Harsh words

Vulnerability is a difficult term to pin down. Are we vulnerable to disease? Natural disaster? Emotional breakdown? Even with an understanding that we are constantly vulnerable to hardship, we do not consider ourselves to be a vulnerable population. This may be because of our socioeconomic positioning, our support network or simply our own will to persevere. An understanding of what makes us progress beyond hardship and into better situations is central to understanding why some of our population considers the vulnerable “weak” and why others consider them “victims”. In my opinion, I do not see how I would be able to continue to carry on without my social support network and the socioeconomic position I was blessed to have been born into. My will to persevere is a direct result of the constant support I receive on a regular basis. Without it, I would consider myself highly vulnerable to potential adversity. Because of this, I find it difficult to label an entire “vulnerable” population without knowing what experiences they have come from and what situation they are currently in. It is this labeling that limits our ability to see beyond a seemingly lazy population.

Vulnerable populations

I believe that the idea of "vulnerable populations" is very real, but difficult to define. As a society, much of what determines an individual's class level and circumstances to wealth, opportunities, and access to essential services such as health care can be due to chance alone. While this may be difficult to grasp, there is much truth to this statement. As a result, society must find a balance (especially when it comes to a topic like health care) to accommodate for their fellow man and be able to contribute to a system in which the masses can support these "vulnerable populations." More than anything else, I believe it takes a change in mindset to be able to buy into a "universal" health care system, and understand that "vulnerable populations" have just as much a place in a society as any other, and should have the same access to health care as any other individual as well.

I wouldn't view them as victims or as sinners. I guess there are issues that need to be addressed because of the demographics of vulnerable populations, but it would be unjust to prototype them as above. These are individuals that need the health care system more than any other section of society and really it is a measure of a systems very functioning whether it is able to care for its vulnerable.

These individuals may be different from others due to their individual dynamics but also due to their community dynamics and all these factors play an important role in their biology. Their physiology may thus vary depending on the built environment.

Also I think language barriers, employment, immigration status, education play a big role in determining their health outcomes. It affects the way they treat their health, stresses and reach out for help. Most of these factors can be overcome though not all.

both ways

I think this argument can have a middle ground. I feel though as the government is responsible to some point to take care of it's entire populations health. If an individual is unable to take care of his own needs beyond this point, the government then has the responsibility to go above and beyond to take care of those individuals.

This can be done in many ways such as subsidizing the cost of medical coverage, by more tightly regulating the cost of medical coverage, and by controlling the cost of pharmaceuticals. If the government became our health insurance provider, everybody would be paying into a system which is utilized by all. The government could subsidize the cost of medical care making treatments more affordable. People would then have to pay a fee for service (unless through some extenuating circumstance they are unable to pay), which would leave an incentive for the public to maintain their own health.

It's somewhere in the middle

There definitely has to be a middle ground. Especially in today's economic crisis, it is not uncommon to see hard working individuals struggling with the same issues as the not-so-hard workers. There are many reasons why vulnerable populations continue to remain vulnerable such as language barriers, physical or mental handicaps, legal status...etc. Although some of these issues can be addressed, many of these cannot thus causing individuals to struggle to excel in the work environment. But as a daughter of Colombian immigrants who came to this country at a very young age, I have witnessed first hand how people who really want to excel can do so. My parents came to this country neither of them college graduates, neither of them speaking english, and both of them extremely broke and teenagers. My parents many times had to chose between buying baby food to feed my sister and I or buying food to feed themselves. Needless to say, they experienced many days of hunger. Nevertheless, they continued to overcome barriers that were keeping them down. Today, my family owns a very comfortable home in San Marino, we have enough cars to keep us moving, and.... I won't say anymore or you all might think I'm bragging :) But the point is, I have personally seen how my family went from definitely being vulnerable to no longer having to struggle with the issue, all due to their perseverance and sacrifice. 

Better Access to Care for the Vulnerable Populations

When it comes to “vulnerable populations,” non-medical determinants such as SES, early life conditions as well as community and built environmental conditions, play a powerful role in the overall health status of these “vulnerable individuals.” The cost and logistical problems involved in visiting the doctor are the main deterrents for these people who need to see a physician. These vulnerable patients are even less likely to seek treatment when rising costs are coupled with an increased difficulty in securing an appointment, clinics with short hours or finding a suitable primary care physician. More children from low-income families are not getting preventive care, and their families are waiting longer to bring them in for sick visits in the hopes that the illness will resolve without medical intervention. However, the irony is that, if these kids had had adequate insurance coverage and gotten preventative treatment, they may have not needed an expensive hospital admission, which ultimately is much more costly to the health care system. In addition, many preventive procedures and screening tools are not paid for by most insurance companies, leaving sick patients with no choice but to wait until they are sicker before seeking treatment. The most direct way of improving the health indicators of these groups is to improve access to care and focus on preventive medicine, primary care and a focus on a doctor model, where patients have more options.

