Vulnerable and Priority Population Health

Maternal and Child Health (MCH) has historically addressed the health needs of disadvantaged and vulnerable populations, namely women and children. As the field has evolved and expanded, MCH has grown to include a more diverse spectrum of populations that have a disproportionately higher risk for poor health outcomes. These underserved populations include individuals with disabilities, individuals who have been incarcerated, and individuals from the following communities: GLBT, homeless, immigrant, refugee, and low socio-economic status. The Center for Leadership Education in Maternal and Child Public Health at the University of Minnesota School of Public Health is especially aware of the health disparities that exist for these priority populations, and researchers continue to work with community partners to gain insight into these complex issues and create practical ways to alleviate health inequities.

Programming

The Minnesota Department of Health, along with its Office of Minority and Multicultural Health, collaborate with a variety of local, regional, and national entities to provide health care programs to a number of groups. A primary partner in these efforts is the Office of Minority Health with the US Department of Health and Human Services. Two leading international organizations, the Center for Victims of Torture and Minnesota International Health Volunteers, are based in the Twin Cities. Both organizations have strong ties to the University of Minnesota and work locally and internationally to improve the health status of underserved populations.

In addition to the programs mentioned above, the following entities represent a sample of the many organizations that work to improve the health and social status of vulnerable populations:

• The Advocates for Human Rights
• Gay, Lesbian, Bisexual, Transgender Ally Programs Office
• Homeless Shelter Programs
• MENTOR-Mentoring Children of Prisoners: Caregiver's Choice
• National Institute for Occupational Safety and Health: Developmental Disabilities
• Physicians for Human Rights

The MCH Library Knowledge Path on Racial and Ethnic Disparities in Health offers a comprehensive directory of national organizations dedicated to improving the health outcomes of vulnerable populations.

Policy

Policies can dramatically influence the health of vulnerable populations. The national and state public assistance programs, Medicaid and the State Children's Health Insurance Program (SCHIP), are designed to increase access to healthcare for our most vulnerable populations. Medicaid, otherwise known as Title XIX of the Social Security Act, was passed into law in 1965 and was developed to assist states in providing healthcare coverage for individuals in need. SCHIP, officially named Title XXI of the Balanced Budget Act of 1997, was developed to address the nation's children without health insurance. Although these programs have been criticized, each has been fundamentally designed to increase access to healthcare for some of our most vulnerable citizens.

Health Inequity Research

Much research about health inequity explores the disparities that exist between racial and ethnic groups. However, it has become increasingly apparent that health outcomes are influenced by a number of sociocultural and economic factors beyond race and ethnicity. As part of its commitment to address the broad spectrum of health disparities among vulnerable populations, the Center for Leadership Education in Maternal & Child Public Health holds an annual MCH Summer Institute on Health Disparities. Past themes have included Family-centered program development and advocacy ; Culture, communications, and health ; and Building blocks for healthy families and communities .

The Commonwealth Fund recently published a chartbook entitled
“Racial & Ethnic Disparities in U.S. Health Care,” an excellent resource for individuals wishing to further explore health inequity.

University of Minnesota Involvement

The faculty members listed below, as well as colleagues, students, and graduates of our MCH Program work locally and nationally to alleviate the poor health status of vulnerable populations.

• Linda Bearinger, PhD : Health promotion with vulnerable adolescents
• Kathleen Call, PhD : Access to health insurance coverage and health care services among vulnerable populations
• Amos Deinard, MD, MPH : Oral health of poor children; enhancing parenting skills of high risk mothers
• Rhonda Jones-Webb, DrPH : Minority health issues; behavioral epidemiology
• Donna McAlpine, PhD, MA : Racial and ethnic disparities, medical sociology, barriers to health care among cultural communities
• Ira Moscovice, PhD, MS : Rural health care, the impact of health policy on disadvantaged populations  
• Luanne Nyberg, MPH : Health disparities; child health; advocacy; public health policy
• Michael Oakes, PhD : Social epidemiology
• Charles Oberg, MD, MPH : Health disparities; childhood poverty; health care access & finance
• Simon Rosser, PhD, MPH, LP : Health disparities of sexual minorities

Courses:

• Social Inequalities in Health
• Social Epidemiology
• Immigrant Health Issues
• Advocacy & Children's Rights
• Medical Sociology
• Cultural Knowledge, Health, and Contemporary Cultural Communities

Resources:

• Center of American Indian & Minority Health
• The Center for Leadership Education in Maternal and Child Health
• Gay, Lesbian, Bisexual, Transgender Ally Programs Office
• Institute on Race & Poverty
• Program in Health Disparities Research
• School of Public Health – Health Disparities Working Group
• State Health Access Data Assistance Center

Healthy Generations:

• American Indian Health
• Childhood Poverty
• Food Insecurity and Hunger
• Immigrant and Refugee Health