 41% of the homeless population

• In 2005 an average of 744,000 experienced homelessness

• In 2007, it is reported that 1 in 50 children are homeless Almost half are under the age 6

• Social Factor-varySource: The National Center on Family

Homelessness, 2007 MSBNC

Those with Disabilities orSpecial Needs• Those disabled due to a progressive illness or a

sudden accident.• Includes the blind or those with low vision, the

deaf or hard of hearing.• The medically fragile: unstable conditions & those

with HIV/AIDS, Diabetes, or those on life-sustaining medications.

• Those with physical limitations.• Those with mental disabilities.• Social Factors-vary Source: Commonwealth Fund 2006

Rural Americans

• 20% of Americans live in rural areas but only 10% of doctors practice there.

• Many have long distances to travel for health care.

• Results in less visits and less preventive care.

• Social Factor-Lack of accessSource: 2004 National Health Care Disparities Report

Immigrants / Refugees• Immigrants can be invisible in our

communities• Isolated from health care services.• Lack legal status, afraid they will be reported.• Need interpreters due to language barriers.• Fear discrimination. • Suffer from chronic illness, diabetes, asthma,

heart disease, and obesity.• Have mental health needs due to trauma of

relocation & culture shock.• Social Factor-Poverty, Lack of access,

education Source: Robert Wood Johnson Foundation

2006

Migrant Workers• 2.5 million persons hired as

seasonal and migrant workers.• 70% work in crop agriculture.• Suffer from muscle and joint

problems, depression, and STD’s.

• Mainly Latino , Mexican, Guatemalan, Puerto Rican, Caribbean, Jamaican.

• Social Factors-Poverty, Lack of access, education

Source: Migrant Clinicians Network, 2009