Mechanic and Tunner (2008), from definitions and determinants, define vulnerability as an inclination to harm, which results from an interaction between life challenges and the resources accessible to communities and individuals to combat these threats. As such, vulnerability stems from various causes. These sources include incapacities on a personal level; overall problems in development; environmental and neighborhood degradation; and an inadequacy in support of interpersonal networks. The World Health Organization defines vulnerability as the level of which a population, organization, or an individual is unable to forecast, resist, cope with, or recover from disastrous impacts ("WHO | Vulnerable groups," 2018). In public health, most practitioners work on the identification and removal, or at the very least, a reduction of potential threats. However, harm usually manifests through various shades and affects individuals and communities differently. While some communities are susceptible to threats, others are resilient. Therefore, my definition of vulnerability is the plausibility of exposure to harm due to the lack of resources to counteract persistent or consistent exposure to negative natural or fabricated uncertainties of life; the former being people like the elderly, and the latter socioeconomic challenges.
As it applies to public health and more precisely, bioethics, vulnerability is often interpreted as a concept that reflects individuals or groups as having a specific status, with an impending negative impact upon their well-being (Wrigley & Dawson, 2016). This definition extends to the fact that practitioners have the duty to preserve this state of well-being due to the individuals’ or the communities’ inability to do so themselves. Challenges arise in the definition of vulnerability due to a consensus in the ambiguity of characterizing the notion of “special category.” This duty to preserve vulnerable persons and communities has led to the design and development of custom health education approaches attuned to vulnerable people, groups, and populations. This paper discusses vulnerability and the health prevention, promotion, and education approaches attuned to individuals and community groups within this subset.
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Vulnerability Dimensions
As mentioned above, vulnerability entails various dimensions, which interrelate naturally. Socially, the use of the term “social capital” reflects the potentiality of useful networks that bring people together through shared norms and values. People increasingly have the idea that social capital represents a notion of community solidarity and relations. Contrariwise, the social stress process produces divergent vulnerable results depending on challenges experienced by individuals, communities of populations. Consequently, as defined in sociology and psychology, a vulnerable adult is, in essence, an individual unable or unwilling to maintain pertinent skills and unable to improve by their efforts without the direct assistance of a typical adult.
Vulnerable communities represent a group of individuals sharing similar social discord as a normative way of daily life; the elderly easily represent these (Mechanic & Tanner, 2007). While healthcare promotion and education are a great way to streamline vulnerable community groups, they also require major hands-on interventions such as employment creation and the involvement of family members and friends, among others. Vulnerable populations refer to individuals with similar challenges spread across homes, neighborhoods, communities, states, and eventually the entire nation (Mechanic & Tanner, 2007). This subset of vulnerability often feels neglected by the community and excluded in state and national affairs. This is why there are normally tendencies of vulnerable populations to form their rogue associations serving neither their interests as a whole nor those of the communities in which they come from. This renegade tendency supports the creation of a health prevention, promotion, and education approach as a way of bringing such groups together and giving them the skills and tools to alleviate their vulnerable status.
Health Prevention, Promotion, and Education Approaches
Presently, health promotion is decidedly pertinent. Globally, the acceptance rate of social well-being and health is increasing exponentially. It is determined by various variables external to the health system such as consumption patterns, socioeconomic conditions, family history, learning environs, the cultural and social fabric, global environmental change, and commercialization and trade among others (Kumar & Preetha, 2012). These determinants of social well-being also affect individuals, communities, and populations making them either vulnerable or resilient. Therefore, in such circumstances, the adoption of holistic methodologies designed for use in fostering public health leadership, the empowerment of individual health responsibilities, and the promotion of cumulative community action aimed at enacting germane public health policies and sustainable health systems are apposite, particularly among the elderly.
Negative Health Effects Prevention
Predominantly among the elderly, the promotion of health anchors on the control of health inequities and inequalities comprises the prevention of negative health effects. Trinh-Shevin et al., (2015) describes inequities and inequalities in health as disproportionate disease burdens within some communities and the variables that affect disparities and health in the population. To counteract the emergence of vulnerable communities through health promotion, a health equity approach will be apposite. Moreover, its application as a promotional approach to alleviate vulnerability requires the understanding of health inequity and inequality. According to the Center for Disease Control, health inequality refers to a discrepancy in the status of health of individuals attributed to uneven disease burdens or utility services. In addition, health inequality may also affect individuals pertaining to a particular community. Contrary to inequality, inequity represents social justice in defining avoidable, unfair, and unjust health discrepancies. Overall, the use of both health inequalities and inequities are interchangeable in relation to variables such as social structures, organizations, and environmental and institutional racism. Among the elderly, inequity, especially in America, is largely socioeconomically stratified
The negative health effects prevention approach addresses health inequities as a complicated framework. This model is in effect multi-level in structure and incorporates social and structural determinants, the former being cultural and contemporary values and the latter policies affecting social status, education access, and the segregation of residential areas. Addressing issues to do with health inequities is, therefore, a formidable approach to negative health effects prevention among the elderly. The process of this approach begins by addressing pertinent challenges occurring at birth and continuing into childhood, adolescence, and adulthood, representing an evolution into larger likelihoods of pervasive social and health disadvantages that eventually lead to vulnerable individuals and groups. Therefore, in designing a prevention approach, and in comprehending these factors and their influence on future generation, a life course perspective is required (Trinh-Shevin et al., 2015). In addition to equity, health prevention among individuals takes on a conscious role through thorough sensitization programs.
