Addressing the nutritional needs of vulnerable populations - Working with low income communities in Ontario, Canada

2000 ◽  
Author(s):  
Fiona Knight ◽  
Ursula Lipski
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Nutritional Needs

scholarly journals Implementing Telemedicine Visits in an Underserved Ophthalmology Clinic in the COVID-19 Era

2021 ◽  
Vol 12 ◽  
pp. 215013272199627
Author(s):  
Mona Adeli ◽  
William R. Bloom
Keyword(s):  
Latin America ◽  
High Risk ◽  
Vulnerable Populations ◽  
Low Income ◽  
Office Visit ◽  
Medically Underserved ◽  
Uninsured Patients ◽  
Potential Barriers ◽  
Ocular Morbidity

Introduction: Many of the potential barriers to providing telehealth services already disproportionately impact vulnerable populations. The purpose of this study was to assess the incorporation of synchronous ophthalmology telemedicine visits in a tertiary university-based ophthalmology clinic for low-income and uninsured patients in the COVID-19 era. Methods: The records of 18 patients who were due for an in-person visit in the medically underserved patient clinic at our institute were reviewed. Patients considered high risk of ocular morbidity progression were approved to proceed with an in-person visit. Patients with non-urgent visit indications were attempted to be contacted by telephone to be offered a telemedicine telephone visit as an alternative to a postponed in-person office visit. Results: Clinical triage by an attending ophthalmologist determined that 17 patients (94.4%, n = 18) had visit indications appropriate for evaluation by telemedicine. Six patients (35.3%, n = 17) were successfully contacted and offered a telemedicine visit as an alternative to a postponed in-person office visit. All 6 patients accepted, scheduled, and completed a telemedicine visit. Eleven patients (64.7%, n = 17) were not able to be successfully contacted to offer and schedule either a telemedicine visit or a postponed in-person office visit. Patients who were not able to be successfully contacted were on average younger in age and more likely to be female, Hispanic/Latino, from Latin America, with a preferred language of Spanish. Conclusions: Synchronous ophthalmology telemedicine visits can be successfully incorporated in a tertiary university-based setting for low-income and uninsured patients. The primary barrier to providing telemedicine visits in this population was the ability to successfully contact patients to offer and schedule these visits.

scholarly journals The Rise of the Data Poor: The COVID-19 Pandemic Seen From the Margins

2020 ◽  
Vol 6 (3) ◽  
pp. 205630512094823 ◽  
Author(s):  
Stefania Milan ◽  
Emiliano Treré
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Global South ◽  
Low Income Countries ◽  
Negative Effects ◽  
Critical Data ◽  
Data Gaps ◽  
Relief Efforts

Quantification is central to the narration of the COVID-19 pandemic. Numbers determine the existence of the problem and affect our ability to care and contribute to relief efforts. Yet many communities at the margins, including many areas of the Global South, are virtually absent from this number-based narration of the pandemic. This essay builds on critical data studies to warn against the universalization of problems, narratives, and responses to the virus. To this end, it explores two types of data gaps and the corresponding “data poor.” The first gap concerns the data poverty perduring in low-income countries and jeopardizing their ability to adequately respond to the pandemic. The second affects vulnerable populations within a variety of geopolitical and socio-political contexts, whereby data poverty constitutes a dangerous form of invisibility which perpetuates various forms of inequality. But, even during the pandemic, the disempowered manage to create innovative forms of solidarity from below that partially mitigate the negative effects of their invisibility.

scholarly journals Living in the Southern Hemisphere: Metabolic Syndrome and Its Components in Amazonian Riverine Populations

2021 ◽  
Vol 10 (16) ◽  
pp. 3630
Author(s):  
Gabriela P. Arrifano ◽  
Jacqueline I. Alvarez-Leite ◽  
Barbarella M. Macchi ◽  
Núbia F. S. S. Campos ◽  
Marcus Augusto-Oliveira ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Southern Hemisphere ◽  
Vulnerable Populations ◽  
Low Income ◽  
Hdl Cholesterol ◽  
Developed Countries ◽  
Atherogenic Dyslipidemia ◽  
Cross Sectional ◽  
The Metabolic Syndrome ◽  
Low Hdl

