Marginalized Populations

Introduction

Marginalized populations often encounter poor health outcomes. This is due to the great burden of disease experienced among these groups. Despite this condition, many marginalized people are underserved by both healthcare facilities and healthcare professionals. Under such circumstances, many find it difficult to access quality healthcare services. The current literature review examines the findings of various studies pertaining to effective disease prevention and control among the marginalized groups.

Literature Review

Various researchers and scholars have given important views and ideas about the health of marginalized populations. To begin with, O’Donnell et al (2016) studied the factors that hinder and facilitate marginalized populations from accessing various primary care services. The researchers also examined the priorities of these groups on the healthcare services. The study involved 21 participants who were drawn from different marginalized groups. From the results of the study, it was found that marginalized populations have both personal and structural barriers that prevent their access to primary healthcare. It was also recommended that these people share some important experiences that need to be taken into consideration in the process of planning their healthcare. Despite leading to important findings, the study was limited by the small sample size that was drawn from a single urban setting. As a result, it cannot be used to generalize the experiences of all marginalized groups.

Braveman et al (2018) sought to come up with a well-crafted definition of health equity. The study was based on the hypothesis that lack of a common consensus about what health equity actually means hinders effective actions by different policy makers. Such a case is common among different marginalized populations. From the findings of the study, it was established that the best way through which health equity can be achieved is through the reduction of various health facilities. This can be effected through efforts that help to promote the health of socially disadvantaged groups. One of the major limitations of the study is that is addresses the concept of health equity as though it is the only aspect worth public health action. There are many other important factors that need to be considered.

Lopez III et al (2021) examined the disproportionate harm caused by coronavirus disease on the marginalized populations living in the United States. The study was based on the understanding that Black, Hispanic, Asian and other racial minorities in the country experience higher rates of infection and deaths compared to the whites. The findings of the study helped to show that disease outcome disparities in the United States are due to racial, ethnic and socio-economic status of the groups that are affected. Coronavirus only emphasizes the fact that there is need to address such disparities. The study’s main limitation lies within the fact that it only focuses on racial and ethnic marginalization.

Baah et al (2019) integrated various forms of literature on the aspect of marginalization. They based this concept on the various social determinants of health. The researchers specifically intended to answer the question on the association between the social determinants of health and health disparities pertaining to chronic disease burden among populations that are disparate. The study derived from an integrative review of literature. 33 out of the 1,781 articles that were initially retrieved made it to the final list of selection. The findings of the study helped to show that the effort of associating marginalization with different social determinants of health is key t understanding the chronic disease disparities, and healthcare delivery inequities experienced by marginalized groups. This study is mainly limited by the fact that marginalization is a phenomenon that is dynamic. Therefore, the definition of the concept adopted in the study is not absolute.

Pega et al (2017) studied the role of intersectoral actions in addressing various social determinants of health. The study derived from the hypothesis that such actions are crucial in enabling the health care sector to achieve the sustainable development goals of promoting both the health and wellbeing of all people regardless of their age. From the results and findings of this study, it was revealed that it is necessary to monitor the intersectoral actions associated with social determinants of health. This effort can enable the health care sector to find out what needs to be done for the purpose of improving the delivery of care services. The study has some limitations since the researchers did not consider the fact that social determinants of health and the indicators of sustainable development goals vary from one country to another.

Robards et al (2018) explored how marginalized young populations in high-income nations access healthcare services and engage with them. The study was based on a a systematic review of literature. Out of 1,796 that had been initially considered for this study, 68 were selected for final inclusion. The findings of the study showed that young persons from marginalized populations face a lot of challenges in terms of access and engagement with healthcare services. Some of the challenges include lack of knowledge about different health problems, poor healthcare service environments, and poor health seeking behaviors. The main limitation of this particular study is that it was based on the marginalized young people of high-income countries. Therefore, its findings may not be applicable in low-income countries.

Schimitz et al (2019) studied how perceived stigma results in mental health inequalities that are experienced by marginalized groups of societies that allow the existence of stigmatizing frameworks. The study is informed by the hypothesis that young lesbian, gay, bisexual, transgender, and queer (LGBTQ) groups of color face social prejudice and discrimination.  The study included 41 respondents mainly drawn from a Latino LGBTQ population. The results of the study led to the finding that young LGBTQ experience both structural racism and anti- LGBTQ messages pertaining to their mental health. The study was mainly limited by the small sample size selected from a single marginalized racial group.

On their part, Ward et al (2018) sought to recommend an effective synergetic framework which integrates community-based participatory research (CBPR) and Health Impact Assessments (HIAs) in addressing health inequalities. The researchers reviewed literature containing information on health equity. From the findings r results of this study, it was found that integrating health equity dimensions from both HIA and CBPR can play an important role in promoting improved equity outcomes. The review used in this study did not help the researchers to avoid a publication bias. As a result, some important studied with useful information might have been left out.

Conclusion

The findings of the study help to affirm that marginalized groups indeed suffer when it comes to the delivery of healthcare services. Poverty, discrimination, and other factors hinder them from accessing care services of high quality. Yet many live with chronic health problems. This explains why they experience negative health outcomes. In order to effectively promote the health of the marginalized populations, further research on their unique experiences is necessary. It is also important to note that the views of these groups need to be incorporated into policy actions associated with disease control and prevention.

References:

Baah, F. O., Teitelman, A. M., & Riegel, B. (2019). Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health – An integrative review. Nurs Inq., 26 (1): e12268. doi: 10.1111/nin.12268.

Braveman, P., Arkin, E., Orleans, T., Proctor, D., Acker, J., & Plough, A. (2018). What is health equity? Behavioral Science & Policy, 4 (1): 1-14. doi:10.1353/bsp.2018.0000.

Lopez III, L., Hart, L. H., & Katz, M. H. (2021). Racial and Ethnic Health Disparities Related to COVID-19.  JAMA, 325 (8):719-720. doi:10.1001/jama.2020.26443

O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016).Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. Int J Equity Health, 15 (197). https://doi.org/10.1186/s12939-016-0487-5

Pega, F., Valentine, N. B., Rasanathan, K., Hosseinpoor, A. R., Torgersen, T. P., Ramanathan, V., Posayanonda, T., Röbbel, N., Kalboussi, Y., Rehkopf, D. H., Dora, C., Montesinos, E., &Neira, M. P. (2017). The need to monitor actions on the social determinants of health.Bulletin of the World Health Organization, 95 (11), 784–787. https://doi.org/10.2471/BLT.16.184622

Robards, F., Kang, M., Usherwood, T., &Sanci, L. (2018). How Marginalized Young People Access, Engage With, and Navigate Health-Care Systems in the Digital Age: Systematic Review. Journal of Adolescent Health, 62 (4): 365-381. https://doi.org/10.1016/j.jadohealth.2017.10.018

Schimitz, R. M., Robinson, B. A., Tabler, J., Welch, B., &Rafaqut, S. (2019). LGBTQ+ Latino/a Young People’s Interpretations of Stigma and Mental Health: An Intersectional Minority Stress Perspective. Society and Mental Health. https://doi.org/10.1177/2156869319847248

Ward, M., Schulz, A. J., Israel, B. A., Rice, K., Martenies, S. E., &Markarian, E. (2018). A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships.Evaluation and Program Planning, 70: 25-34. https://doi.org/10.1016/j.evalprogplan.2018.04.014

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