Vulnerability,

Equity &
Social Justice
Lida Larson
N208
Delivered by: Neshma Dhanani BScN, RN, MPH
Arlene Masaba, RN, BSN, MSN
By the end of this session, you should
be able to
• Define vulnerability

• Identify factors contributing to vulnerability

• Identify exemplars of health disparity among vulnerable populations

• Distinguish between equality and equity

• Identify determinants of inequity

• Discuss social responsibility

• Identify elements of social justice

• Explain how social justice is achieved

• Identify social justice frameworks

Who are vulnerable
populations?
Vulnerable
Populations
Vulnerable populations refer to groups of individuals
who are at greatest risk for poor health outcomes
(Giddens)
 who are likely to develop health
problems as a result of
excessive risks,
Vulnerable
populations who experience barriers when
trying to access health care
are those services,

or who are dependent on others

for care. (Potter et al.)
Health Disparity Between Countries
Malawi Life expectancy 47 yrs Japan Life expectancy 83 yrs

Marcos Elias de Oliveira Júnior via Wikimedia

Connormah via Wikimedia
 Social status
Health Disparity •

Within Countries • Family income

• Race / ethnicity
• Gender
• Age
• Disability
 Priority Population in
Qatar

Those
Children and
Women Employees Experiencing
Adolescents
Mental Illness

People
Experiencing People with
Elderly
Multiple Chronic Special Needs
Diseases
Factors Contributing to
Vulnerability
Inadequate Transportation
Physical isolation

Increased spending on transportation

Difficulty accessing health care

Strain on budget

Long commutes
Ineffective Communication

Different understandings of
symptoms

Different understandings of
treatment

Comfort with asking questions

or disclosing personal
information
Fast paced clinical settings

The Open University

Language Barriers
Increased medical error

Less effective
communication
Poor follow up and
adherence to instructions
Biased Clinical
Decision Making
Stereotypes
about minorities

Certain groups deemed

less worthy of disgnostic
or therapeutic
procedures or resources
Patient's Mistrust
or Refusal
In response to mistreatment
by healthcare providers

Patient's mistrust, refusal

or poor compliance

Health care providers less

engaged
Let's take a break
 are defined as “a particular type of health

Health disparities
•
difference that is linked with social,
economic, and/or environmental
disadvantage."
Health
inequities
“those inequalities in health that are
deemed to be unfair or stemming from
some form of injustice."
 Health Inequity Health Equity

• Unfair lack of access to health • Absence of systematic disparities

determinants in health that are associated
• avoidable, but outside the control of with social advantage/disadvantage
the individual
Credit: Cultural Organizing
Cartoon by Craig Froehle
Clinical Exemplars of
Health Care Inequity
Unequal Receipt
of Prenatal Care
Unequal Receipt
Immunizations
Unequal Pain
Management
Unequal Breast
Cancer Screening
Unequal Quality of
Palliative Care
 Explore and respect patient beliefs, values,
meaning of illness, preferences, and needs
Build rapport and trust

Cultural Find common ground

Competence
Awareness of one’s own biases/assumptions
for
Interpersonal Knowledgeable about different cultures
Interactions
Awareness of health disparities and
discrimination affecting minority groups
Use of interpreter services when needed
 Diverse workforce reflecting the
diversity of patient populations

Healthcare facilities convenient and

Cultural attentive to communities
Competence
for Language assistance available for
Organizations patients with limited English
proficiency
Ongoing staff training regarding the
delivery of culturally and
linguistically appropriate services
Let's take a break
What is Social Justice?
 Crisp Thinking Group Limited

Is the principle that all persons are entitled to have their

basic human needs met.
Social Justice Regardless of differences in economic status, class, gender,
race, thnicity, citizenship, religion, age, disability or health.
Social Justice
• Refers to providing equitable care and social supports for the most
disadvantaged members of society (Stanhope & Lancaster)
How Can Social Justice
be Achieved?
Reduce
Institutional
Discrimination
Deliver fair,
Non-discriminatory
Care
Reduce Poverty
and Disparities in
Income
Reduce Disparities
in Opportunity
Advocacy
The act of supporting or recommending a cause or course of action
Undertaken on behalf of persons or issues
To create greater equity and better health for all
Social Justice in Instituted minimum wage (2017)
Qatar Abolished exit visa requirement under the
kafala system (2020)
Freedom to change jobs independent of
employer (2020)
Dismantling of the kafala system and forced
labour
National Human Rights Committee (2002) to
oversee and investigate human rights abuses
in Qatar.
Bureau for Human Rights in the Ministry of
Foreign Affairs (2005)
 Visit the Hamad emergency department and

Suggested Challenge
•
interview staff nurses about methods of
working with vulnerable populations
• Observe the pattern of interactions with
patients in the wiating room or treatment room.
• Do you note differences that might be related to
the patient's condition?
• How do nurses respond when you ask them
about caring for the poor, the migrant workers,
and the mentally ill?
• What peroblems do they perceive and how do
they deal with them?
Summary
One-minute paper
What was the most meaningful thing you learned today?

What questions remained unanswered in your mind today?

Next week:
Global Citizenship
Global Health Issues