Better Access to Care for the Vulnerable Populations

When it comes to “vulnerable populations,” non-medical determinants such as SES, early life conditions as well as community and built environmental conditions, play a powerful role in the overall health status of these “vulnerable individuals.” The cost and logistical problems involved in visiting the doctor are the main deterrents for these people who need to see a physician. These vulnerable patients are even less likely to seek treatment when rising costs are coupled with an increased difficulty in securing an appointment, clinics with short hours or finding a suitable primary care physician. More children from low-income families are not getting preventive care, and their families are waiting longer to bring them in for sick visits in the hopes that the illness will resolve without medical intervention. However, the irony is that, if these kids had had adequate insurance coverage and gotten preventative treatment, they may have not needed an expensive hospital admission, which ultimately is much more costly to the health care system. In addition, many preventive procedures and screening tools are not paid for by most insurance companies, leaving sick patients with no choice but to wait until they are sicker before seeking treatment. The most direct way of improving the health indicators of these groups is to improve access to care and focus on preventive medicine, primary care and a focus on a doctor model, where patients have more options.

Assholes raise assholes

Unfortunately, the reality of social hierarchy is that it is very difficult to achieve a social status above that in which you were raised (with few exceptions). Why is this? Because assholes raise assholes. Everything about your place in life is strongly dictated by your upbringing. Highly educated parents are better about educating their children and they pass along smarter genes. Children raised in broken homes are more likely to raise their own children in broken homes. Unfortunately many of the children in these families are victims, though they may be the children of sinner. They have little control over their lives and without help are bound to become as useless as their sinner parents. So what can we do? We can intervene and help these vulnerable populations. 

We already help vulnerable populations in many ways, such as through programs like Medicaid, Headstart,  affirmative action, and big brother programs. And these programs have proven effective in changing the lives and opportunities of those enrolled. Unfortunately the reality of the situation is that some of our efforts will be lost on sinners in order to benefit the victims. But their is no way of knowing who is who. And so for the imrovement of all society we must help them all. 

Middle Ground

I definitely think there's a middle ground. At the hospital I volunteer at, there are a lot of single mothers who work as receptionists at the front desk of the emergency department. One of the "greeters" is in her late 20s, divorced, with a son. She works in the ER 5-6 days a week for 7 hour shifts and is attending school to become licensed in radiology. Although her parents help her take care of her child, they don't provide her with much money so she works at the hospital because not only does she need the money, but she gets free health insurance as well. In situations like this, I believe vulnerable populations are "victims" of an unfair life. 

However, there are many individuals who would not be this devoted and hard-working. For example, there's this new show on E! about models that are hired in music videos (I forgot the name). I watched part of an episode where one of the characters got upset because she thought she was going to get paid $700 for a video shoot but the pay ended up being $150. Rather than doing the shoot anyways because she's a single mother with a child, she didn't complete the shoot because she wasn't getting paid enough. I'm sorry but if you have a job that is paying you any sort of money, you shouldn't be picky about the amount. You should be willing to do ANY job for ANY amount of money if you need it that badly. There is no room for pride when you're low on cash. Of course I'm not saying you should become a stripper or a prostitute, but I do believe that you should go for any job that will bring in the money you need to take care of you child. For people like this, I believe they are "sinners" because they aren't willing to put in the hard work necessary to make money, they always want the easy way out.

victims of history...

I believe "vulnerable populations" are definitely victims and social/ethnic/health disparities have definitely been key in identifying the inequalities that these "vulnerable populations" face. This picture puts it best for me:


The slide defines social disparities as: (1) a result of hundreds of years of inequalities in access to education, employment, and economic opportunities (2) a result of real and perceived barriers due to institutionalized racism, generational cycles of dependency, and political priorities.

Vulnerable Populations

I think that there is a middle ground.  Yes, there are good arguments for both sides but the world is harsh and difficult and makes it rather difficult for major changes to occur, especially  in our current economic situation.  I feel like there are individuals who want to change their situation, but sometimes have to sacrifice  their goals or wants for the benefit of their families. Also, in some situations, these people may not feel like the certain thing are beneficial or cost effective. For example, a person who already lives in poverty will probably not have time to stop working and go to college. And if he/she wanted to slowly go through the process, ends might not meet and they might need to put their education on hold to work full time.  I do realize that there are people that do it, but most often hardships deter people from accomplishing what they want.  On the other hand, I feel like there are so many people who work hard their whole lives so that they can live a good life.  For example, I know people who are for universal healthcare, but do not want to finance it.  They feel like they work hard for their money to get healthcare and support themselves so they don't feel like it is fair that their money pays for someone else.  So, yes I think there is a middle ground. 

