The vast majority of civilized countries provide citizens with a high quality basic medical care. However, there are some patients included in a specific group of people called vulnerable population. These are individuals with a great risk of health problems caused by one of the numerous reasons such as social status, limited economic resources or personal features. Children, women, the elderly, the poor and immigrants are main social groups considered to be vulnerable population. The aim of the first part of the given essay is defining major peculiarities of providing Hispanics with medical care.
Hispanics as Vulnerable Population
The Census defines Hispanic ethnicity as “a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race” (U.S. Census Bureau, 2010). By 2013, it already was the biggest minority in the USA, counting 54 million of people and nearly 17% of the total population of the country (CNN, 2013). Many of Hispanics have the status of illegal immigrants which means they face the problem of unemployment and subsequently, struggle with economic hurdles, have no insurance or even basic medical care. In fact, the measure economic constraints are considered by Bezruchka (as cited in Chesnay & Anderson, 2012) to be “the most powerful determinant of the health of people” (p.5), thus naturalizing Hispanics might be a big step forward in protecting them from poverty. In 2008, more than one-fourth of Hispanic adults in the United States lacked a steady health care provider, while similar proportion had no access to health care information from medical personnel, although some of them received basics from alternative sources such as television or radio (Livingston, Minushkin, & Cohn, 2008). These facts altogether lead to the conclusion that Hispanics are indeed a big part of what is called vulnerable population.
Flaskerud and Winslows Vulnerable Population Conceptual Model created in 1998 has generated a large body of community-based studies investigating the reasons for low-income Hispanics having health problems (Allender, Rector, & Warner, 2014). There is a certain correlation between three major indicators that define required health care level. The degree of vulnerability is primarily distinguished by resources that are allowed to the certain group of the population. These include various socioeconomic factors such as income, job, housing, and education. Limited income and low quality of education are main constraints to receiving proper health care. According to Escarce and Kapurs research in 2006, 23% of Hispanics lived in poverty, comparatively with only 8% of non-Hispanic whites (Escarce & Kapur, 2006). Low-income people naturally cannot allow themselves to spend extra money on health care, even in case they have official medical insurance. Another report dating 2008 showed that nearly 32% of the Hispanic population have less than a high school diploma (Livingston et al., 2008). This fact means that even those who do not lack steady health care provider would not be able to communicate with medical staff and understand the instructions clearly due to a language barrier. Moreover, Hispanics are less likely than non-Hispanic whites to receive health insurance as a benefit from an employer since only 42% of the non-elderly Hispanic population had employer-provided insurance by 2006 (Escarce & Kapur, 2006).
Another factor to treat a social group as a vulnerable population is relative risks including lifestyle, exposure to stressful situations, and genetic risks. In fact, the Hispanic population has a lower prevalence of chronic diseases such as hypertension, asthma, cancer, bronchitis and heart diseases than the U.S. adult population (Livingston et al., 2008). However, 10% of Hispanic adults suffer from diabetes, and almost 40% are overweight in comparison with 6% and 35% of non-Hispanic whites (Livingston et al., 2008). Poor access to information concerning these health problems increases the vulnerability of Hispanics. Moreover, critical socioeconomic factors are the reasons for Latinos taking part in criminal activities that cause stresses, murders, and violence within this group of the population.
The last major element of Vulnerable Population Conceptual Model is health status which is associated with general morbidity and mortality rates of the given social group. The investigation of this issue among Hispanics at the beginning of the 21st century resulted in the concept of “Hispanic paradox” (Alvarez, 2009). The reason for the phenomenon was an evident low level of mortality from cardiovascular diseases among the Hispanic population despite a high prevalence of lack of activity, excess weight, and diabetes. However, a 66% increased risk of all-cause mortality observed by D. Hunt over the last decade became a refutation for “Hispanic paradox” and strengthened the theory that the Hispanic population is more vulnerable to the development of incurable chronic diseases than non-Hispanic whites (Alvarez, 2009).
To sum up, Hispanics are still a vulnerable population in the United States. The reasons for this status are a low level of resource availability, a high prevalence of chronic diseases such as diabetes or obesity, and increasing mortality rates among the most numerous minority in the USA.
Characteristic Features of Basic Health Care System Models
There are four basic health care systems around the world which have some common principles of providing patients with medical care but simultaneously vary to a great extent (Sahu, n.d.). These are the Bismarck model, the Beveridge model, the national health insurance model and the out-of-pocket model.
The Bismarck model was developed by Prussian Chancellor Otto von Bismarck in the 19th century (Fincham, 2011). According to Fincham (2011), the given system is based on the work of health insurance companies “financed by employees and employers via payroll deduction” (p. 29). The key difference of the Bismarck model lies in the non-profitable character of sickness funds. Nowadays, this healthcare system is basic in Germany, Switzerland, France, Belgium, the Netherlands, and Japan (Fincham, 2011). Saha (n.d.) considers the Beveridge healthcare model as “the classic example of socialized medicine” (p. 8). This system makes medical treatment a public service which is fully sponsored by the government through tax payments. The Beveridge model is typical for such countries as Great Britain, Italy, Spain, and Cuba (Fincham, 2011). The Canadian national health insurance model is considered to be the most effective. Fincham (2011) claims “it contains the elements of both the Beveridge and Bismarck models” (p. 29). The only sponsor is the Canadian government which provides the population with universal insurance coverage of all services and public administration of the system throughout all provinces (Fincham, 2011). The out-of-pocket system is typical for poor rural countries such as India, Burkina-Faso, Cambodia and numerous African regions (Fincham, 2011). This model has neither insurance system nor government healthcare plan and thus is financed mainly from the pockets of patients.
Conclusion
All in all, the future of healthcare in the USA is still not quite clear, though not critical comparatively with a number of countries. Despite the government aiming to provide all citizens with a fully socialized medicine, there are some social groups forced to get medical service according to primitive tendencies of the out-of-pocket health care model. I suppose that gradual application of the Canadian national health insurance model would prevent vulnerable population such as Hispanics from the poor level of medical service.
References
Allender, J., Rector, C., Warner, K. (2014). Community & Public Health Nursing: Promoting the Public’s Health. Philadelphia, USA: Lippincott Williams & Wilkins.
Alvarez, J. (2009). The Relationship Between Alcohol Consumption and HDL Cholesterol: A Study of Hispanic Drinking Patterns. Houston, USA: The University of Texas School of Public Health.
Chesnay, M. de, Anderson, B. (2012). Caring for the Vulnerable. Burlington, USA: Jones & Barlett Learning.
CNN. (2013). Hispanics in the U.S. Fast Facts [Press release]. Web.
Escarce, J.J., Kapur, K. (2006). Access to and Quality of Health Care. National Research Council (US) Panel on Hispanics in the United States; In Tienda M. & Mitchell F. (Eds.), Hispanics and the Future of America. Web.
Fincham, J. (2011). Health Policy and Ethics. London, UK: Pharmaceutical Press.
Livingston, G., Minushkin S., Cohn, D. (2008). Hispanics and Health Care in the United States: Access, Information and Knowledge. Washington, USA: Pew Hispanic Center.
Sahu, S. (n.d.). Healthcare Models Across the Globe. Web.
U.S. Census Bureau. (2010). Definition of Common Terms. Web.