Vulnerable Populations and Health Care Provision in the US

Table of Contents

Introduction: General Health Care Access in the United States

For most people, living in a developed country means having access to better health care. Americans care about their wellbeing; they try to live a healthy lifestyle and monitor their health carefully to avoid any medical issues going unnoticed. According to the Commonwealth Fund (2016), more than 80 percent of older adults reported having access to chronic care management, and the vast majority of adults are able to get medical help promptly. The majority of the U.S. population has health insurance; however, high-quality medical care remains a privilege rather than a standard, and a lot of people struggle to receive the level of treatment described above.

What Are Vulnerable Populations?

The Commonwealth Fund defines vulnerable populations as people who belong to racial minority groups, as well as those who have a low income, are homeless, or are not legally documented persons (2016). For instance, the organization states that “the Affordable Care Act bars people who are not legal U.S. residents from Medicaid or marketplace coverage” (The Commonwealth Fund, 2016). Margot Kushel (2011) also discusses health care for homeless people and argues that the majority of deaths in the older homeless population result from a lack of prompt medical care; as the author notes, “mortality among older homeless adults is caused by heart disease and cancer” (p. 5).

What Has Been Done Already?

The problem of health care access for vulnerable populations is not new, and some measures have already been taken to address it in the United States. For example, Federally Qualified Health Centers (FQHC) “provide comprehensive primary and preventive care regardless of their patients’ ability to pay” (The Commonwealth Fund, 2016). The federal government also provides funding for community health centers to enable them to provide primary medical aid to uninsured and vulnerable people (The Commonwealth Fund, 2016). Furthermore, emergency medical care has also been made available in the majority of hospitals, regardless of the patient’s immigrant status or income.

Remaining Issues

Despite the recent improvements in this field, there are still significant inequalities regarding access to proper medical treatment for vulnerable persons. Over 33 million U.S. residents remain uninsured, and the vast majority of them have reported being unable to obtain medical insurance due to their low income (The Commonwealth Fund, 2016). Coverage for pregnant women with no legal resident status, as well as for undocumented children, is only available in some states. Analyzing health care for homeless people, Kushel adds, “research shows a highly vulnerable population living with high rates of disability […] Many of the impairments that they found may be attributed in part to limited access to health care coupled with high rates of harmful health behaviors and unintentional injuries” (2011, p.5).

My personal experiences have confirmed the existence of health care inequality in the United States. My friend’s grandparents are legally registered immigrants from India, and they often experience difficulties getting proper treatment. For example, several years ago, doctors told my friend’s 68-year-old grandmother that she needed a kidney transplant and added her to a waiting list. At that time, the standard wait time in their state was up to five years; however, she had to wait for more than seven years because younger, non-immigrant persons were given higher priority. In the meantime, it was hard for her to obtain certain prescription drugs, as she did not qualify for free or discounted medication.


All in all, it is clear that in the United States, “health coverage remains fragmented, with numerous private and public sources as well as wide gaps in insured rates” (The Commonwealth Fund, 2016). These issues need to be targeted to improve the overall wellbeing of the country’s population, and, as the Commonwealth Fund claims, there are many cost-effective ways to do so. A particularly effective strategy would be to fund safety-net hospitals that specialize in “community services,” such as “serving large numbers of low-income patients, offering unprofitable services, and training the next generation of physicians” (The Commonwealth Fund, 2016). Another possible solution would be to provide supportive or subsidized housing that includes basic medical care for the homeless (Kushel, 2011, p.6). The appropriate application of these projects and tools could result in a major improvement in quality of life for vulnerable populations, as well as a greater health care satisfaction rate nationwide.


The Commonwealth Fund. (2016). Healthcare reports & briefs. Web.

Kushel, M. (2011). Older homeless adults: Can we do more? Journal of General Internal Medicine, 27(1), 5-6. Web.

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