...Epidemiology and Vulnerable Populations Angela Wilson NUR / 408 November 4, 2013 Epidemiology and Vulnerable Populations Introduction Health is a state of optimum well-being, a human right and a social goal. The public health mission is to provide and assure conditions that promote health in the community. Public health, epidemiology and nursing practice share the same goal of disease prevention and control. By definition, epidemiology is the study of population in order to monitor the health of the population, understand the determinants of health and disease in the community, and investigate and evaluate interventions to prevent disease and maintain health. (Stanhope & Lancaster, 2012). Epidemiology today is considered to be the core science of public health and is described as a constellation of disciplines with a common mission: optimal health for the whole community (Stanhope & Lancaster, 2008). Epidemiology has reformed public health and continues to strive for disease prevention and health promotion in communities across the world. The population and disease...
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...Vulnerable Population Laura Nelli Nur 440 11/27/2011 Annette Guinther Vulnerable Population January 19, 2011 — Access to trauma care is limited for many vulnerable patients, according to the results of a cross-sectional analysis reported in the January issue of the Archives of Surgery. "Associated with the increasing closures of trauma centers is the growing concern regarding disparity in trauma access," write Renee Hsia, MD, MSc, from the Department of Emergency Medicine, University of California–San Francisco, and San Francisco General Hospital; and Yu-Chu Shen, PhD, from the Graduate School of Business and Public Policy, Naval Postgraduate School in Monterey, California. "Several studies have highlighted that access to trauma centers is not even for all populations, especially rural and urban groups. Another important aspect of access that has been less studied but suggested as a possible area for intervention is that of socioeconomic disparities in system-level access to care, specifically, race/ethnicity, income, and age." The study goal was to compare geographic access to trauma centers among various populations, including those that are traditionally vulnerable. Data from the American Hospital Association Annual Survey from 2005 were linked with Zip code–level data from the US Census in rural and urban communities, and a multinomial logit model allowed assessment of the odds of having difficult vs easy access to trauma centers for a given subgroup of vulnerable...
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...Epidemiology, Tuberculosis, and the Homeless Population Rebecca J Buck NUR 408 July 29, 2013 Felita Patterson Epidemiology, Tuberculosis, and the Homeless Population Among many misconceptions, tuberculosis is not a disease of the past. Tuberculosis remains a public health issue. It is estimated that one-third of the total world population is infected by tuberculosis (TB). The American lung association (2013) states, in 2011 alone there were nearly 9,000,000 new diagnosed cases of tuberculosis around the world and an estimated 1.4 million deaths because of this disease. In the United States, TB is not as common (but still a problem). In 2011, only 10,500 people reported having TB (Trends in Tuberculosis Morbidity and Mortality). Research shows that there are many preceding factors that predispose a person and increase the risk of contracting TB. Epidemiologists have studied and determined that many of these preceding factors are evident in vulnerable populations around the world, particularly the homeless population. The science Daily (2013) reports that “one in five homeless people with tuberculosis die within a year of their diagnosis” (Death Rate from Tuberculosis in Homeless Alarmingly High). In addition to the high death rate for TB among homeless people, public health officials also recognize a growing threat of drug resistant strains within these vulnerable populations. Theses drug resistant strains of tuberculosis require longer, more consistent treatments...
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...Vulnerable Population in the Workplace Back in 1999 the U.S. Health Department set a goal to, “eliminate disparities in health and in access to service for minorities,” for Healthy People 2010 (Crist, 2002). 2010 has come and gone, and although there have been improvements that goal continues to be in place for Healthy People 2020. Some vulnerable populations are still at risk and face many barriers preventing them access to proper healthcare. Attempting to overcome these barriers will often fall on the shoulders of healthcare providers; it becomes their job to help decrease the overall health disparity suffered by vulnerable populations. In this paper the subject to discuss is the vulnerable Mexican American population and will evaluate barriers faced by them as well as barriers faced by healthcare workers, and the methods that could be used in order to help decrease current health disparities. Mexican-Americans: A Population at Risk Mexican-Americans, especially aging Mexican-Americans are an extremely vulnerable population. Currently, Hispanics are the fastest growing ethnic population in the United States and as of the 2003 U.S. Census, their population, “grew at a rate almost fourfold that of the general population—13% vs. 3.3%--over a 39 month period” (Keating, et al. 2009). That being said, non-English-speaking immigrants are often socially and economically disadvantaged, which impacts health disparities (Keating, et al. 2009). Barriers to Care There are many...