Vulnerable Populations

This is a debate that has always brought about mixed feelings in my mind.  There are certainly people out there that want others to provide for them and they don't have the drive and motivation to better their own lives.  I have seen first hand, working in an ER, certain people who continue to make poor life choices with an attitude that could care less about fixing their quality of life.  However, I do believe that many of the people classified under "vulnerable populations" are not "sinners".  

Unfortunately, it is a fact of our world and societies that every single person cannot be wealthy and have all that they want.  As a product of their environment and social support network, there are people who try extremely hard to consistently better their lives yet they just don't get as far as they would like.  It is this group of people-those giving to others more than they have for themselves, working endless hours in a dead end job just to make their way as a citizen, those fallen ill that can no longer work, etc-that I commend on being compassionate, hard-working and determined individuals, regardless of their financial or health situation.  

It frustrates me to no end that there are people out there we refuse service to or look down upon when they probably work harder than many of us.  Unfortunate for them, they happen to be born into or placed in an environment that doesn't offer them the tools and skills to make their life as successful as they would like.  Yet it doesn't mean that they are any less worthy of recognition and service as you or I.

vulnerable populations

There are strong arguments on both sides of this debate but ultimately, it doesn't matter.  Whether or not our country's poor and needy should be victimized or berated, the rest of the country is going to end up sharing some, or all, of the cost of their healthcare.  During the course of this class we have come to the conclusion that a) everyone has a right to health care, b) we all end up paying for each other's healthcare, so therefore c) we should invest our money more efficiently and focus on primary care and prevention.  This is another social debate that really brings us full circle to our country's lack of primary care.  

Vulnerable Populations

The vulnerable populations are considered medically underserved/disadvantaged because they face greater challenges in accessing timely and needed health care. They are composed not only of the homeless and the poor, but also the elderly/ young, disabled, mentally challenged, etc. It is extremely unfair to say that their health problems are deserved because their vulnerability is largely due to uncontrollable factors like unequal social, economic, health, and geographic conditions. Vulnerability comes from the effects of multiple uncontrollable factors (often pre-disposing) rather than personal deficiency.
The vulnerable are a significant part of our population as a whole, too significant to simply ignore. Although there are still many that are underserved, programs like Medicare, Medicaid, EMTALA, and other regulations recognize their vulnerability. And we should have enough social justice, empathy, and compassion to provide at least basic care to those in need.

Vulnerable Populations are Victims

People are born into certain situations. In other words, we can not choose our parents. Therefore, when a child is born in the U.S. or elsewhere in the world, they are born into a certain socioeconomic status. Hence, a child may have certain disadvantages and advantages from the very beginning. Vulnerable populations in the U.S. are usually born into their vulnerable status. This is not to say that children can improve their situation through hard work and get out of the state of vulnerability but it will be much harder for them to do so than children born into a higher socioeconomic class. Therefore, for the most part, it is proper to view vulnerable populations as "victims" of an unfair and unjust society. Slavery is a perfect example in American history where people were victims of a horrible system.

All in all, society has a responsibility to help and assist vulnerable populations. There is an issue of the degree or how much help should be provided, but overall help has to be delivered. Those who take advantage of assistance through fraud have to be punished. However, those that cannot help themselves need to have help provided for them whether it is help with health care or help with employment.

Moot

I'm not sure I know what "vulnerable" actually means. 

As a couple of people have already pointed out on this blog, "vulnerable populations" seem to have included (under one context or another) every single type of person under the sun except middle-class Caucasian adult males, who, as irony would have it, have probably been made vulnerable by their lack of "vulnerability" because no special health reform agenda will ever be directed at their demographic.

The basic definition given by Meriam-Webster is this: 1) capable of being physically or emotionally wounded; and 2) open to attack or damage.

We can scratch this definition off the list since it is meaningless in the context of healthcare: it includes everyone. That is, it wouldn't make any sense to use the special term "vulnerable population" in health policy discussions if we could actually just say "everyone."

Perhaps there is a more robust bioethical definition. The most consistent one I could find was this:

"Vulnerable populations consist of people at high risk for poor health."

This is a very elegant definition as far as definitions in healthcare go; it is just precise enough to leave plenty of room for interpretation.  As beautifully concise as it may be, however, it is also devastatingly complex, to the point of rendering the idea of "vulnerability" virtually useless.

