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Vulnerable Populations. MODULE ONE: . Objectives. Students will: Name 2 populations considered to be vulnerable and at risk for health care disparities. Describe health care disparities facing vulnerable populations.

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Vulnerable Populations

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Vulnerable populations l.jpg

Vulnerable Populations

MODULE ONE:


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Objectives

Students will:

  • Name 2 populations considered to be vulnerable and at risk for health care disparities.

  • Describe health care disparities facing vulnerable populations.

  • Describe the importance of service and how YHSC volunteers can make a difference in their community.


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In the USA today:

  • The population is 280 million people.

  • 50 million people live in rural & urban communities, many are poor, racially and ethnically diverse, and many are with out access to primary health care.

  • These people and others are considered to be vulnerable and at risk for health care disparities.

    Source: Health Resources & Services Administration-2006


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What are Health Care Disparities?

Differences or inequalities in health care status due to gender, race/ethnicity, education, disability, geographic location or sexual orientation.

  • Example: African American, Asian, and Hispanics have more chronic disease, cancer & infections.

  • Native Americans are 2.5 times more likely to have diabetes that whites.

  • African American women are more likely to die of breast cancer than any other racial group.

  • Rural residents have more chronic conditions such as diabetes and are more likely to die of heart attacks.


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Health Care Disparities cont’d

  • African American infants are 2 times more likely than others to die before the age of one.

  • Native Americans & Alaskans suffer more depression and more substance abuse issues than others.

  • In 2002, fifty percent of those infected with Hepatitis B were Asian and Pacific Islanders.

    Source: National Health Care Disparities Report- 2003


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Racial & ethnic minority groups

Uninsured

Underinsured

Low income children

Frail older adults

Mentally disabled

Homeless

Physically disabled

Rural Americans

Immigrants/Migrant Farm workers

People with HIV/AIDS

Who are the Vulnerable?


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Little or no insurance

  • 45 million people in the U.S. are “uninsured” because they don’t have or can’t afford health insurance.

  • 16 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.


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Low Income Children

Poverty affects physical and mental development and school achievement.

There are 13 million low income children.

16 % of families with children are hungry.


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Low Income Children

States with high levels of child poverty:

  • Texas 22%

  • West Virginia 23%

  • Mississippi 24%

  • Louisiana 25%

  • New Mexico 25%

  • Arkansas 30%


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Low Income Children

  • 35 % African American

  • 28% Latino

  • 29% American Indian

  • 11% Asian

  • 10% white

  • 26% children of immigrants

  • 20% under age 6

    Source: National Center for Children in Poverty

    Dec. 2006 Report


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Frail Older Adults

  • Elderly population age 80-90 is growing.

  • Many have physical & mental health problems.

  • Many live alone, rely on family, and can’t afford to pay for help at home. Medicare doesn’t pay for long-term care.

  • Have little financial reserves. In 2001, the median income for this age group was $14,000 (below poverty level.)

  • Baby boomer population growing. By 2050, those over age 85 will go from 4.3 million to 20.9 million!

    Source: 2002 Health and Retirement Study


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The Homeless

  • In the United States, approximately 3.5 million people experience homelessness each year.

  • Families with children make up 50% of the homeless population.

  • The homeless population is growing.

  • Children under the age of 18 account for 25% of the urban homeless population.

  • 51% of the homeless population are peoplebetween the ages of 31 and 50.


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The Homeless

  • Approximately 23% homeless adults suffer from some form of severe and persistent mental illness.

  • Addiction disorders, such as drug abuse and alcoholism, affect about 30% of the homeless population.

  • Shelters are overcrowded or filled to capacity.

  • The two most common causes of homelessness are substance abuse and mental illness.

  • The federal and state programs that provide assistance are only short-term solutions.


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The Homeless by Race

  • In 2003, the homeless population was:

    • 49% African American

    • 35% Caucasian

    • 13% Hispanic

    • 2% Native American

    • 1% Asian

    • Like the total U.S. Population, the ethnic makeup of the homeless varies according to geographical location.

      Source: www.Endhomelessness.org


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Adults 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.

    Source: Commonwealth Fund 2006


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Rural Americans

  • 20% of Americans live in rural areas but only 9% of doctors practice there.

  • Many have long distances to travel for health care.

  • Results in less visits and less preventive care.

    Source: 2004 National Health Care Disparities Report


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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.

  • Lack transportation and insurance.

  • Suffer from chronic illness, diabetes, asthma, heart disease, and obesity.

  • Have mental health needs due to trauma of relocation & culture shock.

    Source: Robert Wood Johnson Foundation 2006


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Migrant Farm Workers

  • 2.5 million persons hired as seasonal and migrant workers.

  • 70% work in crop agriculture.

  • Relatively young and mostly male (sexually active).

  • Single or married but away from family (depression).

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

  • Average of 6 years of formal education.

  • Poor (weigh illness against wages).

  • 1/3 are undocumented (fear of accessing care).

    Source: Connecticut Migrant Health Network


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Social Factors affecting the Vulnerable: Poverty

  • Poverty is defined by family income and the number of people in a family.

  • Poverty guidelines help determine financial eligibility for assistance.

  • Example: Children in a family of 4 that has an income of $20,000 or less are considered poor and eligible for some state health care programs.

    Source: US Dept. Health & Human Services 2006, Poverty Guidelines


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Social Factor: Lack of Education

  • Lack of health education & prevention of disease.

  • Low literacy levels- unable to read & understand doctors orders or medication labels.

  • Lack of skills to communicate with the doctor.

“Those with the greatest health care needs may have the least ability to read and comprehend information…” AMA Report 1998


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Lack of Access to health care - no insurance, job or money to pay for insurance

No transportation to get to the doctor

Isolation- in some rural areas, no health care close by

Examples: Part time worker doesn’t qualify for health care benefits

Rural elderly may live over 100 miles from the nearest hospital.

Social Factor: Lack of Access


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HRSA-Health Resources & Services Administration- U.S. Federal agency

  • Responsible for increasing access to and quality of health care for all especially those who are vulnerable (AHEC’s are part of HRSA).

  • Improving outcomes & quality of health care.

  • Eliminating health disparities.

  • Increase Health Care Response in Public Health Emergencies.


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HRSA Workforce Goals

Increase the health care workforce by:

  • Recruiting more under-represented people to health careers.

  • Increasing the cultural competency of health care providers.

  • Improving the distribution & retention of the workforce in underserved areas, including rural & border areas.


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HRSA Health Disparities Goals

Eliminate health disparities by:

  • Increasing the early screening of children for special health care needs.

  • Raising awareness about major health risks through education & outreach to vulnerable populations.


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Summary: the Impact of Service-What can YOU do?

  • Volunteer at community sites such as shelters, community centers.

  • Reach out to low income children in after school programs and community settings.

  • Volunteer with professionals to educate about and prevent health problems.

  • Be part of the solution! Volunteer!

  • YOU CAN MAKE A DIFFERENCE!


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