The metabolic syndrome (MetS) epidemic is a global challenge. Although developing countries (including Brazil, India, and South Africa) present a higher proportion of deaths by cardiovascular diseases than developed countries, most of our knowledge is from these developed countries. Amazonian riverine populations (ARP), as well as other vulnerable populations of the Southern Hemisphere, share low-income and traditional practices, among other features. This large cross-sectional study of ARP (n = 818) shows high prevalence of hypertension (51%) and obesity (23%). MetS was diagnosed in 38% of participants (especially in women and 60–69 years-old individuals) without the influence of ancestry. Only 7–8% of adults had no cardio-metabolic abnormalities related to MetS. Atherogenic dyslipidemia (low HDL-cholesterol) was generally observed, including in individuals without MetS. Still, slight differences were detected between settings with a clear predominance of hypertension in Tucuruí. Hypotheses on possible genetic influence and factors (nutrition transition and environmental pollutants -mercury) are proposed for future studies. Moreover, a roadmap to MetS progression based on the most prevalent components is provided for the development of tailored interventions in the Amazon (initially, individuals would present low HDL-cholesterol levels, later progressing to increased blood pressure characterizing hypertension, and ultimately reaching MetS with obesity). Our alarming results support the need to improve our knowledge on these vulnerable populations.

scholarly journals How to use relevant data for maximal benefit with minimal risk: digital health data governance to protect vulnerable populations in low-income and middle-income countries

2019 ◽  
Vol 4 (2) ◽  
pp. e001395 ◽  
Author(s):  
Nicki Tiffin ◽  
Asha George ◽  
Amnesty Elizabeth LeFevre
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Digital Health ◽  
Health Data ◽  
Digital Data ◽  
Data Governance ◽  
Data Breach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Programmes

Globally, the volume of private and personal digital data has massively increased, accompanied by rapid expansion in the generation and use of digital health data. These technological advances promise increased opportunity for data-driven and evidence-based health programme design, management and assessment; but also increased risk to individuals of data misuse or data breach of their sensitive personal data, especially given how easily digital data can be accessed, copied and transferred on electronic platforms if the appropriate controls are not implemented. This is particularly pertinent in low-income and middle-income countries (LMICs), where vulnerable populations are more likely to be at a disadvantage in negotiating digital privacy and confidentiality given the intersectional nature of the digital divide. The potential benefits of strengthening health systems and improving health outcomes through the digital health environment thus come with a concomitant need to implement strong data governance structures and ensure the ethical use and reuse of individuals’ data collected through digital health programmes. We present a framework for data governance to reduce the risks of health data breach or misuse in digital health programmes in LMICS. We define and describe four key domains for data governance and appropriate data stewardship, covering ethical oversight and informed consent processes, data protection through data access controls, sustainability of ethical data use and application of relevant legislation. We discuss key components of each domain with a focus on their relevance to vulnerable populations in LMICs and examples of data governance issues arising within the LMIC context.

Nutrition in marginalised groups

2017 ◽  
Author(s):  
Rosalind Fallaize ◽  
Julie Lovegrove
Keyword(s):  
Low Income ◽  
Potential Benefit ◽  
Dietary Intervention ◽  
Clinical Excellence ◽  
Physical And Mental Health ◽  
Dietary Choices ◽  
Marginalised Groups ◽  
Nutritional Needs ◽  
Bed And Breakfast ◽  
Specialist Groups

This chapter examines key nutritional issues and contemporary advances in human nutrition in marginalised groups. Evidence suggests that the dietary choices of communities on low income, including the homeless and families residing in temporary accommodation, are compromised. Homelessness in particular is associated with increased physical and mental health needs. The chapter reviews the evidence for the nutritional requirements, dietary intake and associated health and lifestyle factors in homeless individuals. It considers the unique challenges faced by single homeless adults and homeless families (residing in temporary or bed-and-breakfast accommodation), along with possible interventions to overcome these. It also discusses the potential benefit and community responses to dietary intervention, food banks and voucher systems within the context of complex nutritional needs, food insecurity and marginalised housing scenarios. UK policies and guidelines, including the National Institute of Clinical Excellence (NICE) and specialist groups, are analysed as well.