Consider what kind of people are at high risk for poor health. 

The first groups that may leap to mind are those that are socioeconomically disadvantaged: the homeless, the addicted, the newly immigrated, and most of all, the poor. These are probably the most often cited because they are the most visible and obvious.

Then there are those who are more susceptible to disease because of their genetic make-up, preexisting health conditions, or age. Some examples include women (who are vulnerable if we consider certain conditions such as pregnancy or illnesses such as ovarian or breast cancer), men (who are vulnerable if we consider certain other conditions such as mid-life crises or testicular cancer), the mentally ill, the physically disabled, the elderly, and children.  

But then there are also those that are at high risk for poor health because they lack access to healthcare in another way: they don't have health insurance. It is very important to note that the uninsured population isn't just comprised of those who cannot have insurance, but also those who can have insurance but choose not to regardless. But now we're wandering into murky ethical territory. Interestingly, this is the only kind of ethical territory that exists outside of academic theory. Is not buying insurance (despite having the means to do so) an irresponsible personal choice? Should society at large be held accountable for suffering the consequences of all these bad personal choices?

What about people who drive cars? Surely they're putting themselves at higher risk of being killed than people who sit at home in the corner. 

But let's not go just there yet, since we're still not done figuring out what it means to be"vulnerable." 

There are also a host of external factors at play. Populations can be made vulnerable not just by their own personal situations or conditions, but also by the healthcare system of which they are a part. A rich suburban community without a single doctor is probably far more vulnerable than a poor rural community with a doctor for every household. Again, vulnerability now becomes a dynamic concept; populations can become more or less vulnerable depending on how many providers settle down and how many leave, how the distribution of specialties changes over time, how many clinics are built or shut down, whether those clinics are 24-hour facilities or only available from 9 to 5, the skill level of the physicians operating those clinics, which in turn depends on the number and caliber of medical schools or residencies available in that region, the quantity and quality of medical equipment available, the pricing of that equipment as well as that of drugs, and so on and so forth until we list every supply-side variable ever studied in public health.    

Okay, now let's go back.

There is also a whole other level of "health risk" at play when it comes to social justice. "Vulnerability" can be defined not only in practical or material terms, but also in moral terms. According to Dan Brock (a leading bioethicist), there are those who are put at risk by injustice, those that are put at risk by misfortune, and those who put themselves at risk. That's three seperate tiers of "vulnerability" beyond the categories that we created based on socioeconomic status, health insurance coverage, genetics, availability of providers, quality of healthcare, and so on and so forth. The implication is that these three groups must be treated differently, not necessarily because there is a question of fairness involved, but simply because you cannot solve three different problems stemming from three different causes with the same solution.   

I could go on forever (and there have indeed been volumes written about what it means to be "vulnerable"), but let's pause for a second and take a look at the bigger picture. 

What is the point of figuring out whether a group of people are vulnerable or not? 

I would argue that the ultimate purpose of defining vulnerability is to eliminate it. If we knew how and why certain populations are more vulnerable than others, then we could theoretically level the playing field and make sure that everyone was brought up to an equal standard of care.

I would also argue that it is entirely possible to do this WITHOUT defining vulnerability at all. In fact, the concept of "vulnerability" is extremely damaging to the populations that it is meant to serve because it segregrates them from "the rest of us." It is just another way to fragment an already extremely fragmented system. It pits the AIDS coalitions against the muscular dystrophy groups, the feminists against the advocates for alcoholics, the uninsured against the insured, the middle-class against the lower-class, the cities against the farms. More importantly, however, it is (believe it or not) morally backwards. It is saying that some people deserve more help than others, when in fact healthcare should be indiscriminately, incontrovertably, and blindly available to everyone regardless of just how "vulnerable" they really are. Consider the converses: would you deny a high level of care to someone who was filthy rich and owned half of North America? What about someone who raped and murdered small children? Someone who never paid a cent in his life for health coverage?

The answer is no. Once you start drawing these lines, you can only go downhill. Our only option is to not make the distinction between different kinds of people at all, because even one distinction inevitably sets the precedent for inequality.

Circumstance is Everything

As pointed out by people as far back as Aristotle, and more recently Malcolm Gladwell, author of such fine works as "Outliers" and "Blink,"  authors and historians have always understood the importance of circumstance in terms of a persons ability to succeed in life.  I believe it was Aristotle who stated the importance of not being of "ignoble" birth or class in order to have great success in life in his book entitled "Ethics." 

