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Table 2 Data charting

From: Mapping the concept of vulnerability related to health care disparities: a scoping review

Citation (type, language, location) Study population Main objectives Vulnerability factors involved Main findings
1. Bieler et al., 2012 (RS, QN, EN, Switzerland) Patients ofan Emergency Department (ED) To identify the social and medical vulnerability factors associated with ED frequent use An accumulation of different social and medical factors ED frequent users are more likely to accumulate social and medical vulnerability factors
2. Broyles, McAuley & Baird-Holmes,1999 (RS, QN, EN, USA) Poor and uninsured elders To assess health status and use of physician care of the medically vulnerable Old age associated with illness, poverty and lack of insurance Vulnerable elders are more likely to experience unmet medical needs and less likely to see a physician
3. Broyles, Narine & Brandt, 2000 (RS, QN, EN, USA) Elders, poor (Medicaid beneficiaries) and uninsured people reporting a poor or fair health status To assess the use of hospital care by the medically vulnerable Illness associated with old age, poverty and lack of insurance Vulnerable elders who reported poor or fair health were less likely to experience hospitalization and consumed fewer days of service
4. Carlson & Blustein, 2003 (RS, QN, EN, USA) Enrollees in commercial HMOs (Health Maintenance Organizations) To assess access to care among vulnerable populations enrolled in commercial HMOs Low income and education associated with ethnicity and poor health More vulnerable enrollees were more likely to report greater difficulties in seeing a specialist, obtaining help by telephone and getting tests or treatment
5. Denberg et al., 2006 (RS, QN, EN, USA) African Americans with low-income and/or widowed To assess the influence of patient race and social vulnerability on urologist treatment recommendations in prostate carcinoma Race associated with low- income and widow status More vulnerable patients experienced lower rates of recommendation for aggressive therapy
6. German & Latkin, 2012 (RS, QN, EN, USA) Low-income women (96 % of the study participants were primarily African-American) at risk for HIV To evaluate the role of accumulated vulnerability in association with HIV-related risk behaviors Homelessness, incarceration, low-income, as indicators of social (in)stability Each vulnerability indicator was significantly correlated with at least one HIV risk
7. Giger et al., 2007 (DP, EN, USA) Racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. To discuss the development of cultural competences to eliminate health disparities Poverty, belonging to a racial/ethnic minority, old age Health and health care disparities could be eliminated by the development of specific knowledge, skills and competencies among health care professionals.
8. Fiscella & Shin, 2005) (DP, EN, USA) Low-income persons, racial and ethnic minorities, the insured, etc. To review disparities in health status and access to healthcare for vulnerable populations. Low SES, belonging to a racial/ethnic minority, lack of insurance chronic illness, residence in underserved areas. Healthcare policies do not adequately confront the paradox of the inverse care law, therefore disparities persist and, in some instances, actually worsen.
9. Mechanic & Tanner, 2007 (DP, EN, USA) The poor and people with low education, ethnic minorities, inmates, people with physical and cognitive impairments. To discuss the influence of values on how the society views the vulnerable and implications on health assistance. A combination of individual and community dimensions Limited access to high quality medical care is due to inadequate healthcare policies.
10. Monod & Sautebin, 2009 (DP, FR, Switzerland) Older adults To discuss elders’ vulnerability factors Old age associated with loss of autonomy, multimorbidity, social exclusion and poverty Older adults are suffering from limited access to care
11. Pauly & Pagán, 2007 (RS, QN, EN, USA) People who are less likely than average to obtain medical care of an appropriate quality and quantity - the uninsured To determine how the uninsurance rate is positively associated with lower quality care for the insured (negative spillover) Poverty, ethnic minority, lack of insurance, chronic health conditions, psychiatric disorders There are negative spillover effects from the uninsured to the insured in terms of the quality of health care, as a result of the low demand for quality by the uninsured
12. Pitkin Derose, Escarce & Lurie, 2007 (DP, EN, USA) Immigrants in the United States To discuss the sources of vulnerability to inadequate health care in immigrants A combination of factors involving socio-political marginalization and a lack of socioeconomic and societal resources Immigrants have reduced access to both personal medical services and public health services and programs (e.g. immunizations)
13. Rieder et al., 2010 (DP, FR, Switzerland) Inmates To discuss sources of shared vulnerability between inmates and health professionals Detainee status associated with illegal immigration and psychiatric troubles There are difficulties in access to health care in prisons in conditions of overcrowding and related to the lack of flexibility of prison functioning
14. Rogers, 1997 (DP, EN, Canada) The poor, homeless, chronically ill and disabled, frail elderly people, immigrants and refugees. To consolidate the available material on vulnerability and to introduce a vulnerability model for nurses’ use. A combination of personal and environmental components. The vulnerable experience reduced access to essential health care due to financial or social barriers.
