Introduction
The natural disasters, health, medicine and the environment form the bases of the history of vulnerability. In the present world, the young population is more vulnerable based on some issues like early parenthood, homelessness, lack of education, and engagement in crimes. In most cases, vulnerability is associated with poverty because poor people are at greater risks of experiencing vulnerable conditions. A vulnerable population is that at higher risks for poor psychological, physical, or social health. These groups of people have greater-than-average risks of developing health issues. The major health issues associated with a vulnerable population include chronic diseases, high morbidity and mortality rates, and poor health (Chesnay, 2005). With the efforts and goals by the United States to minimize health disparities in the healthcare sector, significant number of issues continue affecting vulnerable populations, like the people of Dallas, Texas.
The Dallas community forms one of the most vulnerable populations in the United States. The state of Texas leads in United States in terms of population growth rate as evidence from the 2000-2010 census reports from U.S. Census Bureau. See figure 1 below for reference. An increase in population growth rate of an area calls for a significant need for more health care services in order to cope with the high number of needy people. As the population continues growing in Texas, the number of minority groups living in Dallas also increase. According to (Managed Markets Networks, 2014), vulnerable populations consist of the economically disadvantaged, the uninsured, low-income earners, and racial and ethnic minorities. Minority groups are more associated with health disparities and form the highest number of vulnerable populations in the United States.
Figure 1: Data from U.S. Census Bureau showing population growth rates for a ten-year period in six states in U.S. (Source: U.S. Census Bureau)
Health care disparities in Dallas have forms a major concern from the Texas Department of Medicine and Health. The availability of higher number of minority populations, and the poor conditions found in the community increases makes disparities a common phenomenon. The major minority health issues experienced in Dallas include diabetes, hypertension, obesity, and sexually transmitted diseases. On the other hand, the area is associated with different types of crimes. Moreover, majority of older adults in Dallas live on a fixed income making crime the main source of income for many especially the younger generation. The government has set up different institutions for victims of crime in Dallas, such as centers for child abuse, rape crisis centers, and centers for battered women (Texas Department of Public Safety, 2013). The following characters make Dallas community a vulnerable population requiring special healthcare attention.
Another factor that makes Dallas community a vulnerable population is its involvement in the workplace violence towards healthcare providers. The problem of violence in the workplace against healthcare workers affects the whole of United States, but the County of Dallas has the highest number of cases. The most affected healthcare area is the emergency department (ED). A report from the Emergency Nurses Association (ENA) showed that in Texas, violence towards healthcare providers increases each year as more nurses and medical doctors report cases of physical abuses and threats from patients and their care-givers. In addition, 10 percent of healthcare providers working in EDs face violence every week (ENA, 2013). The training processes undertaken by institutions offering healthcare courses gives professional nurses knowledge on how to relate interpersonally with co-workers and patients in order to avoid cases of violence in the workplace. The high number of violence cases reported in healthcare facilities across the Dallas County makes the community more vulnerable.
Hurst’s use of the phrase “Elephant in the Room” as applied to vulnerability
The phrase “Elephant in the room” also means vulnerability. An elephant is believed to be a huge and wonderful creature that attracts the attention of many people. Similarly, defining vulnerable populations or persons becomes a difficult task that attracts the attention of many people. The quality of health continues to deteriorate in most States across U.S. despite the effort by the federal government and the Ministry of Health to contribute resources, strategies, and programs aimed at improving the quality of life. Many factors contribute to the poor quality and safety in health care. Presence of vulnerable populations in the country contributes more to the problem. Even with the availability of money, technology, strategies and programs to improve healthcare, the vulnerability nature of some communities makes health care improvement a vocabulary. Vulnerability forms the most uncomfortable issue delaying development in the healthcare sector because of its complexity. Getting rid of vulnerability is as complex as getting an elephant out of a room.
Vulnerability has become a huge problem for both the health care sector and the nation at as a whole. Imagine an elephant in a room and the amount of trouble it would cause to the house dwellers. Vulnerability in a population causes the same impact as that of an elephant in the room, hence the application of the phrase to vulnerability. Vulnerability occurs as a practical and a theoretical problem because it prevents proven justifications for its claim and practical application of necessary protections (Hurst, n.d).