Unfortunately, class systems have formed in all great democracies since its existence.  As much as we would like to believe that there are no "haves" and "have-nots"  in our society, a demarcating line divides us all in terms of socio-economic status and ability to achieve. Circumstance clearly dictates success and ability to achieve great things in life.  I, for one, think that this dividing line should not exist when it comes to health related issues, and believe in the idea that health in society should be the glue that binds it together, rather than ripping it apart.

This being said, I am entirely optimistic that in the near future, we, as a society, will start to shift towards believing that even the "underserved,"  "outliers" of our population MUST be taken care of and treated like human beings, just like the rest of us.  If we continue to fundamentally attribute success with the person and not their circumstances, we will never truly be the shining light from which future societies model themselves from.   The status quo illustrates that we have not even broached our full potential.

It is what it is

The south side of Chicago is home to several low socioeconomic individuals. Many of whom are very talented and capable beyond belief. I've seen, first hand, how these individuals are often labeled "lazy", "incapable", and sadly "good-for-nothing". Unfortunately, these inconsiderate adjectives are used to describe an array of "vulnerable" populations and many of these individuals are fully trying their hardest to better themselves to improve their state of living.

I think oftentimes vulnerable populations can only do so much given the resources and opportunities that their environment provides. Certainly a lot of that is true because stereotypes and labels have been nourished by generations of discrimination had hatred. But I really do believe that there are individuals within this "vulnerable" population who, even with the limited opportunities are still driven and able to better themselves and their families. That is not to say that there aren't people who make matters worse by listening to people who tell them that they wont amount to anything in life and choose to do nothing to better themselves. I think there are definitely two sides to this issue. At at the end of the day, these individuals are sometimes forced to cope with double standards and unfair conditions, but it is completely up to an individual to, at the bare minimum, have the will to achieve a better life.

vulnerable populations

There are vulnerable populations all over the world but the focus should be on how to help and prevent the cycle of continued bad health choices. They shouldn’t be viewed as sinners because most of the time, the circumstances are out of their control. For example, children have no control of secondhand smoking or not having health insurance. However, their parents should know that certain behaviors (smoking & excessive drinking) can lead to poor health outcomes and can affect those around them. Education has a lot to do with lifestyle choices, although behaviors such as the ones mentioned above are pretty apparent in terms of negative health risks. The truth is SES, ethnicity, residence and other factors are related to health. The key is implementing health education into these vulnerable populations, whether it is through media (billboards in the local area) or having healthcare providers in the area hold workshops about how to apply for public programs.

Living in the Shadows

The vulnerable populations are victims of an unfair and unjust society. I find it hard to believe that they are sinners who bring on their own health problems. The reason I say this is because if we were to drive out to the inner city of South Los Angeles and take a look around we would not fail to see that the options available to them are few compared to other neighborhoods. I am not just talking about food. I’m talking about schools, housing, parks, political clout and so forth. The way I see it is there are two groups. One group has what it needs to get by in life and contribute to society. While the other group regardless of how hard it might work day in and day out will only successfully land a few individuals into the other group. Those that never make it out will use the only resources available to them and thus self perpetuate the cycle living as a vulnerable population and continue to be victims of an unfair and unjust society pushing them further into the shadows.

Vulnerable Populations

Perhaps one problem is that we have this almost compulsive need to label people. Of course it's important to be able to group people when studying them but using those labels outside of scientific studies seems a little irresponsible in my opinion. Consider the idea of a self-fulfilling prophecy. People who don't have the same resources as other people (and are constantly reminded that they don't) may very well use that as an excuse (legitimately or not) to limit themselves. Likewise, people who do have resources may take for granted their opportunities and find themselves in vulnerable situations later in life. I believe that though environment and society can have a major impact on your "vulnerability" in life, it really comes down to personal choices and motivation in the end. I also believe that as a society we should work more diligently to ensure that everyone has similar opportunities in life but I know that in reality, that's not going to happen. As such, as a member of society, it's up to me to overcome whatever challenges, obstacles or interferences I may face when navigating toward a more secure and less vulnerable state in life. Going back to the idea of labels, we know in studies of learning development children who are called "dumb" and discouraged are less likely to succeed then kids who are encouraged and told they are smart and capable. I can imagine there is a similar impact in how we define society. Terminology can be very powerful. I could be wrong but it's just something to consider.