Health Promotion
Vulnerable individuals within the community particularly the elderly greatly benefit from community-based participatory research. Recent dynamism in healthcare has brought about emergence and an increase in population health frameworks resulting in recognition of drawbacks in therapies that are evidence-based, the dissemination of pertinent guidelines for treatment and prevention, and eventually, their incorporation and implementation in both individual and community settings. Therefore, my health promotional approach focuses on participatory research as a way of studying vulnerability determinants among the aging and suggesting preventative methods. Moreover, the present emergence of translational research shows community concerns and their willingness to improve the design and development of relevant interventions, and ultimately, the adoption of pertinent empirical and evidence-based interventions.
The health promotion approach I will use to counteract vulnerability will also incorporate a population perspective. The approach’s design centers on six elements pertinent to health promotion among the elderly within the community. This includes a focus on wellness rather than illness; the understanding of needs and solutions through community contact; the address of equity; the address of health determinants in a social or multiple perspectives; and the embrace of inter-sectoral partnerships and actions. While this is an approach for communities, for individuals, the health promotion approach will center on behavior change programs. Habits reflect well-being; therefore, for vulnerable individuals to attain independence, their daily behavioral tendencies require proper surveillance and suggestions that are more proactive and beneficial
Health Education
The health education approach for vulnerable individuals and communities has to be wholesome in its approach, with facilitators playing central roles in the processes of information dissemination and dispensation. As such, it is critical for educational systems to incorporate the development of plans and policies that have the capacity of impeding vulnerable conditions among the elderly. The educational approach will represent a resilient cohesion that reflects the promotion of inclusion and equity. The approach follows a regular process that commences with the educational sector, followed by the formulation of policy, then plan preparation, then M & E framework, and finally the cost and financing. The approach aims at developing capacities, joining developmental and humanitarian partners, and the implementation of coordination mechanisms. Moreover, this education approach employs the use of three adult education options: andragogic education, transformative education, and appreciative education (Pawlak & Bergquist, 2018).
Various types of circumstances result in the elderly being prone to vulnerabilities such as poor health. Such factors range from situations such as inadequate housing to exposure to toxic substances or violence. In America, the highest predictor of poor health, disability, and mortality is attributed to poverty. Numerous relationships exist concerning the link between poverty to a vulnerability in terms of health and overall well-being. Apart from the elderly, most times, vulnerable populations include individuals who are homeless, chronically malnourished, disabled or chronically ill and living with HIV/AIDS among others. While there is a heavy representation of such populations in the U. S., preventative approaches, particularly those attuned to health continue to offer better prospects in curbing the exponential risks involved when an individual has the vulnerability status.
References
Kumar, S., & Preetha, G. (2012). Health promotion: An effective tool for global health. Indian Journal Of Community Medicine , 37 (1), 5. http://dx.doi.org/10.4103/0970-0218.94009
Mechanic, D., & Tanner, J. (2007). Vulnerable People, Groups, And Populations: Societal View. Health Affairs , 26 (5), 1220-1230. http://dx.doi.org/10.1377/hlthaff.26.5.1220
Pawlak, K., & Bergquist, W. (2018). Four Models of Adult Education . The Professional School of Psychology . Retrieved 26 March 2018, from https://psychology.edu/about/four-models-of-adult-education/
Trinh-Shevrin, C., Islam, N., Nadkarni, S., Park, R., & Kwon, S. (2015). Defining an Integrative Approach for Health Promotion and Disease Prevention: A Population Health Equity Framework. Journal Of Health Care For The Poor And Underserved , 26 (2A), 146-163. http://dx.doi.org/10.1353/hpu.2015.0067
WHO | Vulnerable groups . (2018). Who.int . Retrieved 26 March 2018, from http://www.who.int/environmental_health_emergencies/vulnerable_groups/en/
Wrigley, A., & Dawson, A. (2016). Vulnerability and Marginalized Populations. Public Health Ethics Analysis , 203-240. http://dx.doi.org/10.1007/978-3-319-23847-0_7
