Promoting andProtecting the Health

ofVulnerable Aggregates

Prepared By Husain Mansour Ali

1.Rural Health Care.

2. Urban Health Care, Poverty, and Homelessness.

3.Migrant Families and Seasonal Workers.

4.Clients With Disabilities and Chronic Illnesses.

5.Clients With Mental Health Issues.

6.Clients in Correctional Facilities.

Content

Rural Health Care

• Definitions of Rural:

1. All territory, population, and housing units located outside of urbanize areas (UAs) and urbanized clusters (UCs).

2. Communities with >10,000 residents and county population <1000 people per square mile.

• Population Characteristics:

1. Age and Gender.

2. Race and Ethnicity.

3. Education.

4. Income and Occupations.

Rural Populations At Risk

1. Homeless Families: should (1) seek out homeless families, (2) assess

their health needs, (3) connect the families with available resources

(eg, health, financial, housing), and (4) remain connected with the

families until they have stabilized.

2. Perinatal Clients: The question is whether rural women have

adequate access to prenatal care to ensure the births of healthy

infants. Perinatal clients are pregnant women in the last half of

pregnancy and their newborn infants until 1 month of age.

Rural Populations At Risk cont.

3. The Elderly: the older adults are Vulnerable to the chronic and acute

health conditions that they experience.

4. The Mentally Ill: Rural residents experience mental illness as do people

in urban communities. Community health nurses need to be aware of

the mental health resources available in the rural community and

assist rural residents in obtaining those services.

5. Farm Workers: Agricultural workers operating family farms are another

population at risk.

Rural Nurse Characteristics

1) They have close community ties.

2) They are expected to be all things to all people.

3) Confidentiality is a concern because of blurring of social and professional roles.

4) Autonomy is important in retaining and satisfying rural nurses.

5) Rural nursing staffs are generally cohesive; there is less burnout than urban

nurses.

6) Rural nurses are seen as positive assets to their community.

Urban Health Care,Poverty, and Homelessness

• Poverty Define: To be poor is to have few or no material

possessions as well as inadequate access to family and

community resources. Low socioeconomic position in society

is determined by social and economic deprivation that

includes poor income, no accumulated assets, no access to

power, poor education, and low-status occupation.

Social Characteristics1) Marginalization: the poor are often marginalized, meaning that they live on the margins,

or edges, of society rather than in the mainstream. Another term used is disenfranchised.

2) Social status: is a person’s rank or standing in society. Social status is affected by gender, age, and race.

3) Social support: involves the quality of interpersonal ties between individuals; the strength and extent of these personal ties determine the individual’s abilities to cope with adversity.

4) Neighborhood Resources: include religious organizations, safe housing, crime-watch programs, good schools, libraries, safe and affordable day care centers, recreational facilities, public health care clinics, and other social services.

5) Gender and Age: growing numbers of women have fallen into poverty.

6) Employment Status:

7) Lifestyle:

Health Effects Of Poverty

• Increased Morbidity and Mortality: Public health professionals

are committed to reducing the greater risk of illness and death

that is caused by poverty. Using the three levels of prevention

(Primary Prevention, Secondary Prevention & Tertiary

Prevention).

• Reduced Access to Health Care: Low-income people are less

likely to have access to preventive and therapeutic health

services.

HOMELESSNESS

• Poverty results in homelessness when limited resources make

housing unaffordable.

1. Why Are People Homeless?

2. Health of the Homeless:

3. Programs to Help the Homeless:

Migrant Families andSeasonal Workers

• Farmworkers: are defined as having income derived primarily from

work in the agricultural industry. Seasonal farmworkers live in one

geographic location and labor in the fields of that particular area,

whereas migrant farmworkers travel to find agricultural work

throughout the year, usually from state to state.

• Demographics, Migrant Streams and Patterns, Migrant Lifestyle,

Recent Population Changes & Occupational Hazards.

HEALTH RISKS OF MIGRANTWORKERS AND THEIR FAMILIES

• The life expectancy of a migrant worker is 49 years, compared with 73 years for the general population.

• The migrant infant mortality rate is 125% higher than the national average.

• The death rate from flu and pneumonia is 20% higher than the national average.

• The rate of parasitic infection is estimated to be 11 to 59 times higher than that of the general population.

• The death rate from tuberculosis (TB) and other communicable diseases is 25 times higher than the national average.

• The hospitalization rate of migrant families is 50% higher than the national average.

The Role Of Community Health Nurses In Caring For A Mobile Workforce

1. Improving existing services.

2. Advocating and networking.

3. Practicing cultural sensitivity.

4. Using lay personnel for community outreach.

5. Utilizing unique methods of health care delivery.

6. Employing information tracking systems.

Clients With Disabilitiesand Chronic Illnesses

• International Classification of Functioning, Disability, and

Health (ICF) published by the World Health Organization

(WHO) in 2001. both impairments and handicaps were

removed. In the revised document, disability serves as a

broad term for impairments, activity limitations, or

participation restrictions. It is linked with functioning, a term

that encompasses all body functions, activities, and

participation.

Model of functioning and disability. (WHO. [2001]. ICF)

Organizations Serving The Needs Of The Disabled And Chronically Ill

• Government

• Private

The Role Of The Community Health Nurse

1. Clinician.

2. Educator.

3. Advocate.

4. Manager.

5. Collaborator.

6. Leaders.

7. Researcher.

Clients With Mental Health Issues

Factors That Influence The Vulnerability Of The Mentally Ill Population.

Vulnerable Mentally Ill Population

Psychological Variables

Psychological stress, Child neglect and abuse, Low self-esteem, Alcohol abuse &Drug abuse

Biological Variables

Family history of mental illness, Birth defects, Genetics, Traumatic

injuries & Illness Age

Sociocultural Variables

Economic stress Poverty Inadequate mental health services Inadequate family and community support Stigmatization

by community

Environmental Variables

Geography Excessive climate conditions Seasonal changes Noise, crowding,

crime Lead poisoning

Needs of the Mentally Ill

1.Physical Problems

2.Psychological Problems

3.Social Problems

Community Mental Health Resources

• Community Mental Health Centers

• Community Support Programs

• Mobile Crisis Teams

• Self-Help Groups

• Private Mental Health Services

Models for Preventing Mental Disorders

A. The Public Health Model: proposed population interventions

at three prevention levels: (Primary prevention, Secondary

prevention & Tertiary prevention).

B. The Mental Health Intervention Spectrum Model: The MHISM

model presents a range of interventions for mental illness

that includes prevention, treatment, and maintenance.

Correctional Facility• A correctional facility: is one whose primary objective is to provide safety to the

public by incarcerating those who have committed crimes and who are deemed to be threats to the community.

• Health Care in Correctional Institutions advocated the following actions::

1. Use of outside health care agencies in an effort to increase the variety of services offered, decrease costs, and reduce the isolation of health care personnel.

2. Collaboration with community liaisons in all aspects of correctional care, including ties to medical and nursing schools and to professional organizations.

3. Development of a high-quality, consistent, and reliable system of health care.

4. Improvements in medical record-keeping systems.

ROLE OF THE COMMUNITY HEALTH NURSE

1) Educational and Literacy Issues: Literacy is defined as the

ability to read and write to an extent that allows the

individual to function in daily life.

2) Advocacy:

3) Bridge Programs With the Community:

4) Personal Safety, Stress Reduction, and Self-Care:

Thank you for

listening