Vulnerable Populations- buzz word

“Vulnerable populations” has been such a buzz word especially in the public health sector. It is indeed a very loaded term. Some might even find it offensive had they found themselves labelled under this category. Vulnerable populations is a term used to describe a wide spectrum of peoples, it is an umbrella term. I’ve seen this term used looslely in undergrad, I was a sociology major and naturally social workers and soc majors cater to “vulnerable populations” which would include women, children, the handicapped, disabled, HIV positive individuals, the un-insured, homeless people, high-risk teens, low-income families, single-parents family, immigrants, seriously-ill children, commerical sex workers, and the list can go on. Having studies sociology in undergrad and currently public health at USC, it isclear to me that health is not solely the result of genetic factors. Health is the outcome of many contributors such as environmental, societal, governmental, economic, educational factors. The “diseased” or the “ill” should not be blamed as sinners for the physical ailments or abnormalities. For instance, many homeless individuals are victims of mental health disorders who were either pre-disposed genetically or were born into circumstances which had lead them to become homeless ie.) alcoholism, depression, unemployment which in turn could have been the fault of the economy, the environment etc. Another example of someone who may be labelled under vulnerable populations are teen commerical sex workers. I’ve worked and counselled many of them at juvenile hall and if a female prostitute is diagnosed with an STD, surely it was her behavior that lead her to become exposed to STI’s, but she is a “vulnerable” person in the grand scheme of things because she is a child who has been sexually violated, abused, and neglected which had lead her to prostition. I clearly had seen them as victims. Currently at MCA where I work which is an AIDS research clinic, there are two categories most of our patients fall under: the were either infected with HIV perinatally or behaviorally (mostly through sexual intercourse). Those who were born with HIV were infected through mother to child transmission. Are the more of victims than of those who actively had sex with someone who was HIV?

Vulnerable populations

I believe there are vulnerable populations in the sense that they are limited in access to resources for healthy living. There are health disparities caused by many reasons such as income status, ethnic background, and sexual orientation. A person cannot be blamed for being born into a certain status or condition. Yes, as the person grows, he has choices and actions that lead him into his subsequent position, but society provides the resources that will allow certain choices. Some people have bumpier roads than others when reaching similar destinations. People will grow up with different levels of support from society. In support I don’t refer solely to monetary but also social and psychological support. When speaking about dysfunctional neighborhoods, many people will fall into the cracks and sadly add on to a vicious cycle. The society that one lives in determines the services and resources that a person has access or doesn’t have access to. People who are raised in more advantaged societies and are blinded to the experiences that disadvantaged groups face, and cause them to think that people cause their own problems. It’s one thing to know about the issues that poor populations go through and another is to actually live through them.

Victims of their life circumstance

If one out of 100 in the popolation is a substance abuser or ex-offender, we may have less compassion for him because he is responsible for his behavior and also, his vulnerability. But if 90 out of 100 have the same problem, I would absolutely consider them as victims and think of some reason above individual level. Actually vulnerability is due to many reasons: race, social networks, physical location, SES, community context....
So I think what they need is not only additional health care programs, but also long-term interventions to improve their life circumstance.

Consider this!

It is important to understand how an individual becomes vulnerable so that we can work to prevent or at least decrease population vulnerabilities. I would like to describe a schematic (because I cannot draw) and I am curious to see what people think of it. I think that all individuals who are in the vulnerable population their whole lives, are born as 100% victim, then slowly (through adolescence and into adulthood), but never completely, phase into being sinners.
In early childhood, there are causes of vulnerability that the child cannot control like the neighborhood, low educational stimulation, low parental involvement, low positive encouragement, race, since its looked at to analyze vulnerability, and parental language barrier. In adolescence, even though the individual begins to make choices, the are factors that make him part of the vulnerable population include living in a low morale, low SES, low educational stimulation, low sex education, high stress, and high negative encouragement. In adulthood, an individual can make his own choices but there are factors that make him part of the vulnerable population like not having a higher education, low employment opportunities, low social capital, substance abuse, STD's, early parental and martial status, homelessness, and self language barrier.

doesn't really matter if they r sinners or victims.

Yes many people who categorized as "vulnerable population" are lay in gray area and perhaps some are more a "sinner" or "victim" than others. However, how does that matter? Vulnerable population is vulnerable population, it doesn't matter how you want to see them as sinners or victims because we still get to help them. We need to help them for many reasons, and there is one reason that might stimuli people to help them - helping the vulnerable population will indirectly help us. It will help the economy that will all benefit us if we can help the vulnerable people to back to healthy or capable of working and spending money to boost economy. I truly think America is an individulistic country that we care so much about if we should help the under-represents or not, seems we are not willing to share and help others who are maybe disadvantaged. Let's not care if they are sinners or victims, just help them.

I don't see the point of needing to place a label on these so-called vulnerable populations. What does it matter if they are victims or sinners? They ought to receive and access to the same quality of care that is available to others. Everything works in cycles...whatever made them vulnerable in the first place made someone else not vulnerable, and vice versa. Are we now going to limit (or overcompensate) healthcare based on whether someone deserves it or not? Even prisoners get high-quality care in the clink.

