The health of vulnerable and marginalized populations is impacted by myriad factors including an individual’s socioeconomic status, and what kind of community they are immersed in. Individual factors also include sexual orientation, gender, ethnicity, religion, geographical location and disability, all of which contribute to the way that people view and receive care. Lack of income can influence level of education, transportation, stress levels, mental health, and lifestyle choices. Current healthcare systems don’t cater to individuals regardless of these factors, which creates a lack of access to resources, as well as opportunities. With healthcare not readily available, marginalized populations are less likely to seek out care and are more likely to face discrimination when they do, which creates a cycle of them not receiving necessary care.
Historically, healthcare in the United States has been disproportionately available to white, English-speaking, job-holding citizens, which creates a stark contrast between those with and those without access. In America, access to care has almost always been contingent upon either having money or having a job that comes with good benefits. Not everyone has the capabilities needed to acquire wealth or security, largely because of the factors mentioned above. In order to resolve these disparities, we must first tackle the systems that exacerbate the problems faced by vulnerable and marginalized populations. Ideally, America would have universal, publicly funded healthcare, which would allow for complete coverage of most healthcare services. This creates an equal playing field for citizens and non-citizens alike, regardless of race, gender, sexuality, financial status, or religion. However, the problem of access can still be a problem when we factor in geographical location, and profession. If someone is the sole breadwinner in a household that supports multiple family members, and they work all day and can’t make time for healthcare, then it’s important for healthcare workers to come to them. Making healthcare more accessible may mean that offices, businesses, or individuals need to be more flexible with when and where they offer care. I think another aspect that would be helpful is the implementation of case workers or social workers. Vulnerable or marginalized populations often have difficultly following up with healthcare professionals for many of the reasons previously discussed, and therefore may benefit from having a caseworker specifically assigned to make sure they have transportation, time off, and anything else that helps get them to their appointment.
I think that having a strong foundational knowledge about the social determinants of health will help me understand all future patients I may have. Our society tends to blame the individual rather than the system, and it’s important to gain insight into a person’s background before making assumptions or judgements. Someone’s life choices do not directly reflect their intentions, and as a future nurse, I must remember that it’s my responsibility to advocate for and understand where my patients are coming from.
