1-Why is it the case that single men are prominently represented in the homeless? Is there a primary prevention program that could be a part of a public health initiative that would address this cohort specifically?
2- APA Style
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Chapter 18: Underserved Populations
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Chapter Highlights #1
Vulnerable versus underserved populations
Social determinants of health/health disparities
Genomics and underserved populations
Health priorities in rural areas, particularly elders
Health priorities in gay, lesbian, bisexual, and transgender people; in people in correctional institutions; and in people who are homeless
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Chapter Highlights #2
Access to quality care
Chronic disease management
Veteran’s health
Human trafficking
Health personnel issues
Risk, prevention, and health promotion in hard‐to‐reach populations
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Context of Health Risks
Vulnerability
Social determinants of health and health disparities
Genomics and underserved populations
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Question #1
Which of the following are included in the notion of social injustice?
A. Belief of those in power that others are inferior
B. Denial of human rights to certain populations
C. Disparities in access to services, such as healthcare
D. All of the above
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Answer to Question #1
D. All of the above
Rationale: Social injustice involves the denial of economic, sociocultural, political, civil, or human rights of certain populations or groups based on the belief of those with power that others are inferior. In healthcare, it manifests as disparity in access.
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Vulnerability
Underserved populations
Subgroup of the population
Higher risk of developing health problems
Greater exposure to health risk because of marginalization
Sociocultural status
Access to economic resources
Age
Gender
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Social Determinants of Health and Health Disparities
High‐risk mothers
Chronically ill and disabled people
People living with HIV/AIDS
Mentally ill people
Substance abusers
Homeless people
Immigrants and refugees
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Rural Populations
Health personnel issues
Morbidity and mortality issues
Elderly people
Occupational and environmental health problems
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Question #2
Is the following statement true or false?
Accessibility is insufficient number and diversity of formal services and providers, or lack of acceptable services and human service infrastructure to elders in rural areas.
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Answer to Question #2
False
Rationale: Availability—insufficient number and diversity of formal services and providers; lack of acceptable services and human service infrastructure.
Accessibility—shortages of adequate, appropriate, and affordable transportation; cultural and geographic isolation.
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Correctional Health: Underserved Populations in Jails and Prisons
All levels of prevention need to be addressed for all people who end up in correctional facilities.
Most inmates are males who are African American or Latino.
The average age of inmates is 37 years.
After release from incarceration, inmates often face social injustices and economic problems.
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Gay, Lesbian, Bisexual, Transgender, and Queer Community #1
Four subgroups—gay, lesbian, bisexual, and transgender people—have unique needs.
Few population‐based studies have been conducted in LGBT groups, with the exception of HIV‐related research, particularly in men who have sex with men.
Specific questions on surveys related to sexual orientation are lacking.
Recognition of same‐sex heads of households has not always been included in survey data.
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Gay, Lesbian, Bisexual, Transgender, and Queer Community #2
More serious physical and mental health conditions, including interpersonal violence and substance addiction
Particular health concerns from a prevention perspective include obesity, injury, violence, and access to healthcare facilities
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Veterans and Health
2 million reintegrated veterans in the civilian sector
1 million veterans suffering from nonvisible or visible trauma
Need for civilian nurses to understand military culture
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Human Trafficking
Recruitment and transportation of people for exploitation
Nurse’s role of recognizing victims and responding based on approved protocol
Maintaining safety of victim and healthcare personnel
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Homeless Populations #1
Deinstitutionalization efforts of the 1960s to mainstream the mentally ill into society
Unemployment and underemployment
Domestic violence
Abandonment
Natural disasters and fires
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Homeless Populations #2
Disability
Substance abuse and addiction
Immigration
Political unrest and wars
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Nurses’ Approach to Homeless People
Show respect and use a positive approach, which builds trust.
Support primary (advocacy), secondary (tuberculosis screening), and tertiary (“detox” treatment) prevention to make it easier to cope with difficult, challenging lives.
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Key Nursing Considerations
Recognize the biases and prejudices that can be barriers to understanding the needs of populations.
Community and family assessments need to be grounded in trusting approaches.
Allow nurses to do what they do best: heal, and not necessarily fix, healthcare situations
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