Promoting and protecting the health of vulnerable aggregates
Transcript of Promoting and protecting the health of vulnerable aggregates
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:
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