scholarly journals Impact of the Medicare hospital readmissions reduction program on vulnerable populations

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yunwei Gai ◽  
Dessislava Pachamanova
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Risk ◽  
Vulnerable Populations ◽  
Low Income ◽  
Hospital Readmissions ◽  
High Risk Patients ◽  
Reduction Program ◽  
Risk Patients ◽  
Linear Probability

Abstract Background The Hospital Readmissions Reduction Program (HRRP) was established by the 2010 Patient Protection and Affordable Care Act (ACA) in an effort to reduce excess hospital readmissions, lower health care costs, and improve patient safety and outcomes. Although studies have examined the policy’s overall impacts and differences by hospital types, research is limited on its effects for different types of vulnerable populations. The aim of this study was to analyze the impact of the HRRP on readmissions for three targeted conditions (acute myocardial infarction, heart failure, and pneumonia) among four types of vulnerable populations, including low-income patients, patients served by hospitals that serve a high percentage of low-income or Medicaid patients, and high-risk patients at the highest quartile of the Elixhauser comorbidity index score. Methods Data on patient and hospital information came from the Nationwide Readmission Database (NRD), which contained all discharges from community hospitals in 27 states during 2010–2014. Using difference-in-difference (DD) models, linear probability regressions were conducted for the entire sample and sub-samples of patients and hospitals in order to isolate the effect of the HRRP on vulnerable populations. Multiple combinations of treatment and control groups and triple difference (DDD) methods were used for testing the robustness of the results. All models controlled for the patient and hospital characteristics. Results There have been statistically significant reductions in readmission rates overall as well as for vulnerable populations, especially for acute myocardial infarction patients in hospitals serving the largest percentage of low-income patients and high-risk patients. There is also evidence of spillover effects for non-targeted conditions among Medicare patients compared to privately insured patients. Conclusions The HRRP appears to have created the right incentives for reducing readmissions not only overall but also for vulnerable populations, accruing societal benefits in addition to previously found reductions in costs. As the reduction in the rate of readmissions is not consistent across patient and hospital groups, there could be benefits to adjusting the policy according to the socioeconomic status of a hospital’s patients and neighborhood.

scholarly journals Neighborhood Access to Transit by Race, Ethnicity, and Poverty in Portland, OR

2013 ◽  
Vol 12 (2) ◽  
pp. 134-155 ◽  
Author(s):  
Brian S. McKenzie
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Spatial Mismatch ◽  
Low Income Population ◽  
The Poor ◽  
Race Ethnicity ◽  
High Concentrations ◽  
Using Data ◽  
In Transit ◽  
Housing Options

Scholarly discussions of accessibility and spatial mismatch largely ignore transit's role in linking vulnerable populations to opportunity. Yet as the nation's low–income population has become more suburban in recent decades, transit access may become an increasingly valuable, yet scarcer link to opportunity for those with the fewest resources and housing options. This study explores differences in transit access for neighborhoods with high concentrations of heavy transit users. Using data from the 2000 Census and the 5–year 2005–2009 ACS, it compares changes in transit access levels across neighborhoods with high concentrations of blacks, Latinos, and the poor in Portland, OR. Results show that Portland's neighborhoods of Latino concentration had the poorest relative access to transit. Further, levels of transit access declined for neighborhoods of black and Latino concentration during the study period.

scholarly journals Flood Recovery Outcomes and Disaster Assistance Barriers for Vulnerable Populations

