GLOBAL1

Deliverable 4 - High-risk and Vulnerable Global Populations

Competency

Integrate social determinants, ethical concerns, and human rights for high-risk and vulnerable global populations.

Scenario As a nurse on the ethics committee of a free clinic, you are educating staff on a high-risk or vulnerable population in the community. You focus on a health condition that affects the community and also impacts the population globally. To help explain the topic, you plan to show the staff a concept map.

Instructions

Create a concept map showing the relationship of health disparities, pertinent determinants of health, ethical considerations, and human rights for a condition affecting a high-risk or vulnerable population. Your concept map should:

· Identify the main concept (a condition affecting a high-risk or vulnerable population)

· Describe the supporting subtopics of:

· Health disparities impacting the population globally

· Pertinent determinants of health (at least three)

· Ethical considerations (at least three)

· Human rights from the Universal Declaration of Human Rights (at least three)

Some notes to give you an idea of what the instructor is looking for

Many global health initiatives focus on the needs of high-risk and vulnerable populations. The term high-risk is often used to describe a population with an increased risk for a specific disease or condition. Vulnerable populations are those that have multiple increased risks due to geographic, socioeconomic, or physical factors (Jacobsen, 2019). Some examples of vulnerable populations today are refugees, children, people with disabilities, and inmates (Jacobsen, 2019).

Refugees

Refugees are people who were forced to move out of their home country due to conflict, political instability, or persecution (Jacobsen, 2019). Common health problems affecting refugees include malnutrition, injuries from violence, and mental health problems. While some refugees gain better access to healthcare in their new location, many continue to have challenges (Jacobsen, 2019).

The refugee crisis in Syria is one of the biggest humanitarian crises today (United Nations High Commissioner for Refugees [UNHCR], 2018). There are more than 5.6 million refugees from Syria who fled the country since 2011 (UNFCR, 2018). Most Syrian refugees are living in neighboring countries such as Turkey, Jordan, and Lebanon. Many refugees struggle to pay for food and healthcare. About 70% of refugees in Lebanon live below the poverty line (UNFCR, 2018).

The UNHCR provides Syrian refugees with cash and items to help meet basic needs. The agency estimates that $8 billion will be needed in new funding to assist with the crisis (UNHCR, 2018). Financial support from the international community is essential for the success of UNHCR’s refugee initiatives.

Children

Children are another vulnerable group because they are not able to advocate for themselves. Children who are part of other vulnerable groups, such as refugees or those living in poverty, are even more at risk for health and safety issues. For instance, preventable childhood illnesses effect children in poorer countries at higher rates than children in more affluent countries (Jacobsen, 2019). Children living in conflict zones or unstable housing are susceptible to physical and psychological harm.

Agencies such as the United Nations International Children’s Emergency Fund (UNICEF) work to save and protect children across the globe. The agency helps children in 190 countries, with a focus on providing safe and inclusive environments from early childhood through adolescence (UNICEF, n.d.). Staff at UNICEF respond to emergencies and also participate in community development for sustainable change.

Sources

Jacobsen, K. H. (2019). Introduction to global health. Burlington, MA: Jones & Bartlett Learning.

United Nations High Commissioner for Refugees. (2018). Syria emergency. Retrieved from https://www.unhcr.org/en-us/syria-emergency.html

United Nations International Children’s Emergency Fund. (n.d.). What we do. Retrieved from https://www.unicef.org/what-we-do

People with Disabilities

Over 15% of the world’s population–about one billion people–have a disability (World Health Organization [WHO], 2018). People with disabilities are considered a vulnerable population because they may experience barriers to healthcare. These barriers include limited access to healthcare facilities (due to mobility issues), lack of individualized healthcare services, and high cost of care (WHO, 2018). Consequently, people with disabilities are more susceptible to comorbidities and other health risks.

