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POPULATIONS AT RISK AND VULNERABLE POPULATIONS The concept of a group at risk assumes that there is always a chance that

an adverse healthrelated event will occur. Thus, everyone is potentially at risk at risk of poor physical, psychological and/or social health. Some may however be more or less at risk of poor health at different times in their life. Risk factors encompass those attributes or exposures (smoking, drug use, and lead paint poisoning) that are related to or lead to increase in the probability of occurrence of health related outcomes (RWJF, 2001) On the other hand, Vulnerable populations are those that have a greater than average risk of developing health problems. They include the economically disadvantaged, racial and ethnic minorities, the uninsured, low-income children, the elderly, the homeless, those with human immunodeficiency virus (HIV), and those with other chronic health conditions, including severe mental illness. It may also include rural residents, who often encounter barriers to accessing healthcare services. The vulnerability of these individuals is enhanced by race, ethnicity, age, sex, and factors such as income, insurance coverage (or lack thereof), and absence of a usual source of care. Their health and healthcare problems intersect with social factors, including housing, poverty, and inadequate education (AHRQ, 2004; NHCS, 2005). The needs of medically vulnerable populations are serious, are often debilitating or lifethreatening, and require extensive and intensive medical and nonmedical services; these needs tend to be underestimated. Thus they are candidates to be advocated for. Furthermore the vulnerable often have associated stigma with their disease and as such may not advocate for themselves (NCHS, 2005). The number of patients with chronic conditions is expected to rise by 37% within the next 24 years, placing significant strain on existing healthcare systems, particularly as the condition of

this population is exacerbated by existing social and economic. Thus a community health nurse advocating for this group of people are more likely to experience occupational strain due to a likely out-numbering of healthcare professionals (NHCS, 2005). Conclusion Vulnerable populations, defined as those at greater risk for poor health status and healthcare access, experience significant disparities in life expectancy, access to and use of healthcare services, morbidity, and mortality. Their health needs are complex, intersecting with social and economic conditions they experience.

References Agency for Healthcare Research and Quality (AHRQ). Healthcare disparities in rural areas: selected findings from the 2004 national healthcare disparities report. National Center for Health Statistics (NCHS). Health, United States 2005. Washington, DC: US Department of Health and Human Services; 2005. Robert Wood Johnson Foundation (RWJF). A portrait of the chronically ill in America, 2001.

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