2021 ◽  
Vol 3 ◽  
Author(s):  
Bradley Wilson ◽  
Eric Tate ◽  
Christopher T. Emrich
Keyword(s):  
Vulnerable Populations ◽  
Low Income ◽  
Disaster Recovery ◽  
Grey Literature ◽  
The United States ◽  
Data Availability ◽  
Empirical Knowledge ◽  
Disaster Assistance ◽  
Social Vulnerabilities ◽  
Federal Assistance

Disaster recovery spending for major flood events in the United States is at an all-time high. Yet research examining equity in disaster assistance increasingly shows that recovery funding underserves vulnerable populations. Based on a review of academic and grey literature, this article synthesizes empirical knowledge of population disparities in access to flood disaster assistance and outcomes during disaster recovery. The results identify renters, low-income households, and racial and ethnic minorities as populations that most face barriers accessing federal assistance and experience adverse recovery outcomes. The analysis explores the drivers of these inequities and concludes with a focus on the performance of disaster programs in addressing unmet needs, recognition of intersectional social vulnerabilities in recovery analysis, and gaps in data availability and transparency.

scholarly journals COVID-19 and Venezuelan Refugees

2021 ◽  
Author(s):  
Veronica Escobar Olivo
Keyword(s):  
Latin America ◽  
Social Isolation ◽  
Vulnerable Populations ◽  
Low Income ◽  
Host Countries ◽  
Social Distancing ◽  
The World

As populations around the world adjust to a new reality shaped by the COVID-19 pandemic, across Latin America an estimated 113 million people living in low-income neighbourhoods are struggling to make ends meet with the ongoing lockdown and social isolation procedures (Phillips et al., 2020). In addition to the looming threat of infection, more impoverished populations must contend with the day-to-day struggle of trying to stay afloat financially and the actual feasibility of practising social distancing. Among the most vulnerable populations are refugees and migrants, who are exposed to even more significant hardships as governments attempt to navigate the pandemic (UNHCR, 2020). The already precarious financial situations and housing of most refugees have worsened as host countries make efforts to provide supports and programs for their populations – initiatives which do not necessarily take into account the situations of most refugees. For Venezuelan refugees in particular, the threat to their safety, security, and futures has been further compounded in the course of the pandemic.

scholarly journals Is Sleep Duration Associated with Biological Age (BA)?: Analysis of (2010–2015) South Korean NHANES Dataset South Korea

2018 ◽  
Vol 15 (9) ◽  
pp. 2009 ◽  
Author(s):  
Kyu-Tae Han ◽  
Dong Kim ◽  
Sun Kim
Keyword(s):  
South Korea ◽  
Chronic Diseases ◽  
Sleep Duration ◽  
Vulnerable Populations ◽  
Low Income ◽  
Biological Age ◽  
Negative Effects ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Long Sleep

(1) Background: South Korea ranked worst in sleep duration compared to other countries, but there are no clear healthcare programs to guarantee sufficient sleep. Studies are needed to suggest evidence and arouse public awareness of the negative effects of abnormal sleep duration. In this study, we investigated the relationship between biological age (BA) and sleep duration. (2) Methods: We used data from the Korea National Health and Nutrition Examination Surveys (KNHANES V-VI; 2010–2015, which is an annually cross-sectional study including 29,309 participants). We performed multiple linear regression to investigate the associations between sleep duration and differences in BA and chronological age (CA). (3) Results: A total of 14.22% of respondents had short sleep duration (less than 6 h per day) and 7.10% of respondents had long sleep duration (more than 8 h per day). People with long sleep duration had a positive correlation with difference between BA and CA (>8 h per day, β = 1.308, p-value = 0.0001; ref = 6~8 h per day, normal). Short sleep duration had an inverse trend with the difference, although the result was not statically significant. Associations were greater in vulnerable populations, such as low income, obese, or people with chronic diseases. (4) Conclusions: Excess sleep duration that is greater than the normal range was associated with increased BA. In particular, such relationships that are related to worsening BA were greater in patients with low income, obesity, and chronic diseases. Based on our findings, healthcare professionals should also consider the negative effects of excess sleep, not only insufficient sleep. Alternatives for controlling optimal sleep duration should be reviewed, especially with vulnerable populations.

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