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Objective: Evaluate the concept and implications of health disparities and how environments and populations impact health outcomes.  Introduction: This essay will provide you an opportunity to examine three main impacts on health outcomes for the aging and chronically ill populations in the United States. Each of these impacts leads to health disparities.   First, you will address the effect on the healthcare system of long-term care for the aging and chronically ill population. Second, you will discuss the effect of a social influencer—in this case, poverty—on both individual health and healthcare delivery for the aging and chronically ill. And, third, you will use the concepts of social justice to discuss equity and the removal of disparities in health and healthcare access for the aging and chronically ill.  Deliverables: The essay for this lesson is required to be a minimum of 750 words that clearly demonstrate your understanding of the activity. Essays should have a clear introduction, thesis statement and conclusion, written in APA format (APAstyle.org). A minimum of three sources must be cited in-text and in the Reference list.  Activity Details:  Step 1: Read the following questions, then use what you have learned about this lesson’s objective to summarize your responses: •What improvements could be made in the existing system of long-term care in the United States? How would these improvements be financed? •Discuss three effects of poverty on the physical and mental health of aging and chronically ill Americans. In your discussion, offer a solution for each effect. •Select a theory of social justice (other than John Rawls’ theory) and defend that theory as most appropriate for justifying health equity for the aging and chronically ill in the United States.   Step 2: Write a paper. Please review the essay rubric prior to proceeding.  Use these writing guidelines: •Include a cover page and a reference page in addition to your required word count. •Use correct APA format. •Double-space text. •Use size 12 Times New Roman font. •Use section headings to organize. •Indent paragraphs. •Include in-text citations. •Use correct spelling, grammar, sentence structure and verb tense.

A group that is “at risk,” will have certain risk factors in place that may potentially put them in a high-risk status such as being overweight, smoking, and no physical activity. With these specific risk factors, a person could be at risk for diabetes, heart disease, lung cancer, and hypertension. However, it does not necessarily mean they will develop these chronic conditions.  A vulnerable group is one that is more inclined to suffer from health-related issues, have difficulties obtaining care for their health conditions, and are more likely to encounter poor outcomes or shorter life-span because of their problems.  Vulnerable populations have certain attributes that place them in this category.  Some of these groups can include the poor, homeless, disabled, those with SMI, very young children, and the elderly (Maurer & Smith, 2013). 

The “at risk” population would benefit from education and enrolling in a case management program to help them meet their individual healthcare goals and achieve the best outcomes.  The nurse case manager can assess this group by finding out what lifestyle changes the person may be open to and listening for change talk.  Motivational interviewing is a great tool to use.  Goals should start at what is most important for the patient to modify in their life and implement the plan from what is mutually agreed upon. 

There are many different healthcare disciplines that interact with vulnerable groups who are at increased risk including community health nurses that are familiar with identifying risks correlated with poor health.  According to Maurer & Smith (2013), “working with vulnerable populations, nurses must become adept at identifying risks that are amenable to intervention as well as those that require greater effort to overcome and those that are not alterable.  Economic status is an important factor in the individual’s overall health.  There are ways nurses can advocate for our vulnerable patients such as referring them to social services who can assist with resources for adequate housing/shelter needs and assistance programs applicable to their income status such as Medicaid. Helping patients access food that is nutritious is key to improving diet.  Patients having difficulties accessing health care can be referred to clinics who offer sliding-scale services at a discounted rate.  Patients may need resources to aid with transportation or assistance filling out forms to apply for ADA transport benefits.  Patients with SMI need to be connected with outpatient clinics for close monitoring and ensure there is a treatment plan in place.  Education by nurses is key with this group to help them be successful and assisting them to join groups that are associated with vulnerable groups such as governmental and private assistance programs. 

Maurer, F.A. & Smith, C.M.  (2013). Community/public health nursing practice (5th ed.). St. Louis, MO: Elsevier Saunders.

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