Closing the Gaps Created When Special Vulnerable Populations are Marginalized: A Nursing Perspective

Closing the Gaps Created When Special Vulnerable Populations are Marginalized: A Nursing Perspective

In health care, vulnerable populations are people considered to being at a greater risk of developing health problems (Sebastian, et al., 2002, p. 349). They include migrants, immigrants, clients in the home settings such home care and hospice, and populations in correction facilities (Stanhope & Lancaster, 2011).They are classified vulnerable populations because of their living conditions such as limited access to resources and health care, chronic mental illness, poverty, incarceration, marginalized sociocultural status, homelessness, ethnicity and age.

Various steps have been taken towards providing health care to vulnerable marginalized groups. For example, The Migrant Health Act of 1962 which was enacted to address the needs of MSFW’s by providing primary and supplemental health services and consequently resulted to360 health centers being set up to focus on their health needs. However, despite the availability of these services, they only serve less than 20 percent of this population. This gap in MSFW’s access to health care spreads across other vulnerable marginalized groups and reveals the hazards and risks which they are exposed to. In bridging this gap, nurses can undertake a myriad of steps.

First, public health nurses can come up with channels which can facilitate access to these vulnerable populations. This may include populations in transient, population with tight working schedules, populations who do not have the ability to pay for medical care, populations who avoid public health due to their lack of legal documents and populations with language barriers. Nurses can make use of case finding to find means of tracking this population and referrals to provide the health care they need, or refer these groups to facilities which can meet their need.

Secondly, nurses can also cultivate good working relationships with this population. This will promote development of strong ties and foster trust between the community and the public health nurses. This will in extent nurture trust in medical treatment and health care systems as opposed to cultural beliefs that encourage reliance on folk medicine.

Thirdly, nurses can also avail health care services to these vulnerable populations through education and outreach. This can especially be imperative to populations who lack the knowledge on how to access health care services, or have complexities in accessing these services. This will involve providing health promotions which include contraceptive education, nutrition education, and prenatal care or education, targeted at families and individuals who need skilled nursing care. This step will both address the gap and is also cost effective.

Fourthly, team approach is another tool through which public health nurses can bridge this gap. It involves working with other stakeholders involved in community health care provision such as health workers, faith based organizations and formal and informal CHWs working in neighborhoods. These groups provide invaluable information which can help in the identification and assessment of public health status and as a result enable a public health nurse to take appropriate steps towards safe guarding the health of these vulnerable populations from a particular illness. This falls under the assessment core function of public health which involves monitoring the health status and identifying the health issues within the community and taking steps towards mitigating the occurrence of these health concerns(CDC).

To reach out to the vulnerable population in correctional facilities, public health nurses can provide health care services to this group and communicate to correctional health care systems the importance of good health practices. However, this will require the nurses to be autonomous and to have excellent and well honed assessment skills, good diagnostic reasoning, and skills in planning the delivery of health care under stressful conditions.

To bridge the gap, a nurse also needs to train in multiple areas such as communicable diseases, prenatal and family planning, injury prevention, dental care, child health, adult health and health education. Through this knowledge, a public health nurse can better serve vulnerable populations through field outreach which requires a nurse to possess comprehensive expertise in health care.

A nurse should be ready to face the challenges that come with dealing with vulnerable marginalized populations. This may include environmental challenges such as geographical distances, unpredictable weather, lack of transport, outsider acceptance and a lack of trust. A nurse should also be ready to cope with different cultural attitudes and beliefs and put aside his own beliefs and judgments to be able to better provide health care to this population.

Finally, according to Healthy People 2020, public health nurses can play an imperative role in ensuring the achievement of the set of 10-year, national goals and objectives that were established to help improve the health of the American citizenry. This is especially so in the ability of public health nurses to increase and facilitate the population’s ability to access health care services. However, also play a critical role in the achievement of the other national goals such as the provision of clinical preventive services, improve the well being of mothers, infants and children through home visits, provide counsel on good nutrition, physical activities and healthy body weight, and provide information on reproductive and sexual health services, among many other healthcare services that they are trained and prepared to provide.



CDC, C. (n.d.). Core Functions of Public Health and How They Relate to the 10 Essential Services. Retrieved June 03, 2014, from Centers for Disease Control and Prevention:

Sebastian, J., Bolla, C. D., Aretakis, D., Jones, K. J., Schenk, C., & Napolitano, M. (2002). Vulnerability and selected vulnerable populations. (M. Stanhope, & J. Lancaster, Eds.) Foundations of Community Health Nursing, 349–364.

Stanhope, M., & Lancaster, J. (2011). Public Health Nursing: Population-Centered Health Care in the Community. Elsevier – Health Sciences Division.

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