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...and AIDS is a social problem of poverty and it also looks at other factors such as religion, promiscuity and child rights which also result in the spread of the disease. It is undisputed to say that poverty is implicated in the prevalence in most developing world. Because these countries are generally poor people are normally forced to engage in activities that end up putting them at the risk of HIV. United Nations (2004) revealed that in South Africa more than 6 million people where living with HIV. The paper also revealed that the majority number who were affected were blacks who are generally poor who have no proper housing facilities, mal-nutritional, lack of safe water. Further research has suggested that Botswana and Zimbabwe have high prevalence of the disease due to the poor conditions which prevails in these countries. In Zimbabwe around 2 million people are said to be contracting the disease and an assessment shows that those who are infected are mainly the poor people as compared with those who stay in low density suburbs. The general consensus is that poor people are pushed into risk behavior such as prostitution where they tend to sell their bodies for money so that they can earn a decent living. Part of the complexity of dealing with the relationship...
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...Tuskegee Syphilis Study Dr. Joseph Costa, D.H.Sc, PA-C Health Policy and Management MPH 525 Jessie McCarty April 2013 Table of Contents Chapter Page 1. Tuskegee Syphilis Study 2 2. Tuskegee Basics 3 3. What Went Wrong? 4 Informed Consent 4 Vulnerable Populations 4 Medical Profession Pursued 5 4. Personal Opinion 7 5. Basics of Research 8 Informed Consent 8 Individual Autonomy 9 Beneficence 9 6. Current Policies 11 Policies 11 Exceptions 11 7. Problems with Waving Consent 13 Flexibility 13 Vulnerable Populations 13 Ethical Dilemmas 14 8. Conclusion 16 Chapter 1 Tuskegee Syphilis Study Throughout the years, numerous research studies have taken place. In the United States, on a daily basis thousands of research studies are being conducted. Some of these studies will greatly influence science, while others will make little impact. Historically, some studies have been remembered not for the results, but for ethical dilemmas surrounding the study. The Tuskegee syphilis study is a prime example of a study which made many people aware of the ethical problems surrounding research. The Tuskegee syphilis study made the government begin to analyze how research was performed in the country, and the study opened many eyes to what changes needed to be made. Analyzing the Tuskegee syphilis study allows for one to understand what went wrong with the study and how this study lead to great changes in the world...
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...Vulnerable Population in the Workplace Theresa Didion University of Phoenix The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability. The first goal of this paper is the examination of the vulnerable population of the mentally ill. Second, this paper will review the goals and agenda of Healthy People 2020 as it applies to mental illness. Third, this paper will review my work place assessment for barriers for the care and treatment of mentally ill patients. Finally, this paper will review a short presentation I gave to co-workers in an effort to aid in better treatment for the mentally ill. Recent figures suggest that in 2004, approximately 1 in 4 adults in the United States had had a mental health disorder in the past year, most commonly anxiety or depression ("Healthy People 2020 ", n.d.).. It is estimated that only about 17% of U.S. adults are considered to be in a state of optimal mental health ("Healthy People 2020 ", n.d.). An estimated 26% of Americans age 18 and older are living with a mental health disorder in any given year, and 46% will have a mental health disorder over the course of their lifetime ("Healthy People 2020 ", n.d.). Mental health disorders often have a serious impact on physical health and are associated with the prevalence, progression, and outcome of some of today’s most pressing chronic diseases including diabetes, heart disease, and cancer. Mental...
