Health Disparities, Determinants, and Vulnerable Populations
These are inconsistencies in health determinants between population subgroups, resulting in differences in key indicators, such as immunization rates, life expectancy, morbidity, and mortality, among others. They exist in health outcomes, healthcare access, health-seeking behaviors, and risk exposure. Implicit provider stereotypes and prejudice against minority groups contribute to health disparities. For example, in my practice, most patients from racial minorities presenting for treatment are uninsured. They often make two or three visits weekly to the facility with the same complaint because they cannot afford physician prescriptions through out-of-pocket payments.
These are segments of the population expected to suffer from adverse health outcomes relative to other groups. “Vulnerability” may be due to age, gender, race, economic status, and disproportionate burden of disease, among others. In this regard, children, the elderly, the chronically ill, and American non-English speakers qualify as vulnerable populations based on different criteria. These groups are exposed to certain risks that predispose them to poor health outcomes compared to others. A common example from my practice is immigrant vulnerability. I find it a challenge to offer optimal nursing care to migrant patients who present with chronic conditions because they are often from disadvantaged backgrounds, ineligible for Medicare and Medicaid, and do not speak English.
Social Health Determinants
These are the socioeconomic factors that determine the health of a person or a population – conditions in the social, economic, and physical environment that impact health outcomes. Artiga and Hinton identify six social determinants of health, namely, income status, literacy, safe and affordable housing, occupation, social support, and availability of healthcare services. In one of my clinical encounters, I cared for an overweight, hypertensive patient who, for an unknown reason, was not taking his medication as prescribed. Upon interviewing him, I found out that he could not afford antihypertensive drugs, did not understand the impact of his actions on his health, and the prescriptions were unavailable in the local pharmacy. The social determinants of health specific to this case included low socioeconomic status, limited education, and transportation barriers.
My understanding of these terms before and after the readings
Through these readings, my comprehension of the meaning of the three terms has improved. I have always understood health disparity in the context of healthcare access. Now, I know that other factors, such as health behaviors and environmental risks, also create gaps in health between population subgroups. Further, I previously understood a vulnerable population to be an ethnic or racial minority group. However, from the readings, it is clear that characteristics such as age, gender, and disability increase vulnerability to adverse health outcomes.