Christopher Abrogena

NUR 440

Vulnerable Population and Self- Awareness

Professor Nita McGee-Cornelius PhD, PMHNP-BC, MSN, RN

07/15/2013

Introduction
“Vulnerability is a general concept meaning “susceptibility” and has a specific connotation in health care—“at risk for health problems.” According to Aday (2001), vulnerable populations are those at risk for poor physical, psychological, or social health. Any person can be at risk statistically by way of having potential for certain illnesses based on genetic predisposition (Scanlon & Lee, 2007)(Chesnay 2012). A vulnerable population that I would like to focus on is the island of the Philippines and its people. There are many factors that make this country and its people vulnerable. Being a third world country, the Philippines have many people that live at or below the poverty level. Many Filipino’s live in areas that are susceptible to disease, flooding, and other factors that endanger their life style. In some of these areas, or provinces, a lot of the houses are made of sheet metal, dirt, and even trash. These living conditions leave Filipino’s vulnerable to disease from the trash, water and the many animals and insects that roam around their living spaces.
Demographics
As of the 2012, the demographics of the Philippines contained the following statistics. The population of the Philippines is estimated to be around 103,775,002 people. The birth rate is 24.98 births per 1000 people. The infant mortality rate is 18.75 deaths per 1000 infants, with 21.21 being male and 16,18 female. Life expectancy of the people is about 72 years old. Females average a longer life expectancy at 75 years old while the males are a few years younger at approximately 69 years old. Although the Philippines is a high risk country when it comes to major infectious disease, the total population having AIDS or HIV is less than 0.1 percent (8,700 people) out of the 104 million that live there. According to Index Mundi, the main types of food and waterborne illnesses that affect Filipino’s are bacterial diarrhea, Hepatitis A, and typhoid fever. Vector borne diseases are dengue fever, malaria, and Japanese encephalitis, and the water contact disease is leptospirosis (2012). Other critical demographics that were noted from the Philippines regarding healthcare are that for ever 1000 patients, there is only one physician, and in the hospital, there is only half of a bed for every 1000 patients, making it very hard for Filipino’s to get the much needed care they need in a time of crisis or emergency. For every 1000 births, 99 of them die at or before birth. Obesity is low, recording only 4.3 percent of the population. This could be due to the fact that many Filipino’s are poor and can’t afford the right nutrition leaving them underweight and malnourished. Lastly, almost twenty-one percent of children under the age of five years are underweight, leaving them vulnerable to many diseases and illnesses from lack of nutrition.
Personal Awareness towards this Vulnerable Population
Before studying the demographics of the Philippines, I read and heard from other Filipino’s many stereotypes, biases, and attitudes towards this culture. Some of the things that I read were that Filipino’s are know to have high-blood pressure and high cholesterol because of their diet. Many of the Filipino dishes contain a high amount of sodium and also many of the meats that are cooked are high in fat and these fats are rarely drained or cut off of the meat before or when served. I think this is true because, when I go to Filipino restaurants or to a family gathering, many of the foods are salty and fatty. Other biases that I’ve been exposed to, as a Filipino is that in some countries such as China and Saudi Arabia, the people of those countries treat Filipino’s with little to no respect. "The Chinese treat the Filipinos, like second-class citizens." On their recent trip to Hong Kong and Macau, they experienced it, since most of the domestics (housekeepers) are Filipino. There are a lot of Chinese-Filipinos in the Philippines, and they are very wealthy” (Krutovsky 2009). Another stereotype about Filipino’s is that they like to eat with their hands instead of using utensils. I have seen this first hand from my own family and I have done this on occasion when eating with my family. Although it is a common practice in the Filipino community, it can be unsafe. If hands are not properly washed, this can lead to illnesses such as Hepatitis A. After learning that, I stopped using my hands to eat, and educated my family to try and do the same. If they can’t, I advised them to make sure they properly wash their hands thoroughly before consuming food to be safe.
