Based on the authors' teaching and research at the Johns Hopkins Bloomberg School of Public Health and the Keck School of Medicine of the University of Southern California, the second edition of this landmark text offers a general framework for students, researchers, practitioners, and policymakers for learning about vulnerable populations. It contains in-depth data and information on major health and health care disparities by race or ethnicity, socioeconomic status, and health insurance coverage. It is thoroughly updated to include the latest data and trends and provides a detailed synthesis of recent and increasingly expansive programs and initiatives to remedy these disparities. To keep current with recent trends it incorporates the latest Healthy People 2020 objectives, includes new sections on real-world clinical examples, and discusses the impact of health care reform on vulnerable populations. The book's Web site includes instructor's materials that may be downloaded. Praise for the First Edition of Vulnerable Populations in the United States "e;An excellent primer for undergraduates and graduate students interested in vulnerable populations and health disparities."e; New England Journal of Medicine "e;Combines thoughtful, coherent theory with a large amount of information available in a single source. It will prove to be a valuable resource for policymakers, researchers, teachers, and students alike for years to come."e; Journal of the American Medical Association "e;A very worthwhile read for health care administrators, health policy analysts, public health and health promotion practitioners, students of public health, and health researchers."e; Inquiry "e;It makes clear that, for political, social, and economic (as well as moral) reasons, the country must increasingly make vulnerable populations a national health policy priority."e; Journal of Health Care for the Poor and Underserved "e;I have reviewed a number of books looking for meaningful content to help my students understand and work with vulnerable populations. This is the most comprehensive, yet understandable book on the topic."e; Doody's Reviews "e;Provides much-needed guidance to policymakers challenged with providing solutions to this embarrassing issue in the United States."e; F. Douglas Scutchfield, MD, Peter P. Bosomworth Professor of Health Services Research and Policy, University of Kentucky Companion Web site: josseybass.com/go/shi

Based on the authors' teaching and research at the Johns HopkinsBloomberg School of Public Health and the Keck School of Medicineof the University of Southern California, the second edition ofthis landmark text offers a general framework for students,researchers, practitioners, and policymakers for learning aboutvulnerable populations. It contains in-depth data and informationon major health and health care disparities by race or ethnicity,socioeconomic status, and health insurance coverage. It isthoroughly updated to include the latest data and trends andprovides a detailed synthesis of recent and increasingly expansiveprograms and initiatives to remedy these disparities. To keepcurrent with recent trends it incorporates the latest HealthyPeople 2020 objectives, includes new sections on real-worldclinical examples, and discusses the impact of health care reformon vulnerable populations. The book's Web site includesinstructor's materials that may be downloaded.Praise for the First Edition of Vulnerable Populations inthe United States"An excellent primer for undergraduates and graduate studentsinterested in vulnerable populations and health disparities."New England Journal of Medicine"Combines thoughtful, coherent theory with a large amount ofinformation available in a single source. It will prove to be avaluable resource for policymakers, researchers, teachers, andstudents alike for years to come."Journal of the American MedicalAssociation"A very worthwhile read for health care administrators, healthpolicy analysts, public health and health promotion practitioners,students of public health, and health researchers."Inquiry"It makes clear that, for political, social, and economic (aswell as moral) reasons, the country must increasingly makevulnerable populations a national health policy priority."Journal of Health Care for the Poor andUnderserved"I have reviewed a number of books looking for meaningfulcontent to help my students understand and work with vulnerablepopulations. This is the most comprehensive, yet understandablebook on the topic."Doody's Reviews"Provides much-needed guidance to policymakers challenged withproviding solutions to this embarrassing issue in the UnitedStates."F. Douglas Scutchfield, MD, Peter P. BosomworthProfessor of Health Services Research and Policy, University ofKentuckyCompanion Web site: josseybass.com/go/shi

Figures, Tables, Exhibits xiPreface xviiThe Authors xxiii1 A General Framework to Study Vulnerable Populations 1Learning Objectives 1Why Study Vulnerable Populations? 3Models for Studying Vulnerability 8The Vulnerability Model: A New Conceptual Framework 18Summary 33Key Terms 33Review Questions 34Essay Questions 342 Community Determinants and Mechanisms of Vulnerability 35Learning Objectives 35Race and Ethnicity 36Socioeconomic Status 49Health Insurance 72Multiple Risk Factors 85Summary 90Key Terms 91Review Questions 91Essay Questions 923 The Influence of Individual Risk Factors 93Learning Objectives 93Racial and Ethnic Disparities 94Socioeconomic Status Disparities 110Health Insurance Disparities 124Summary 135Key Terms 135Review Questions 135Essay Question 1364 The Influence of Multiple Risk Factors 137Learning Objectives 137Health Care Access 141Quality of Health Care 152Health Status 164Summary 176Key Terms 176Review Questions 177Essay Questions 1775 Current Strategies to Serve Vulnerable Populations 179Learning Objectives 179Programs to Eliminate Racial and Ethnic Disparities 185Programs to Eliminate Socioeconomic Disparities 198Programs to Eliminate Disparities in Health Insurance 209Summary 217Key Terms 218Review Questions 218Essay Questions 2186 Resolving Disparities in the United States 221Learning Objectives 221The Healthy People Initiative 222Framework to Resolve Disparities 230Resolving Disparities in Health and Health Care 234Integrative Approaches to Resolving Disparities 256Challenges and Barriers in Implementing the Strategies 267Course of Action for Resolving Disparities 272Summary 281Key Terms 281Review Questions 282Essay Questions 282References 283Index 313