Blog Three: NU708
Part A: Marginalized Populations
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What are some of the determinants that make marginalized populations more at risk for chronic disease, substance use, and mental illness?
People experiencing homelessness are at an increased risk for developing and suffering with chronic disease. The homeless or those with housing insecurity are more likely to forgo routine check-ups (Martin et al., 2019). There is a direct correlation between level of housing insecurity and decreased access to care. Adults experiencing homelessness typically have to utilize acute care services as opposed to routine care services (Martin et al., 2019). In addition they typically have to postpone needed medical care and medications due to lack of transportation or other compounding factors (Martin et al., 2019).
Veterans are at increased risk for developing substance use disorder. Substance use disorders encompass alcohol and drug use disorders, and are among the most common of all health conditions among veterans (Lan et al., 2015). Conflicts and experiences that resulted in psychiatric conditions, such as post-traumatic stress disorder, disproportionally cause substance use disorder among veterans (Lan et al., 2015).
How do veterans, homeless, and incarcerated populations intersect?
Veterans, the homeless, and incarcerated individuals are all among marginalized populations. “Marginalized communities are those excluded from mainstream social, economic, educational, and/or cultural life. Examples of marginalized populations include, but are not limited to, groups excluded due to race, gender identity, sexual orientation, age, physical ability, language, and/or immigration status. Marginalization occurs due to unequal power relationships between social groups” (Sevelius et al., 2020).
View and comment on one interview from the website Soft White Underbellies
- What action can we take to address the health disparities experienced by these groups?
Improving health and lifestyle behaviors (Thornton et al., 2016)
Access to adequate food (Thornton et al., 2016)
Access to employment resources (Thornton et al., 2016)
Support for issues such as domestic violence (Thornton et al., 2016)
Health programs that are culturally and linguistically tailored to specific individuals or groups (Thornton et al., 2016)
Health system interventions that address discrimination, access to care, and quality of care (Thornton et al., 2016)
Part B
There has been a ground swell of research on vulnerable populations at risk for substance use in the last 5 years. Locate one research study within this time frame and summarize its findings in your blog. The objective is to share the most recent research relevant to understanding, prevention, treatments and optimizing health outcomes for marginalized populations.
Article Title: Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis (Aldridge et al., 2018).
Article DOI: 10.1016/S0140-6736(17)31869-X
Article URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC5803132/
Summary: The homeless, individuals with substance use disorders, sex workers, and incarcerated individuals experience health inequities across various conditions at higher rates than any other groups (Aldridge et al., 2018). A multitude of studies reviewed showed the same results. These health inequities require policy and service action to improve health outcomes in these individuals who are already marginalized (Aldridge et al., 2018).
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Reference
Aldridge, R. W., Story, A., Hwang, S. W., Nordentoft, M., Luchenski, S. A., Hartwell, G., Tweed, E. J., Lewer, D., Vittal Katikireddi, S., & Hayward, A. C. (2018). Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: A systematic review and meta-analysis. The Lancet, 391(10117), 241–250. https://doi.org/10.1016/s0140-6736(17)31869-x
Lan, C.-W., Fiellin, D. A., Barry, D. T., Bryant, K. J., Gordon, A. J., Edelman, E. J., Gaither, J. R., Maisto, S. A., & Marshall, B. D. L. (2015). The epidemiology of Substance Use Disorders in US veterans: A systematic review and analysis of Assessment Methods. The American Journal on Addictions, 25(1), 7–24. https://doi.org/10.1111/ajad.12319
Martin, P., Liaw, W., Bazemore, A., Jetty, A., Petterson, S., & Kushel, M. (2019). Adults with housing insecurity have worse access to primary and preventive care. The Journal of the American Board of Family Medicine, 32(4), 521–530. https://doi.org/10.3122/jabfm.2019.04.180374
Sevelius, J. M., Gutierrez-Mock, L., Zamudio-Haas, S., McCree, B., Ngo, A., Jackson, A., Clynes, C., Venegas, L., Salinas, A., Herrera, C., Stein, E., Operario, D., & Gamarel, K. (2020). Research with marginalized communities: Challenges to continuity during the COVID-19 pandemic. AIDS and Behavior, 24(7), 2009–2012. https://doi.org/10.1007/s10461-020-02920-3
Thornton, R. L., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R. (2016). Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8), 1416–1423. https://doi.org/10.1377/hlthaff.2015.1357
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