Literature on Vulnerable Populations and Health Policy
Many factors contribute to the availability of vulnerable population in a country. Individual vulnerability and vulnerable populations should be an issue attracting government and healthcare sector concerns in order to look for ways of ensuring these people get good care. Lack of insurance coverage for vulnerable populations limits access to quality and improved healthcare services. Research by Pollack and Kronebusch revealed that lack of health care insurance covers such as Medicaid and CHIP makes it hard for vulnerable populations to access healthcare. Most of these people cannot afford the high cost of healthcare in U.S. and require assistance from health insurance schemes. In addition, the health care policy led to the introduction of the Obama Act that ensures the minority groups receive affordable health insurance and spend less on hospitals.
According to Pollack and Kronebusch (n.d), some health policy analysts recommended that the government should expand social provision and implement comprehensive and clear interventions in order to ensure the vulnerable population acquires secure coverage. The cost of the policy should be balanced with the income of the individual person or the family in order to cater for social, economic, and health needs. The above literature shows that the government ignores the vulnerable populations through denying them access to health insurance. The high cases of violence in the workplace among healthcare providers are connected to this issue. A person from the community would demand quality care like any other individual but the healthcare facility would demand the individual to pay for services rendered. The aggressive nature of these people always invites quarrels with the hospital management resulting to violence.
After understanding the nature of the vulnerable population, healthcare workers should adequately prepared to deal with such people. As stated earlier, most violence cases take place in EDs. Nick, Savoia, Elqura, Crowther, Cohen, Leary, Auerbach & Koh exposed some major problems that limit emergency preparedness planning for the vulnerable population. The study outcome revealed that most health care facilities do not prepare adequately for the vulnerable populations in the emergency departments causes high number of violence cases. The study proposed a citywide collaborative approach as the best program that health institutions should use in preparing for the vulnerable populations in EDs (Nick et al, 2009).
Presently there is limited literature on vulnerable populations in terms of EDs preparedness. Most studies focus on minority groups and people with chronic diseases. In order to understand the concept of vulnerability, it is recommended that future studies incorporate vulnerable populations living in urban areas, like the Dallas community in Texas. High population growth rate of the community makes it vulnerable to health disparities.
Conclusion
Vulnerability is an issue that causes a lot of headache to the health care sector as they device mechanisms of dealing with vulnerable populations. The above analysis shows that a vulnerable population is defined in many terms. A population becomes vulnerable when most people are low-income earners, high number of crimes, high population, and poor access to health care services because of its location to the main town or infrastructures. The Dallas community is termed a vulnerable population because of its dense population and presence of minority groups. The government in collaboration with the departments of health has a duty of ensuring these communities get access to quality care and improved services in order to enjoy a healthy lifestyle.
References
Chesnay, M. (2005). Caring for the vulnerable: perspectives in nursing theory, practice, and
Research. Sudbury, Mass.: Jones and Bartlett.
ENA. (2013). ENA - Emergency Nurses Association - Safe Practice, Safe Care. Emergency Nurses Association Applauds Texas Legislation that Raises Assaults Against Emergency Department Personnel to Third Degree Felony. Retrieved October 28, 2014, from http://www.ena.org/about/media/PressReleases/Pages/Texas-Legislation.aspx
Hurst, S.A. (2008). Vulnerability in research and health care: Describing the elephant in the
Room? Bioethics, 22(4), 191-202.
Nick, G.A. et al. (2009). Emergency Preparedness for Vulnerable Populations: People with
Special Health-care Needs. Public Health Rep, 124(2): 338–343.
Pollack, H. & Kronebusch, K. (n.d). Health insurance and vulnerable populations, ERIU
Working Papers, 5, 1-52
Texas Department of Public Safety. (2013). Texas Public Safety Threat Overview 2013.
Retrieved from:
http://www.txdps.state.tx.us/director_staff/media_and_communications/threatoverview.pdf
U.S. Census Bureau. (2010). 2010 Census. 2010 Census. Retrieved October 28, 2014, from
http://www.census.gov/2010census/
