Running head: VULNERABLE POPULATIONS
Vulnerable Populations
Karin Mogren-Kuzma
Ferris State University
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VULNERABLE POPULATIONS
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Abstract
The purpose of this paper is for the author to assess and analyze health disparities and her own
attitudes and bias in regards to vulnerable populations. Vulnerable population demographics are
identified in addition to the etiology of vulnerability. Included is an analysis of how personal
bias and bias in the healthcare system may reflect delivery of care. Vulnerable populations are
defined as individuals, in various categories, whom tend to have a poor health status as compared
to the general population and are at a greater risk of having poor physical, psychological, and
social health outcomes. The demographics include the uninsured, the economically
disadvantaged, racial and ethnic minorities, low income children, those with human
immunodeficiency virus (HIV), the elderly, the gay, lesbian, bisexual and transgender people
(GLBT), mental illness, immigrants and refugees, drug abusers and residents of rural areas with
barriers to healthcare access. The etiology of health disparity is believed to be the result of
complex environmental interactions and a longstanding history of discrimination (AJMC, 2006).
Negative stereotyping is fairly common in the healthcare setting. Being aware of how bias can
affect care is important to understand as a professional. After conducting scholarly research of
vulnerable populations, the author has gained a better understanding of the implications and the
various groups’ susceptibility for vulnerability and how it relates to health and wellbeing. In
order to improve health outcomes for this population, biases must be eliminated and healthcare
providers must adopt nonjudgmental attitudes.
Keywords: Vulnerable populations, healthcare disparity, bias, stereotypes
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Vulnerable Populations
Vulnerability or the susceptibility to harm is a risk to all individuals. However,
vulnerable populations are diverse social groups, with an increased risk for poor health outcomes
due to certain specific factors. The purpose of this paper is to explore the etiology of vulnerable
populations and determinants of health care disparities. The discussion includes identifying
aspects of vulnerability such as poverty, race and related issues of stigma and discrimination.
Additionally, an analysis of stereotyping amongst vulnerable populations, in the healthcare field
and how bias affects delivery of care, is provided.
Who They Are
In regards to healthcare, vulnerable populations are defined as individuals, in various
categories, whom tend to have a poor health status as compared to the general population and are
at a greater risk of having poor physical, psychological, and social health outcomes. According
to the American Journal of Managed Care (AJMC), vulnerable populations include the
economically disadvantaged, the uninsured, the homeless, racial and ethnic minorities, low
income children, those with human immunodeficiency virus (HIV), the elderly, the gay, lesbian,
bisexual and transgender people (GLBT), and those with chronic health conditions, including
severe mental illness. Additionally, incarcerated men and women, immigrants and refugees,
drug abusers and residents of rural settings who encounter barriers accessing healthcare services
are also considered vulnerable populations (AJMC, 2006).
The etiology of health disparities and vulnerability are believed to be the result of
complex interactions among environmental factors, personal health behaviors, social factors and
genetic variations. Specifically, socioeconomic factors, language, discrimination, race, ethnicity,
age, sex, low income, lack of insurance, and cultural barriers is factors identified to cause or
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enhance vulnerability. As an illustration, cultural beliefs and practices may determine when and
if an individual seeks medical care (AJMC, 2006).
I personally describe vulnerable populations as groups of people, which due to various
life circumstances, are disadvantaged economically or socially and are frequently faced with
unjustified, preconceived attitudes and bias. I believe that generalizations or stereotypes held by
the general public regarding particular social groups are more common than we like to admit;
especially in the healthcare field. Stereotyping does not usually reflect reality or facts correctly.
I believe the reason for this is because stereotypes infrequently change, and we often accept
stereotypes from other people. Unfortunately, negative stereotyping is commonly encountered
and as a nurse caring for diverse patient populations, it is important to recognize personal bias to
ensure it does not affect the care I am providing.