People with disabilities who live in low-income countries are disproportionately affected by barriers to healthcare. According to a WHO (2018) study, between 76% and 85% of people with serious mental disorders in developing countries did not receive treatment in the prior year. In contrast, this figure is 35% to 50% in developed countries. The study illustrates the need for better healthcare for people with disabilities globally.

Health promotion and prevention for people with disabilities can be improved through legislation, financial incentives for healthcare providers, and research. Continuing education for healthcare professionals should include the unique needs of individuals with disabilities. The World Health Organization works to improve access to care for people with disabilities. Their initiatives include increasing awareness of disability needs, facilitating research, and helping to ensure healthcare workers meet the needs of individuals with disabilities globally (WHO, 2018).

Inmates

Inmates in prisons are another population that is vulnerable to healthcare issues. Health standards for people in prisons vary widely across the world. Even though inmates lose the full rights they had before incarceration, the quality and access to healthcare should not be reduced. Yet, adequate healthcare services in prisons is a challenge in some regions. Barriers include lack of funding and policies addressing prison healthcare, as well as public misconceptions about people in prison (International Committee of the Red Cross, 2018).

The World Health Organization advocates for the health of inmates globally. They state that “health services [in prisons should be] equivalent to what is provided in the country as a whole; [that] risks to health are reduced to a minimum; and that the dignity and human rights of every prisoner are respected” (WHO, n.d.). The World Health Organization has multiple publications on the topic, including papers on women’s health and gender inequality in prisons.

Refugees, children, people with disabilities, and inmates are examples of vulnerable populations that need advocacy. The field of global health aims to advocate for these high-risk and vulnerable populations. Legislation, financing, and personnel are essential to carrying out successful initiatives. Creating awareness is just as important. Nurses can participate in all of these activities by getting involved at the community, state, national, or international level.

Sources

International Committee of the Red Cross. (2018). Prison health is public health. Retrieved from https://www.icrc.org/en/document/prison-health-public-health

World Health Organization. (n.d.). Prisons. Retrieved from https://www.who.int/topics/prisons/en/

World Health Organization. (2018). Disability and health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/disability-and-health

Across the world, most leaders agree that everyone has the right to medical care. Yet, access to healthcare remains a globally debated topic today. Some ethical questions include: Do all people have the right to the same type and level of health services? Are higher-income countries obligated to assist lower-income countries with achieving better health?

Applying the ethical principle of distributive justice, the answer to these questions would be yes. Resources, such as healthcare services and medications, should be fairly distributed throughout a population (Jacobsen, 2019). The World Health Organization (WHO) echoes this notion in the preamble to its constitution, which lists nine health related-principles. Among these principles is: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition” (WHO, n.d.).

High-risk and vulnerable populations are especially important to the conversation about the right to healthcare. People in these groups may not be able to advocate for themselves, so others must help advocate for them. Governments, in particular, must take measures to help the most vulnerable in the population. This view is emphasized in another WHO principle: “Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures” (WHO, n.d.).

Related to the concept of health principles are human rights factors. According to the United Nations (n.d), “human rights are rights inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion, or any other status.” The Universal Declaration of Human Rights was developed by the United Nations in 1948 with input from representatives across the world. The document contains articles related to social, economic, political, educational, and healthcare rights. Article 25 addresses healthcare, stating that:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (United Nations, n.d.).

Nurses are uniquely positioned to advocate for health and human rights of vulnerable populations. They apply health principles and consider human rights factors in daily interactions with patients. Nurses also advocate for patients on a larger scale–in community, public, population, and global health arenas. Because patient advocacy is so ingrained in nursing, nurses can lead the way in improving care for high-risk and vulnerable populations globally.

Sources

Jacobsen, K. H. (2019). Introduction to global health. Burlington, MA: Jones & Bartlett Learning.

United Nations. (n.d.). Human rights. Retrieved from http://www.un.org/en/sections/issues-depth/human-rights/

World Health Organization. (n.d.). Constitution of WHO: Principles. Retrieved from https://www.who.int/about/mission/en/

.