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Health Service Utilization among Vulnerable Populations
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Health Service Utilization among Vulnerable Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 13004

Special Issue Editor

Dr. Jane Currie

E-Mail Website
Guest Editor
School of Nursing, Queensland University of Technology, 149 Victoria Road, Brisbane, QLD 4059, Australia
Interests: access to healthcare; vulnerable populations; nurse practitioner

Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health is calling for papers for a Special Issue on Health Service Utilization among Vulnerable Populations. Access to healthcare is a basic human right, and yet so many people struggle to receive the care they so desperately need. Those in greatest need of healthcare are often those who receive the least, particularly vulnerable populations, including people experiencing homelessness and poverty, and marginalized members of our communities. 

In this Special Issue, we welcome submissions of papers that use creative and robust approaches that will deepen our understanding of the challenges of accessing and using healthcare by vulnerable populations, and how these can be overcome. We invite papers for consideration from any healthcare setting and any methodology. Examples include studies that explore the association between vulnerability and healthcare utilization; those that examine models of care that optimize access for vulnerable populations, recognizing vulnerability, human rights approaches, co-production, and complex systems approaches; and strength-based approaches. All articles must make a strong contribution to healthcare science and expand our understanding of the relationship between vulnerability and health service utilization.

Dr. Jane Currie
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • healthcare access
  • healthcare use
  • vulnerable populations
  • health inequalities
  • health outcomes

Published Papers (5 papers)

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Editorial

Jump to: Research, Review, Other

8 pages, 312 KiB  
Editorial
Optimising Access to Healthcare for Patients Experiencing Homelessness in Hospital Emergency Departments
by Jane Currie, Amanda Stafford, Jennie Hutton and Lisa Wood
Int. J. Environ. Res. Public Health 2023, 20(3), 2424; https://doi.org/10.3390/ijerph20032424 - 30 Jan 2023
Cited by 3 | Viewed by 3099
Abstract
The ED is often the first and sometimes the only place where people experiencing homelessness seek medical assistance. While access to primary healthcare is a preferable and more cost-effective alternative to ED, for many reasons, people experiencing homelessness are much less likely to [...] Read more.
The ED is often the first and sometimes the only place where people experiencing homelessness seek medical assistance. While access to primary healthcare is a preferable and more cost-effective alternative to ED, for many reasons, people experiencing homelessness are much less likely to have a regular General Practitioner compared to those living in stable accommodation. Drawing on a growing body of emergency care and homelessness literature and practice, we have synthesised four potential interventions to optimise access to care when people experiencing homelessness present to an ED. Although EDs are in no way responsible for resolving the complex health and social issues of their local homeless population, they are a common contact point and therefore present an opportunity to improve access to healthcare. Full article
(This article belongs to the Special Issue Health Service Utilization among Vulnerable Populations)

Research

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14 pages, 373 KiB  
Article
Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study
by Jessica A. Heerde, Gabriel J. Merrin, Vi T. Le, John W. Toumbourou and Jennifer A. Bailey
Int. J. Environ. Res. Public Health 2023, 20(3), 1711; https://doi.org/10.3390/ijerph20031711 - 17 Jan 2023
Cited by 1 | Viewed by 2078
Abstract
People who experience social marginalization and vulnerability have uniquely complex health needs and are at risk of poor health outcomes. Regression analyses using longitudinal data from a cross-national, population-based sample of young adults participating in the International Youth Development Study, tested associations between [...] Read more.
People who experience social marginalization and vulnerability have uniquely complex health needs and are at risk of poor health outcomes. Regression analyses using longitudinal data from a cross-national, population-based sample of young adults participating in the International Youth Development Study, tested associations between social marginalization and vulnerabilities and physical health, mental health, and substance use outcomes. Participants from Victoria, Australia, and Washington State in the US were surveyed at ages 25 (2014) and 29 years (2018; N = 1944; 46.7% male). A history of adverse childhood experiences (ACEs), LGBT identity, financial insecurity, and justice system involvement at age 25 predicted poor health outcomes at age 28, including lower perceived health status, risk for chronic illness, depression and anxiety symptoms, and diagnosed mental health/substance use disorders. Tests of model equivalence across states showed that a history of ACEs was more strongly related to health status and serious injury at age 28 and justice system involvement at age 25 was more strongly related to age 28 serious injury in Victoria than in Washington State. Findings strengthen the case for future population-based research identifying life-course interventions and state policies for reducing poor health and improving health equity among members of socially marginalized groups. Full article
(This article belongs to the Special Issue Health Service Utilization among Vulnerable Populations)
11 pages, 381 KiB  
Article
‘I Didn’t Know Where to Go’: A Mixed-Methods Approach to Explore Migrants’ Perspectives of Access and Use of Health Services during the COVID-19 Pandemic
by Ana Gama, Maria J. Marques, João Victor Rocha, Sofia Azeredo-Lopes, Walaa Kinaan, Ana Sá Machado and Sónia Dias
Int. J. Environ. Res. Public Health 2022, 19(20), 13201; https://doi.org/10.3390/ijerph192013201 - 13 Oct 2022
Cited by 3 | Viewed by 1768
Abstract
The COVID-19 pandemic put pressure on health systems, affecting populations’ use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants [...] Read more.
The COVID-19 pandemic put pressure on health systems, affecting populations’ use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants in Portugal. A mixed-methods approach was used. A community-based cross-sectional survey was conducted involving migrant communities residing in the Lisbon Metropolitan Area. Analyses of a subsample of participants (n = 929) examined factors associated with perceived worsening of access to health services during the pandemic. Semi-structured interviews with 14 migrants were conducted and thematically analyzed to further understand experiences and difficulties in health services’ use. Around 44% of surveyed participants reported worsening of access to health services since the pandemic, more frequently women, those with lower income, and those who perceived being at moderate or high risk for COVID-19 infection. Digital change in services and lack of formal and informal support during lockdowns were highlighted by interviewers as main barriers in access to healthcare for migrants. The pandemic renewed concerns about inequalities in healthcare access among migrants. It is key that in following years health systems are able to address the potential accumulated burden of disease. Full article
(This article belongs to the Special Issue Health Service Utilization among Vulnerable Populations)

