Environmental Contexts of Vulnerable Populations: Implications for Nursing Research
Background: It is now widely recognized that health outcomes depend far more on social and physical environments than on medical care. The interplay of biologic, social, economic, behavioral, environmental, and other factors influence the health of individuals, populations, and sub-groups. The environmental context contributes to the underlying causes of health, wellness, and illness and perpetuates health disparities, particularly among vulnerable populations. Nurse researchers face many barriers when working with vulnerable populations, such as rural residence, poverty and isolation. Barriers rooted in the environment create unique challenges in research that require attention. An environmental perspective in nursing research can result in a broader understanding of determinants of health and improved access to high-quality health services.
Methods: This presentation briefly highlights the components of succeeding presentations that address the role of the environment in healthcare equity and access among vulnerable populations.
Results: A detailed background that identifies several research projects that both identifies barriers to care and reports on methods used to either overcome these will be presented. A nurse scholar conducting research among low-income populations with latent tuberculosis infection identifies complex social-cultural barriers, such as personal illness beliefs to accepting and completing treatment. A research project among American Indian Plains tribes identifies both environmental factors and illness beliefs that inhibit access to care. And finally, a post doctoral fellow presents the very real problem of uranium contamination on the Navajo reservation that is mired in unequal access to information, screening and healthcare surveillance which may result in future illness. These presentations have both common factors as well as unique issues that require exploration for adequate solutions.
Implications: There is a significant need for increased attention and recommendations regarding the contribution of environmental factors on health as well as equity and access to healthcare among vulnerable populations. Key findings in these research projects point to the need for better understanding of environmental contexts of health as well as environmental barriers to care. These research projects call for an environmental lens in nursing research as well as changing structures for healthcare delivery and policy to address complex equity and access issues