Date: September 8 2022
Summary: An overview and summary of vulnerable populations that are particular to rural US
Keywords: ##bibliography #review #vulnerable #populations #rural #us #archive
K. M. Gonzalez, "A Systematic Review of the Health of Vulnerable Populations within US Rural Societies," OJRNHC, vol. 18, no. 1, pp. 112–147, 2018, doi: 10.14574/ojrnhc.v18i1.507.
I wanted to read this paper to get more a sense for vulnerable populations. Although I was less interested in the specific applications to rural communities, I found the discussion around rural vulnerabilities very interesting as well as clarification around definitions.
Vulnerable populations are those subgroups that are at risk for experiencing elevated healthcare disparities. (De Chesnay & Anderson, 2016; Shi & Stevens, 2010).
A potential model to assess vulnerability is that proposed by (Grabovschi et al., 2013) where it can be visaulized as a right triangle with the horizontal axis representing healthcare accessibility and quality; vertical axis represents healthcare needs; hypotenuse is the level of vulnerability.
Health disparities continue to be a severe problem across US populations. (Crosby, Wendel, Vanderpool, & Casey, 2012; Penman-Aguilar et al., 2016) Trends in inequalities emerge for patients seeking healthcare across multiple factors such as race, socioeconomic status, and provider accessibility.
Rural dwellers tend to lack insurance compared to urban settings (Barker, Londeree, McBride, Kemper, & Mueller, 2013; Soni, Hendryx, & Simon, 2017)
Many rural dwellers travel more than 30 minutes for healthcare - it is especially exacerbated where public transportation is lacking and severe poverty exists (Warren & Smalley, 2014, p. xiii)
46 articles were studied for this systematic review. Population sizes ranged from 10 to 30,874 people. For quantitative studies, populations ranged from 28 to 30,874 participants.
| Aspects of Vulnerability Considered | Included papers, n (%) |
|---|---|
| Low socioeconomic status | 22(47.8%) |
| Racial/Ethnic Minority | 18(39.1%) |
| Chronic physical or mental illness | 11(23.9%) |
| Low level of education | 11(23.9%) |
| Old age | 8(17.4%) |
| Youth | 8(17.4%) |
| Residence in medically underserved area | 6(13.0%) |
| Disability | 5(10.9%) |
| Pregnancy | 4(8.7%) |
| Smoking | 3(6.5%) |
| Substance Abuse | 3(6.5%) |
Only one article calculated a power analysis (Komro et al., 2015).
Power analysis are used in quantitative research to limit error between hypothesis and findings.
There was observed an overrelianceon descriptive correlational designs that impeded adequate theory testing. Studies should incorporate theories and theoretical applications relevant to rural populations.
Zelko, Jacob. A Systematic Review of the Health of Vulnerable Populations within US Rural Societies. https://jacobzelko.com/09082022131551-systematic-rural-review. September 8 2022.