The area chosen for vulnerable population assessment is North Miami Beach, a rather quiet residential neighborhood in which the general level of well-being is high, and health-related indicators are favorable. However, a vulnerable population is identified in the area: homeless people. Although there are not many of them seen in the streets, homeless people face significant problems that need to be addressed from the perspective of community health. The purpose is to assess the vulnerable population by describing its specific characteristics, exploring strengths, risk factors, and barriers observed in the population, examining community resources, and explaining how community health nurses can contribute to improving the situation.
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Vulnerable Population Overview
The selected vulnerable population in the area is homeless people. Not many of them can be seen in the streets, but it is noticeable that their living conditions are poor, and they are unable to access resources to provide for their living. Not only is their appearance alarming, as they wear dirty and ragged clothes, but also their health may cause concern because some of them look sick. What homeless people seen in the neighborhood are involved in doing during the day includes walking along the streets and collecting trash, mostly singly; however, sometimes they are seen in groups talking to one another and often consuming alcoholic drinks.
There is an ongoing debate on what causes homelessness (Kalesnikaite & Garcia-Zamor, 2014), and there does not seem to be a single answer. Personal stories of homeless people may include economic difficulties, backgrounds that complicate employment, or health conditions that cause them to lead the lifestyle they lead; such conditions may be substance abuse or mental illness.
Strengths, Risk Factors, and Barriers
From the perspective of public health, several strengths, risk factors, and barriers can be identified for the homeless as a vulnerable population. A major barrier to addressing the issue of homelessness is a high recurrence rate, i.e., people who were homeless before are likely to become homeless again, often voluntarily. The persistence of the state of homelessness is explained by specific psychological characteristics developed in individuals who lead the homeless lifestyle for a considerable amount of time.
Second, it should be recognized that current public policies aimed at addressing the issues of homeless people often fail to acknowledge existing barriers. For example, Kalesnikaite and Garcia-Zamor (2014) stress that, in Miami, the initiatives associated with accommodating homeless people rarely include the stage of transition. If homeless people are given a permanent place to live without being prepared for it (e.g. by having temporary accommodation), it may increase the recurrence rate. Poor policies, therefore, are risk factors in worsening the homelessness situation; other factors include low income, health problems and addictions, and lack of social support.
In North Miami Beach, there are many facilities and service providers that can be used by homeless people. It is noteworthy that they provide various types of support that are not limited to homeless shelters but also include help for children and single mothers, residential services (such as low-income housing or assistance with everyday tasks associated with temporarily or continuously running a household), food assistance, and health care-related services (“North Miami Beach,” 2017).
Although professional services are provided by most of these facilities, it can be argued that there is a lack of comprehensive support programs that would address homeless people in an integrated manner, i.e. various types of support, including nutritional, psychological, residential, and legal, that would be provided as part of coordinated projects.
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Community Health Problem Diagnosis
It has been established that mental illness may be a risk factor in the homelessness issue and a factor often overlooked in recovery. One of the Healthy People 2020 objectives is to “increase the proportion of homeless adults with mental health problems who receive mental health services” (“Mental health and mental disorders,” 2017). This objective does not fully reflect the scope of issues that homeless people face as a vulnerable population in the addressed area, but it is still important that mental health-related risks and barriers are recognized. In this area, a community health nurse can make a positive impact.
Particularly, Kalesnikaite and Garcia-Zamor (2014) discuss the concept of sustainable community and suggest that community development and community engagement activities can help address the homelessness issue by creating conditions in which homelessness is addressed as a societal issue instead of dealing with each case separately or struggling homelessness through such practices as criminalization, i.e. prosecuting homeless people for sleeping in public places or similar activities which they are forced to do due to the absence of home.
The assessed vulnerable population is homeless people in the North Miami Beach neighborhood. The causes of homelessness are debatable, but they can be related to income issues, substance abuse, and mental illness. Services provided to the population can be improved by applying an integrated approach with the recognition that homeless people need many different services in their recovery, including accommodation, residential services, psychological and community support. Community health nurses can improve the situation by promoting a more integrated approach to addressing the homelessness issue.
Kalesnikaite, V., & Garcia-Zamor, J. C. (2014). The sustainable development of Miami: Tackling the homeless problem. Current Urban Studies, 2(3), 188-197.
Mental health and mental disorders. (2017). Web.
North Miami Beach homeless shelters & services for the needy. (2017). Web.