Review

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15 pages, 714 KiB  
Review
Dementia and COVID-19 among Older African American Adults: A Scoping Review of Healthcare Access and Resources
by Idorenyin Imoh Udoh, Elias Mpofu and Gayle Prybutok
Int. J. Environ. Res. Public Health 2023, 20(4), 3494; https://doi.org/10.3390/ijerph20043494 - 16 Feb 2023
Cited by 3 | Viewed by 1711
Abstract
African American/Black communities comprise 12.2% of the U.S. population, with a COVID-19 infection rate of more than 18% and marginal access to healthcare services. This scoping review synthesizes the emerging evidence on healthcare accessibility among older African American adult communities with dementia and [...] Read more.
African American/Black communities comprise 12.2% of the U.S. population, with a COVID-19 infection rate of more than 18% and marginal access to healthcare services. This scoping review synthesizes the emerging evidence on healthcare accessibility among older African American adult communities with dementia and COVID-19, as well as the resource requirements for this population during the pandemic. Searches of different databases for empirical studies and other sources on dementia and COVID-19 among older African American adults yielded 13 studies that met the following inclusion criteria: (a) focus on dementia and COVID-19, (b) sampled older African American adults, (c) investigated healthcare accessibility and resources, and (d) published between 2019 and 2022. Following the initial selection of the studies, eight were selected for relevance based on the Population, Concept, and Context (PCC) inclusion and exclusion criteria. Thematic analysis indicated that older African Americans with dementia and COVID-19 experienced longer delays in accessing timely healthcare, including transportation, intensive care units (ICUs), and mechanical ventilation. They also had reduced healthcare resources associated with a lack of health insurance, low financial resources, and an increased length of hospital stay, which further aggravated the negative effects of comorbid dementia and COVID-19 infections. Evidence showed that racial and age disparities affected older African American adults with dementia and COVID-19, resulting in lower healthcare access and marginal resources. This is consistent with historical and systemic inequities in meeting the healthcare needs of people of color in the United States, which was compounded for older African Americans during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Health Service Utilization among Vulnerable Populations)
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11 pages, 342 KiB  
Case Report
Heat Illness Requiring Emergency Care for People Experiencing Homelessness: A Case Study Series
by Timothy English, Matthew Larkin, Alejandro Vasquez Hernandez, Jennie Hutton and Jane Currie
Int. J. Environ. Res. Public Health 2022, 19(24), 16565; https://doi.org/10.3390/ijerph192416565 - 9 Dec 2022
Cited by 7 | Viewed by 2831
Abstract
Extreme heat and hot weather has a negative impact on human health and society. Global warming has resulted in an increase in the frequency and duration of heatwaves. Heat-related illnesses are a significant negative consequence of high temperatures and can be life-threatening medical [...] Read more.
Extreme heat and hot weather has a negative impact on human health and society. Global warming has resulted in an increase in the frequency and duration of heatwaves. Heat-related illnesses are a significant negative consequence of high temperatures and can be life-threatening medical emergencies. The severity of the symptoms can depend on the pre-existing medical conditions and vary from mild headaches to severe cases that can lead to coma and death. The risk of heat-related illness may be higher for people experiencing homelessness due to a lack of access to cool places and water, and the complex interactions between mental illness, medications and substance use disorder. This paper presents two cases of people experiencing homelessness who were admitted to the emergency department of a hospital in Sydney, Australia during a heatwave in November 2020. Both cases were adult males with known risk factors for heat-related illness including hypertension and schizophrenia (Case One) and hepatitis C, cirrhosis, and alcohol use disorder (Case Two). These cases show that severe weather can not only be detrimental to homeless people’s health but can also cause a significant economic toll, evident by the $70,184 AUD expenditure on the care for these two cases. This case report highlights the requirement to determine the risk of heat-related illness to people experiencing homelessness and need to protect this vulnerable population from weather-related illness and death. Full article
(This article belongs to the Special Issue Health Service Utilization among Vulnerable Populations)
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