Vulnerable Populations and Health Care Disparities

By Redman, Richard W. | Research and Theory for Nursing Practice, January 1, 2007 | Go to article overview

Vulnerable Populations and Health Care Disparities


Redman, Richard W., Research and Theory for Nursing Practice


The issue of vulnerable populations in health care can be examined on multiple levels. By definition, all consumers in health care are vulnerable; that is, the potential for harm or injury is almost always present. Consumers rely on and trust the providers and the delivery system to meet their needs with honesty and equity, delivering the best care possible that is safe, effective, and ethical. The term vulnerable populations is also closely related to health care disparities. Vulnerable populations often experience disparities in the health care they receive or in their outcomes of care. It is such disparities in treatment and outcomes that often are the focus of providers and researchers.

Statistics inform us that patients are extremely vulnerable and are at risk simply by entering the health care system. This is especially true for hospitalized patients, where the risk of errors occurring and potential for injury are much higher than the health care system or the general public are willing to accept (Page, 2004). Today, patient safety has become a universal concern in every type of practice setting.

Typically, the issue of vulnerable populations is examined more specifically with a focus on particular socially defined characteristics of groups of patients. Care received by a designated group is then examined and compared with the care received or the health outcomes demonstrated in society at large. These groups generally have some type of specially defined rights or are protected because of limited capacity of some type. This would include groups such as infants and young children, prisoners, and the cognitively impaired or mentally disabled. Groups of this nature are considered to have great vulnerability because they are generally less able to stand up for their individual rights or health care needs.

Despite ongoing improvement in the overall health of populations, racial and ethnic minorities generally still experience higher rates of morbidity and mortality. Considerable data exist about disparities, or differences, in health care related to race, ethnicity, and socioeconomic status. In fact, disparities are observed in almost all aspects of health care. Recent data reveal that disparities exist across all types of care, ranging from preventive care through management of chronic disease. Disparities also exist in many clinical conditions including heart disease, HIV/AIDS, substance abuse and mental health, cancer, diabetes, and end-stage renal disease. These disparities in treatment are found in all care settings. They also are found within many subpopulation groups such as children, women, elderly, and individuals with special health needs (Agency for Healthcare Research and Quality, 2006). Considerable opportunities exist for reducing disparities in health care.

One challenge that exists is defining the breadth and depth of disparities in health care. A model has been developed that identifies various sources and types of health care disparities. …

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