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...Contagion is a movie based on a deadly virus, MEV-1, which spreads around the world in a matter of days (Shamberg, Sher, Jacobs & Soderbergh, 2011). The premise is that the MEV-1 virus is spread person-to-person via airborne droplets produced by sneezes or coughs, as well as by viruses deposited on fomites, such as glasses, doorknobs, peanuts, and so on. The virus circles the globe in a matter of days, causing coughs, fevers and seizures as scientists from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) scramble to identify the pathogen and develop a vaccine. MEV-1 is presented to the audience as a pandemic. During a pandemic preserving the functionality of society is a priority (Gostin, 2008). Contagion raises a host of ethical dilemmas such as paternalism, beneficence, non-maleficence, and justice. The prospect of encountering a deadly pandemic such as that in Contagion, can create an overwhelming healthcare and community concern. The preparation for and response to an unusual turn of events of this magnitude requires goals that aim to benefit the community, as a whole. This involves an ethical viewpoint based on utilitarianism, with a primary focus on the good of the community, as opposed to the typical medical ethical view that focuses on the individual autonomy of patients. Ethics based on this notion of utility will most indeed pose a conflict between the community and the health of the individuals who make up that community...
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...Human Subjects Research (HSR) Series CITI Program’s HSR series consists of modules from two basic tracks, Biomedical (Biomed) and Social-Behavioral-Educational (SBE), and a set of Additional Modules of Interest. Organizations may group these modules to form a basic Biomed or SBE course, or a course that combines the two tracks. The Additional Modules of Interest should be used in any course variation, if relevant. The basic Biomed modules have three corresponding sets of refresher modules and the basic SBE modules have two corresponding sets of refresher modules. These refresher modules are intended to provide learners with a review of what was covered in the basic level modules. It is generally recommended that organizations select refresher module requirements that reflect their selections for the basic course(s). Refresher courses should be taken in a cycle at an interval specified by your organization (for example, Refresher Stage 1: 3 years after completion of basic course; Refresher Stage 2: 6 years after completion of basic course). Three additional standalone courses are available: Institutional/Signatory Official: Human Subject Research, and IRB Chair. The Institutional/Signatory Official: Human Subject Research course provides a general introduction to the roles and responsibilities of the institutional official at an organization holding a Federalwide Assurance (FWA). The IRB Administration course offers members of an Institutional Review Board’s (IRB)...
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...One fifth of the world’s population is located in south Asia. It is the most disposed region in the world. The majority of the poor people also lived there. There is a big figure of undernourished people according to FAO 2009.Climate change appeared as the single most persistent issue dominatingsociety on a global basis, with severe consequences for the food security of billions of people in the developing countries. The inter-annual, monthly and daily distribution of climate variables (e.g., temperature, radiation, precipitation, water vapor pressure in the air and wind speed) disturbs a number of physical, chemical and livingprocesses that vigor the yield of agricultural, forestry and fisheries systems (Easterling et al. 2007).Climate change...
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...What is Environmental Justice? http://www.epa.gov/compliance/environmentaljustice/ Abstract- Among evidence of environmental injustice is the fact that three out of five African-Americans and Hispanics, and nearly half of all Native Americans, Asians and Pacific Islanders live in communities with one or more uncontrolled toxic waste sites, incinerators or major landfills. A recent Greenpeace study found that minorities make up twice as large a population share in communities with these unwanted sites as in communities without them. In 1980 the average minority population near a landfill or hazardous waste facility was about 22%; in 1994 it was 36%. I. INTRODUCTION People of color in the United State and around the world are subjected to a disproportionately high level of environmental health risk in their neighborhoods and on their jobs. Minorities, who tend to be poorer and more disadvantaged that other residents, work in the dirtiest jobs where they are exposed to toxic chemicals and other hazards. More often than not they also live in urban ghettos, barrios, reservations and rural poverty pockets that have shockingly high pollution levels and are increasingly the site of unpopular industrial facilities, such as toxic waste dumps, landfills, smelters, refineries and incinerators. Environmental Justice combines civil rights with environmental protection to demand a safe, healthy, life-giving environment for everyone. II. ORIGIN In 1987 the Reverend Benjamis Chavis...
