Running head: VULNERABLE POPULATIONS
Vulnerable Populations
Nanette Brown
NURS 340
Ferris State University
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VULNERABLE POPULATIONS
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Vulnerable Populations
Vulnerable populations in healthcare are defined as those individuals or groups of people
that there is a noted gap or difference in the healthcare they receive as opposed to the general
public (Harkness and DeMarco, 2012 p. 32). There are a variety reasons that individuals or
populations fall into the vulnerable or underserved populations in healthcare. Race and culture
are not the only factors, for example gender, sexual orientation, particular diseases, lower
socioeconomical status or geographic location can play a role in healthcare disparities (Healthy
People 2020, 2013). The vulnerable population focused on in this paper are Spanish speaking
Hispanics. It is an exploration of my own personal bias and information on their healthcare
gathered from research on this population.
Providing nursing care to Spanish speaking patients has been a struggle for myself in my
nursing career. I find it frustrating primarily due to the fact that the language barrier interferes
with my ability to give the best care that I can. I am not confident that the patient understands
their illness, treatments and care given. I do not feel as though I understand what all of their
needs are. It gives me a feeling of inadequacy; that I am not able to care for my patient the way I
would like to. Another issue for me is that it takes much more time to care for them thus taking
away time from my other patients. That being said, I do feel all patients should have access to
and receive quality health care.
It is apparent to me that we fail some of these patients when I see they are readmitted to
the hospital for complications or worsening of their disease because they did not understand to
take their medication or have a means to get it or understand their aftercare/discharge
instructions. For example, I had a family continue to give water to their family member with
severe dysphagia which resulted in many admissions for aspiration pneumonia. Not only was it
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not well understood why the patient could not have anything by mouth but I believe culture
played a part also. Fortunately with the advent of language lines and more interpreters available
than when I first entered the nursing field; communication with this population has improved.
We also now have many patient education materials available in Spanish which is also has also
improved communication. However there still is room to further enhance communication thus
providing better health care to this population.
In a study of nearly 18,000 Hispanics by DuBard, C. and Gizlice, Z. (2008) the following
demographic characteristics where found. Of the Spanish speaking population include lack of
education, 59% of Spanish-speaking Hispanics have less than a high school education compared
to 18% of English- speaking Hispanics. Low socioeconomic status having an income less than
$15,000 was reported in 36% of the Spanish-speaking as compared to 15% of English-speaking
Hispanics even though more than 60% of both groups had jobs. Lack of health insurance was
higher in the Spanish-speaking population; 55% as compared to 23% of English-speaking
making access to care more difficult for the Spanish-speaking. According to the United States
census (2011) 69% of all Hispanics have health insurance and 30% are uninsured. In the State of
Michigan there are 89,953 Hispanic people (State of Michigan, 2012). In Montcalm County
3.1% of the population is Hispanic compared to 4.4% in Michigan (Mid-Michigan District
Health Department, 2013).
Living in an area where more Spanish-speaking people live seems to increase access to
care (Gresenz, C., Rogowski, J. & Escarce, J., 2009). This was felt to be possibly due to having a
stronger social networks and being able to aid one another in accessing care. Both studies found
that few have a primary care physician (PCP), 58% Spanish-speaking compared to 29% Englishspeaking do not have a PCP (DuBard & Gizlice, 2008). There tends to more Spanish-speaking
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physicians in areas that have a larger population of Spanish-speaking individuals (Gresenz et al.
2009).
Although research supports that there is a huge disparity in health care for Spanishspeaking Hispanics, it is not for the same reason that I am biased. It is my lack of comfort in
being able to give good care with the language barrier. Therefore I would say the research did
not change my bias, but did open my eyes to how large this population is in the United States;
many of which do not have access to health care. In looking at the number of individuals who
speak Spanish I do feel as a professional that I should do something to lessen the barrier. Perhaps
after school I will take some Spanish classes for health care workers. Maybe having classes in
Spanish should become part of all health career education; not that everyone would be proficient
but would at least have some ability to speak or understand the language. If we can communicate
better with the Spanish-speaking population, we have the opportunity to understand their needs,
improve education for them regarding their health care needs and the need for preventative
health care. Based on the size of this population we have tremendous job ahead of us to lessen
the disparities in healthcare for this group of people.
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References
DuBard, C., & Gizlice, Z. (2008). Language spoken and differences in health status, access to
care, and receipt of preventive services among U.S. Hispanics. American Journal of
Public Health, 98(11), 2021-2028. doi:10.2105/AJPH.2007.119008
Gresenz, C.,Rogowski, J. & Escarce (2009) Community demographics and access to health care
among U.S. Hispanics. Health Services Research, 44(5) pp.1542-1562.
doi:10.1111/j1475-6773.2009.00997.x
Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing: Evidence for
practice. Philadelphia, PA: Lippincott Williams & Wilkins.
Healthy People 2020 (2013) disparities. Retrieved from:
http://healthypeople.gov/2020/about/DisparitiesAbout.aspx
Mid-Michigan District Health Department (2013) Montcalm county community health
assessment. Retrieved from:
http://www.mmdhd.org/cha/montcalm/CHA_Montcalm_Co_Profile.pdf
State of Michigan (2012) Census and demographics data. Retrieved from:
http://michigan.gov/cgi/0,4548,7-158-54534-305736--,00.html
United States Census (2011) Hispanic population in the United States: 2011. Retrieved from:
http://www.census.gov/population/hispanic/data/2011.html
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VULNERABLE POPULATION SCHOLARLY APA PAPER (Individual)
Scholarly paper 2-3 pages in correct APA format. The focus of the paper will be on health
disparities; an analysis of the etiology of the health disparity; (how the determinant(s) and
culture can affect disparity; and an analysis of how personal bias can affect health care delivery.
In this paper it is acceptable to speak in first person due to the personal reflection component.
NUR 340 Vulnerable Populations and Self-Awareness Paper Rubric
Vulnerable Population and Self-Awareness Paper
Total possible
points=150
Content: 100 points possible
Points Points
earned possible
Vulnerable population clearly identified. Include factors that
can cause vulnerability. Describe your personal awareness
of this population (attitudes, biases, stereotypes) before
studying the demographics.
Describe demographics of the population based on research
of professional literature and Web sites including local, state,
or national levels.
State the effect of research on personal attitudes after
gathering knowledge.
60
60
60
60
Pts
earned
Pts
possible
30
30
Use a self- reflection to evaluate your perception
before and after learning about the population
Include how knowledge of bias might affect delivery of
health
care. Include how this knowledge of bias can improve
public policy regarding care of vulnerable populations.
Paper Organization and Mechanics :30 points possible
The content is scholarly, comprehensive, and accurate, and the
paper is directed toward a nursing audience with a professional
tone appropriate to the content and assignment. The
introduction provides sufficient background on the topic and
previews major points. The conclusion is logical, flows from the
body of the paper, and summarizes the major points. The paper
structure is clear, logical, and easy to follow, and transitions
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between sections aid in maintaining the flow of thought.
The paper structure (including the title page, citations, and
reference page) follows APA format. Cite a minimum of four
references with at least three references from a peer reviewed
journal
Total Points Earned:
150
150