Vulnerable Populations and Determinants of Health 1 Sex and age Alcohol use, unprotected sex Economic Factors Discrimination, income Where a person lives and crowding conditions Access to quality health care and having or not having health insurance Center for Disease Control. Social Determinants of Health; Frequently Asked Questions (http://www.cdc.gov/socialdeterminants/faq.html)
Hispanic Youth and Higher Rates of Suicide Attempts 2 Economic Factors Latinas (gender) exhibit higher rates of suicide attempts Hispanic adolescent youth are showing an increase in binge drinking Acculturation stress, anxiety, depression, poverty, women heads of households Exposure to violent crimes, higher rates of criminal justice involvement 34 % of Hispanics are uninsured, limited proficiency in English reduces access to health information in the media Zayas LH, Pilat AM. (2008). Suicidal behavior in Latinas: Explanatory cultural factors and implications for intervention. Suicide & Life-Threatening Behavior, 38(3), 334 342.
Seniors and Prescription Medication Misuse/Abuse 3 Economic Factors Use of more prescription and over-the-counter medications; conditions which are common in populations such as pain, sleep disorders, insomnia, and anxiety One fifth of emergency department visits involving pharmaceutical misuse and abuse among older adults were made by persons ages 70 or older Older women likely to use psychoactive medications associated with divorce, widowhood, lower income, poorer health status, depression and/or anxiety Shrinking social networks, poor living conditions, retirement, and family losses Hurried office visits, stigma or shame about substance use, reluctance to seek professional help, lack of financial resources or transportation Substance Abuse and Mental Health Service Administration. (2012). Older Americans Behavioral Health; Issue Brief 11: Reaching Diverse Older Populations and Engaging Them in Prevention Services and Early Interventions. Retrieved from http://www.aoa.gov/aoaroot/aoa_programs/hpw/behavioral/docs2/issue%20brief%2011%20reaching%20and %20Engaging.PDF
Disabilities & Depression (Poorer Mental Health Status) 4 Economic Factors Prevalence rates increase with age (higher among females), greater disparity between MI & US disability rates for blacks, women are more likely to report intimate partner violence and non consensual sex Higher rates of smoking, lower rates of heavy or binge drinking Those with fair to poor health status tend to have lower household income and education, some not able to see a doctor when needed due to cost Social isolation, physical access to buildings Poor physical health status & higher rates of chronic conditions, attitudinal barriers that may prevent healthcare providers from seeing the whole person Disability and Health Program, Michigan Department of Community Health. (2013). Health of Persons with Disabilities in Michigan, Annual Data Report. Retrieved August 20, 2014 from http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_54051_54052-255399--,00.html.
Model: Culturally Competent Prevention 5 Cultural Competence Techniques Improved Prevention Reach and Effectiveness Considering inequities + determinants across the Strategic Prevention Framework (SPF) for vulnerable populations Prevention programs Translations Cultural adaptations Education and training Organizational supports Policy development Improved prevention outcomes for vulnerable individuals and populations Behavior change Improved functioning Social/community connectedness Reduction in substance abuse disparities for vulnerable populations
Can Cultural Competency Reduce Disparities? 6 Vulnerable Populations Linguistically Ethnically Culturally Cultural Competency Effective techniques Sound implementation Appropriate Services for Vulnerable Populations Preventive Screening Diagnostic Treatment Improved Outcomes for Vulnerable Populations Health status Use, abuse & consequences Functioning Satisfaction Reduction of Health Disparities Ensure focus on communities facing behavioral and physical health disparities (Michigan PFS High Need Counties) Meet cultural and linguistic needs of diverse populations (Cultural/Linguistic Competency) (Michigan PPC- Guide) Transforming Cultural and Linguistic Theory Into Action: A Toolkit for Communities Cultural competence strategic plan and system expectations infused into routine business practices and operations, and continuous quality improvement. (BSAAS) Strengthening Families & Active Parenting for Teens: Families in Action (Michigan SPF-PFS) All services and supports be individualized based on the needs, preferences, and cultural context of the individual, family or community. (Michigan ROSC ) Continually improve the quality of services and health outcomes for all cultural groups. (Michigan SPF- PFS) Strengthen collaboration and partnerships with FQHCs, LPHDs, IHS, and CC&UH/CCs serving individuals and families in need prevention services (Michigan SPF-PFS) Targeting health disparities directly Developing and Monitoring through Impact Statements (Michigan SPF- PFS) Brach C., Fraserictor I. (2000). Can Cultural Competency Reduce Racial And Ethnic Health Disparities? A Review And Conceptual Model. Medical Care Research and Review, 57(1), 181-217.