Vulnerability

In general, I understand that the vulnerable populations are special types of populations that need “extra” care. We have to give them more helps and supports. Not to blame and criticize them. So, I’m in favor of viewing them as a “victims”. The main reason for viewing them as “victims”: being their reduced access to health services. But, the underlying reasons can be varied though. They might be vulnerable due to poor socio-economic status, age and ethnicity, or due to lack of education and knowledge etc. Or, simply because of they are sick and uninsured.

I also believe that health is the basic human right, and, any barrier that prevents those vulnerable populations from equal and fair access to health should be removed.

On the other hand, I also see some good reasons in opposing ideas like they don’t work hard enough to better their lives and they should take care of their own health problems. But, they are individuals, which might not represent the whole vulnerable populations.

Of course, there will be enormous strains to health care systems due to large demands by these vulnerable populations. But, I think we should plan and design our health care system to address those special needy populations. Not to opt them out.

Who are we to label?

As easy as it would be to simply categorize people as either victims or sinners, I don't think it's really that clear cut. Of course, you will always have people that do fall nicely into one of these categories, but I do not think that's the norm. Yes, there are people out there that are truly victims (e.g. people who do not hold the capacity to think or fend for themselves) and there are people out there that are truly sinners (e.g. people who fail to use resources that are easily accessible to them). But I do think a majority of people do fall into the gray area. We never know what everyone's past experiences have been, thus shaping them into the person that we are to label as "sinner" or "victim." Perhaps they are extremely skeptical to use hospital services because they have been victimized by medical error in the past. If someone were not privy to that information, they would most likely label that person as "sinner" and be done with it because that's what it appears to be - someone with the option of using the hospital and choosing not to do so. People are difficult to label because our choices today are shaped by our experiences in the past, so unless we know everything about someone's past, we aren't really in a position to speculate whether or not they bring on their own health problems or are lazy to better their own lives.

Vulnerable Populations and Scapegoats

First, I'd like to say that I agree with Aaron on the point that the population in question deserves help more than it does scrutiny about why they need help. Regardless of the source of the problem, the problem exists and (in my opinion) as a society we have the moral and ethical obligation to fix it, scapegoats and blame aside.

That being said, I think that it's impossible to label "vulnerable" people exclusively as victims or sinners, since a society is made up of a very motley array of people, and while one group may predominate over another at a given time, things are constantly changing (e.g. the current economic situation), including the degree to which people (are able to) take care of their health. Also, no matter how "fair and just" a society is, from a statistical standpoint there will always be some people who will slip through the cracks and fall victim to one loophole or another, just as some people will bring their own health problems upon themselves. What seems important to me is the idea that we should have a society in which the proportion of innocent victims is minimized, and that people have a resources they need to stay healthy. And yes, I did just evade giving an actual answer to the question.

all my single ladies, all my single ladies

let's take a large population in the united states: single males and females. are we going to say that they are single because they arent going out to find others out there and they arent taking the intiative to find someone to be their significant other? or are we going to say they are all victims and they have all been hurt so they are too injured to find anyone else? there is no good way to label ALL of these single individuals, other than what they are: without a significant other. why do we have to have to label "vulnerable" in only a certain way? there are many ways a population could be vulnerable, i dont see why we have to pick just one.

in the situation above, i am taking being single as a negative (which may or may not be true for many, but that's another topic in itself). "vulnerable" is such a broad word in itself that i dont even know how it can be used to describe such a broad population. i think that it needs to be elaborated upon when being used, or maybe we should just stop trying to decide why these "vulnerable" populations are in their status quo. all i know is that they need help, and thats what we need to focus on.

people are single for different reasons, by choice or not, just like people are in their "vulnerable" situations, by choice or not. beyonce said if we liked it, then we should have put a ring on it. these "vulnerable/single" populations need a ring, and that ring is for us to help them out, no matter why they're single.

Victims or Sinners

I believe that there are people that can be categorized as either “victims” or “sinners”. Many children are victims of the choices that there parents made and the choices that were made for them. The environment that they are exposed to may have determinant effects on their health but they may not be able to come out of that vulnerable situation. People that belong to these vulnerable lifestyles lead a very different life possibly due to the resources that are available for there use. They may not be able to afford a gym membership to stay healthy, but there is also no safe neighborhoods around to jog. People can be shaped by their surrounding.
I still do however believe that sometimes people allow themselves to become vulnerable populations. I am a person that does not sympathize very much with obese people. I feel like they know how to prevent and control their situation, but don’t try and allow themselves to become obese. I feel that sometimes people become lazy and allow themselves to become labeled as a vulnerable population. They use it as an excuse to continue living the way that they are. I believe that sometimes they give actual vulnerable populations a bad name.