15. Ruiz & Egli, 2010 (DP, FR, Switzerland) Patients with diabetes and other chronic diseases To discuss the metabolic syndrome in relationship with socio-cultural determinants Chronic conditions related to socio-cultural factors such as poverty and ethnicity Healthcare policies should take into consideration the sociocultural characteristic of patients
16. Shi, Forrest, von Schrader & Ng, 2003 (RS, QN, EN, USA) Civilian, non-institutionalized persons in the 48 contiguous states of the United States To examine whether patients’ perceptions of their relationships with primary care practitioners vary by vulnerability status A combination of predisposing, enabling and need attributes of risk Racial disparities were identified in office waiting time and having a specific clinician at the primary care site.
17. Shi & Stevens, 2005a (RS, QN, EN, USA) White adults and adults belonging to racial and ethnic minorities. To present a profile of risk factors for poor access based on income, insurance coverage, and having a regular source of care A combination of predisposing and enabling characteristics. Individuals with combinations of risk factors are more likely to delay medical care.
18. Shi & Stevens, 2005b (RS, QN, EN, USA) Individuals 18 years and older who completed a survey To operationalize vulnerability as risk profiles of pre-disposing and enabling factors, and to determine their association with preventive care A combination of predisposing and enabling characteristics Each additional vulnerability risk factor was associated with a lower likelihood of receiving preventive services
19. Shi & Stevens, 2007 (RS, QN, EN, USA) The uninsured and Medicaid insured To examine the primary care experiences of uninsured and Medicaid patients Poverty, ethnicity, lack of insurance, chronic illness Vulnerable people experience greater disparities in primary care (in terms of access, continuity and comprehensiveness)
20. Shi, Stevens, Faed & Tsai, 2008 (DP, EN, USA) Those at greater risk for poor health status and without adequate potential access to care: ethnic minorities, low income and uninsured populations To introduce and discuss a general model of vulnerability A combination of community-level and individual risk factors Vulnerable populations experience limited regular access to health care and preventive services.
21. Stone, 2002 (DP, EN, US) African Americans who have Medicare or other healthcare coverage To summarize recently published data about healthcare disparities experienced by African Americans A combination of race and poverty Vulnerable populations should be proportionally represented at all levels of decisions that affect health care and that are aiming to eliminate healthcare disparities
22. Stevens, Seid, Mistry & Halfon, 2006 (RS, QN, EN, USA) Children and adolescents 0–19 years old. To analyze vulnerability as a profile of multiple risk factors for poor pediatric care based on race/ethnicity, poverty status, parent education, and insurance status Childhood associated with poverty, belonging to a racial/ethnic minority, being uninsured, having parents with a low level of education Higher risk profiles were associated with greater barriers to accessing primary care for children in ‘fair or poor’ health. Vulnerable children who have the greatest health care needs also have the greatest difficulty obtaining primary care.
23. Walker et al., 2010 (RS, QN, EN, USA) Middle-aged and older adults living in a multiethnic, low-income area To assess the disparities in health care related to age, low-income and belonging to a racial/ethnic minority A combination of predisposing, enabling and need factors Middle-aged and older adults who are uninsured and in poor health reported more problems receiving needed medical care or preventive services.
  1. Legend : RS: Research study; QN: Quantitative Research Report; DP: Discussion Paper;
  2. EN: English, FR: French.