Demographics
As mentioned previously, vulnerable populations refer to social groups with increased
relative, or susceptibility to health-related problems. According to the Centers for Disease
Control and Prevention (CDC), demographic factors of vulnerable populations include
race/ethnicity, low socioeconomic status, low education level, old age, rural geographic location,
disability, primary language spoken, religion, and risk status related to sex and gender (CDC,
2012). Income status is identified as a powerful variable that explains health disparities. The
AJMC explains that chronic illnesses are more prevalent among the uninsured, unemployed, and
less educated (AJMC, 2006). Language and cultural barriers is another salient factor that plays a
major role in access to healthcare in addition to the physical environment. Sexual preference is
also identified as an indicator for health disparities. According to McKirnan, Du Bois, Alvy, and
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Jones (2013), homosexual men appear to have less access to healthcare and experience more
barriers to healthcare compared to heterosexual men (McKirnan et al., 2013).
Self Reflection
After researching and gathering data regarding populations that are considered
vulnerable, I realize that vulnerability is prominent in more groups of people than I initially
thought. Prior to researching this topic, I portrayed vulnerable populations as mostly ethnic
minorities and uneducated individuals living at or below poverty level, in rural areas. However,
I have gained a new understanding that health disparities also apply to population groups the
opposite of my preconceived view, for example, the GBLT population. McKirnan et al., states
that perceived stigma may lead this population group to not seek out medical services, and
morbidity can be predicated by nondisclosure of sexual orientation because of implications for
treatment and transmission of HIV and other sexually transmitted infections (McKirnan et al.,
2013). Understanding that cultural, educational, and geographical barriers are not the only
determinants of vulnerability will help me better assess my patient’s needs. The literature
demonstrates that healthcare outcomes and disparities are associated with “the existence of
unconscious or unintentional bias on the part of healthcare providers” (Aronson, Burgess,
Phelan, & Juarez, 2013, p. 50). Bias in healthcare can generate negative relationships between
the healthcare provider and patient. Self-awareness of personal bias, while ignoring stereotypical
comments regarding patients is important in providing quality care, free of prejudice.
I believe that in order to improve health outcomes amongst vulnerable populations,
healthcare providers must eliminate their biases and understand the stigma, intolerance, and
discrimination that these individuals frequently experience. I believe the unpleasant experience
of negative stereotyping directly affects the avoidance of healthcare and therefore, less
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appropriate care. The sooner we can eliminate bias and stereotypes in healthcare, the sooner
vulnerable populations will decline in numbers.
Conclusion
Vulnerable populations are individuals that due to societal and environmental factors are
at higher risk for mortality and morbidity, lower life expectancy, reduced access to care, and
diminished quality of life. Stereotyping of these social groups is common and adds to their
discrimination and disassociation from mainstream society. As a professional, it is important to
explore what my personal biases might be and eliminate them in order to give my patients the
care and compassion they deserve. To reduce and eventually completely eliminate health
disparities, healthcare professionals must examine and put an end to their own prejudice and
adopt a nonjudgmental attitude and openly accept the cultural differences and life choices that
cause these groups to be discriminated against.
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References
Aronson, J., Burgess, D., Phelan, S. M., & Juarez, L. (2013). Unhealthy interactions: The role of
stereotype threat in health disparities. American Journal of Public Health, 103(1), 50-56.
doi: http://0-dx.doi.org.libcat.ferris.edu/10.2105/AJPH.2012.300828
Centers for Disease and Control Prevention [CDC]. (2012).
http://www.cdc.gov/minorityhealth/populations/atrisk.html
McKirnan, D. J., Du Bois, S. N., Alvy, L. M., & Jones, K. (2013). Health care access and health
behaviors among men who have sex with men the cost of health disparities. Health
Education and Behavior, 40(1), 32-41. doi: 10.1177/1090198111436340
The American Journal of Managed Care [AJMC]. (2006). Vulnerable populations: Who are
they?. American Journal of Managed Care, 12(13), 348-532. Retrieved from
http://www.ajmc.com/publications/supplement/2006/2006-11-vol12-n13Suppl/Nov062390ps348-s352/1