Find the Middle Ground

As a society, we need to come together and find a compromise between the polar views that currently exist regarding “vulnerable populations.” Personally, I do not think that people in “vulnerable populations” purposely refuse a better, healthier lifestyle. They do not have access to the same type of opportunities as other people that come from more privileged areas, (i.e. grocery stores, healthier food options, etc.) and they do not know how to eat/live any differently than what they are used to unless they are educated otherwise (i.e. on the importance of eating right, exercise, etc.) Then again, knowledge alone will not create change. We must also provide the tools for change. I think that it is necessary to step back and take a look at the other issues that “vulnerable populations” face, including cultural and environmental challenges. It is necessary to find strategic solution(s) to effectively address these problems, and then to specifically tailor solutions to people living in these circumstances.

Helping people help themselves

Vulnerable populations. This is a hot topic in health care, as it should be. There exist certain populations in this country who simply don't receive the same amount of consideration as other populations, in terms of health care access, quality, and consistency. Not to mention schools, safe recreational areas, employment opportunities, clean streets ... the list could go on and on.

Why is it that 5% of our population accounts for 50% of the health care spending? This doesn't mean they are spending extravagantly - instead, this means that they need more assistance. I think anyone who sees that statistic should be alarmed. I certainly am. Clearly something needs to be done so that these so-called "vulnerable populations" can rise up out of the depths of poor health care and quality of life to join the rest of the population. This will take lots of effort and will require certain choices to be made.

A shift in the country's view of these people as somehow less than the CEO's and businessmen of the world needs to occur - everyone should be viewed as a person, no less, no more than someone else. At the very least, we need to recognize that part of our constitution includes the right to life. If access to health care isn't part of the right to life and the pursuit of happiness, then I don't know what is. When and if this shift to universal health care actually happens, I think the "vulnerable populations" will become less so.

Additionally, I really feel that when people are given resources, they will most often use them. By this I mean that if we, as the future policy-makers and health care providers of this country give appropriate opportunities to everyone who needs them, chances are that they will be utilized. If kids are given great teachers, good books to use, modern facilities, and motivation from home, who is to say they are going to choose not to learn and make the most of themselves. If the best doctors are made accessible and affordable all across cities and rural areas, and not just in one hospital in the main city in a state, who is going to argue that no one will take advantage of their services to keep up with their diabetes or cholesterol management? My point is that in dealing with these underserved, "vulnerable" populations, we need to remember that at their core, the vast majority people really do want to make the most of their lives and be their best person. If given universal opportunities, along with some assistance, who knows what could happen in the future.

Collective

These polarized opinions are what researchers are constantly having to deal with.  Take for example childhood obesity research.  For some time, this field has concentrated on research for the individual.  They have cooking classes, nutrition classes, parental classes, exercise classes, counseling, and other interventions focused on teaching or exposing the individual to knowledge and skills of eating healthier and exercising.  This form is prey to the idea that these children and adolescents who are obese or have metabolic problems can change their lives for the better if they just knew how to eat better and if they just knew their hot cheetos and gatorade diet might not be that great for them.  

Recently the idea of the built environment has taken the spotlight.  I say recently because even a year ago in reviewing built environment articles in an educational setting of primarily individual focused intervention projects, experts in the field were still questioning the idea of the built environment.  Arguably it is harder to measure the effects of built environment, it takes more money to do large scale interventions, and of course that most of the extinguished journals in the field of obesity were still centered on individual change.  But now that the bandwagon of built environment has started, everyone is trying to get a piece of it if they understand it or can turn their head around to agree with the idea that maybe it isnt just the individual.

Maybe the kids in south central aren't fat because they lack the knowledge to not eat hot cheetos, or that they arent motivated to stop eating cheetos.  Maybe its because they dont have markets that offer food and vegetables that can actually be eating or bought on the income of the household.  Maybe its because they cant go out to exercise because they have to be ready to dodge bullets without notice.  Maybe its because their parents cant cook for them because they are working 4 jobs or wont let them go outside because they dont want to lose their kids to violence.  The list goes on... but the bottom line is that I think both are right and that their cant be polar opposites as a solution.

We need to change the environment so vulnerable populations have access, have opportunities, have possibilities, and have what they need to do better instead of being in a prison of their neighborhood.  At the same time, generations have grown up in these neighborhoods knowing nothing else and we need to educate, empower, increase efficacy, and increase motivating in the individuals and the community to do better for themselves.  We can't have one simple solution, we can only have a collective, comprehensive solution that can be done by the people in the population within their population.