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...Lawrence O. Gostin Georgetown University Law Center, gostin@law.georgetown.edu Georgetown Public Law and Legal Theory Research Paper No. 976413 This paper can be downloaded free of charge from: http://scholarship.law.georgetown.edu/facpub/479 http://ssrn.com/abstract=976413 297 JAMA 737-740 (2007) This open-access article is brought to you by the Georgetown Law Library. Posted with permission of the author. COMMENTARIES Biomedical Research Involving Prisoners Ethical Values and Legal Regulation Lawrence O. Gostin, JD U NTIL THE EARLY 1970 S , R. J. R EYNOLDS , D OW Chemical, the US Army, major pharmaceutical companies, and other sponsors conducted a wide variety of research on prisoners—a captive, vulnerable, and easily accessible population.1,2 During that time, approximately 90% of all pharmaceutical research was conducted on prisoners, who also were subjected to biochemical research ranging from testing diet drinks and simple detergents to studies involving dioxin and chemical warfare agents.3 From 1962 to 1966, for example, 33 pharmaceutical companies tested 153 experimental drugs at Holmesburg Prison in Philadelphia, including a Retin-A (tretinoin) study in which researchers did not seek informed consent and prisoners were not adequately treated for pain.4 By the mid-1970s, biomedical research in prisons sharply declined as knowledge of the exploitation of prisoners began to emerge and the National Commission for the Protection of Human Subjects...
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...Prostitution; An Abolitionist Perspective We can learn a great deal about women and prostitution by studying the construction of prostitution as a « Social problem ». Two dominant questions oppose each other when it comes to prostition, One of them wich advocates abolition, and the other claiming its recognition as a full time job. These two positions appear to be largely balanced despite their opposition to the extent that they mobilize the same arguments, that is to say moral. But throughout his work, his analysis shows that prostitution is a widely heterogeneous universe, crossed by numerous divisions and whose participants are located mainly in the same position in the economic and social field. The first chapter explains the construction of prostitution and claims that it only creates misery and populism, as often when it comes to socially subordinate groups. In both cases, there is a certain essentialist representation of the prostitute - because often we forget men who engage in commercial sex, and the blurred boundaries of genders that include transvestites and transsexuals. More worryingly, it shows that some sociologists use their scientific legitimacy to defend highly ideological positions (in this case abolitionists). To get out of these preconceptions of considering prostitution not in only in the terms of sexuality – just like the idea of taboo in our society, but as a means of economical “subsistence” for individuals who practice it. This is often led...
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...FOOD SAFETY KNOWLEDGE AND PRACTICES OF FOOD RECOVERY AGENCY WORKERS BEFORE AND AFTER FOOD SAFETY TRAINING A Thesis Submitted to the Graduate Faculty of the Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Master of Science in The School of Human Ecology by Sara Katherine Waggoner B.S., Texas Christian University, 2002 May 2004 ACKNOWLEDGEMENTS I would like to express my deep appreciation to Dr. Michael Keenan who served as one of my major professors on this project. His concern for his students and colleagues is extraordinary, and his enthusiasm regarding the field of nutrition is inspiring. A sincere expression of gratitude goes to my other major professor Dr. Elizabeth Reames. She is an excellent mentor, and it has truly been a blessing to work with such an amazing person. I would like to thank Dr. Maren Hegsted, a committee member who has been an incredible support to me during my time here at LSU. She has always been there to offer advice and to answer my endless questions. Also, I would like to show appreciation to Dr. Georgiana Tuuri, a committee member whose energy and smile were always sources of encouragement. A very special thank you is also extended to my family and friends for their patience, understanding, and support throughout this endeavor. Finally, thank you to the entire faculty, staff, and students of the School of Human Ecology for their thoughtfulness...
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...Environmental Health Impact Assessment., Evaluation of a Ten-Step Model Rainer Fehr "Environmental impact assessment" denotes the attempt to predict and assess the impact of development projects on the environment. A component dealing specifically with human health is often called an "environmental health impact assessment." It is widely held that such impact assessment offers unique opportunities for the protection and promotion of human health. The following components were identified as key elements of an integrated environmental health impact assessment model: project analysis, analysis of status quo (including regional analysis, population analysis, and background situation), prediction of impact (including prognosis of future pollution and prognosis of health impact), assessment of impact, recommendations, communication of results, and evaluation of the overall procedure. The concept was applied to a project of extending a waste disposal facility and to a city bypass highway project. Currently, the coverage of human health aspects in environmental impact assessment still tends to be incomplete, and public health departments often do not participate. Environmental health impact assessment as a tool for health protection and promotion is underutilized. It would be useful to achieve consensus on a comprehensive generic concept. An international initiative to improve the situation seems worth some consideration. (Epidemiology 1999;10:618625) Keywords:...
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