Effect of Research on Personal Attitudes After gathering the demographics of the Philippines, I feel that the Philippines needs more aid so that the country can build more hospitals to supply more beds for those that need special care that can only be provided in a hospital setting, such as necessary surgeries, containment of contact and airborne precautions. There are many health providers in the country but there are not enough facilities for these providers to practice in. Also, many health care providers including physicians, nurses and other healthcare workers tend to work in other countries such as the US and Saudi Arabia leaving little help for the people in the country that really need the care and help necessary to survive and maintain their health. It’s unfortunate that many health care providers do not want to practice in the country because they can get paid more in another country, and this makes the people of the Philippines more vulnerable everyday to disease and poor health because they can’t see a physician when they need to.
Knowledge Affecting Health Care
Knowing that there are not enough beds and physicians to go around for the people of the Philippines can deter some individuals from seeking the medical attention the need, should something serious happen to them. Many might chose to see someone who uses herbal medications or other holistic remedies for the patient. Although, that might sound like a good idea for some, I think that if the illness or disease is severe such as AIDS, I feel that the person needs to seek professional medical attention to get the proper medications and care that herbs and holistic medicine is not proven to provide for these types of diseases. For the elderly community, knowing that the life expectancy is lower than it use to be, seniors might be hesitant to seek care when they need to because if they care close to the average age, the person might just come out with the attitude that, there is no use, he/she is going to die soon anyway. Having a negative attitude can make your risks of illness higher, because he/she might not take their health serious; eating wrong, not exercising, and just neglecting their health in general. Also, with healthcare changing all the time, elderly people might just not want to deal with the many changes that go along with it. “Furthermore, the rapid changes in the health care system that have already occurred have had significant effects on the care provided to the elderly” (AHRQ 2001).
Example of Stereotype/Bias and how it Should be Dealt With
One stereotype that I think should be dealt with based on the knowledge that I have gathered from the information I read about the Philippines, is the stereotype of Filipino’s having high cholesterol and high blood pressure. I would like the health care providers of the country make more of an effort to educate the risks of too mush sodium in the diet and what types of effects foods high in fat can have on an individual. More information on myocardial infarctions, cerebral vascular accidents and hypertension should be made available to the people of the Philippines. More demographics and statistics of heart attacks, strokes, and hypertension should also be made available and taught to the people on a consistent basis. I feel that if more people read and see the outcomes of a diet high in sodium and fat and what it can lead to may help more people change the way meals are prepared, improving their lifestyle and hopefully extending life.
Conclusion
Being a Filipino myself, I have first hand experience of many of the things I learned from the demographics of the Philippines. I too ate foods high in sodium but I learned to control the fat content prepared most of the meals I ate. I was diagnoses with essential hypertension and was put on medication to control it. I never went to the see my doctor and after becoming a nurse I wanted to manage my health. I see my doctor regularly and I read and learn about more ways I can help myself stay healthy and I educate my family and tell them to see their physician regularly too. Word of mouth is a very good tool when relaying information, especially when it comes to health. I think if more people here the negative affects of something simple such as food, then it can help those that have high blood pressure or high cholesterol take notice and change their lifestyle. A small step like this can lead to better things, more doctor visits, demanding more physicians and hospital beds, to longer life and less fetal and infant mortality.

References
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De Chasney, Mary (2012). Caring for the Vulnerable: Perspectives in Nursing Theory,
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Task Force on Aging (2001).

Retrieved from: http://www.ahrq.gov/research/findings/final-

reports/olderam/oldam1.html

Krutovsky, Alisa (2009). 10 Most Common Stereotypes About Filipino Culture

Retrieved from: http://www.examiner.com/article/10-most-common-

Stereotypes-about-Filipino-culture

Philippines Demographics Profile (2012).

Retrieved from:

http://www.indexmundi.com/philippines/demographics_profile.html

Scanlon, A., & Lee, G. (2007). The use of the term vulnerability in acute care: Why

does it differ and what does it mean? Australian Journal of Advanced Nursing,

24(3), 54–59.