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Population Risk Paper

Amy Polzin
Ferris State University


Vulnerable Populations

Health care and medicine are more advanced now than they have ever been before, and
continue to grow every day. However, certain population groups face health disparities and are
considered vulnerable to health care equality. The lesbian, gay, bisexual, and transgender
(LGBT) community is one group facing health care disparities and is considered a vulnerable
The inequality the LGBT community faces stems from the lack of knowledge that nurses
may have regarding their special needs and associated risk factors. Some factors that can cause
vulnerability and place this population at risk include health care providers not examining the
assumptions made about lifestyles based on stereotypes (Harkness & DeMarco, 2012, p. 346)
and instead using heterosexuals as the standard in patient care. Health care providers should take
into consideration that not all LGBT patients are open about their sexuality, and confidentiality is
absolutely essential in order to promote a healthy patient-provider relationship (Harkness &
DeMarco, 2012).
In order to avoid discrimination toward patients in the LGBT community, health care
workers should make it a priority to educate themselves and their coworkers about the needs of
LGBT persons. They should also promote equal policies and work to improve laws regarding the
treatment of LGBT patients. Discriminatory practices should be reported, and appropriate
existing policies should be utilized for protection of the patient and their loved ones (Lambda
Legal, 2010).
Members of the LGBT community face bias in health care every day, whether or not it is
intentional or happens subconsciously by the provider. Potential bias may stem from a personal
stance on the LGBT community. Health care providers may disagree with the LGBT lifestyle,


and this may impede their ability to treat an LGBT patient fairly. Attitudes toward clients of the
LGBT community may include discriminatory behavior. Most heterosexual health care providers
have a preference for caring for heterosexual patients. This can create problems for LGBT
patients, and may lead to them receiving subpar care. Some LGBT clients have even been denied
health care, due to their sexuality, for things like infertility treatments (Ard & Makadon, 2015).
Other discrimination experienced may include work, housing, health insurance, and financial
supports (Harkness & DeMarco, 2012).
Demographics of the LGBT are difficult to determine. This is partially due to the nature
of the community. Medical research regarding the LGBT community is really lacking. Many
members of the LGBT community are not open about their identities and may not be willing to
answer survey questions. It is also difficult to define and determine who is considered LGBT; It
is really based on personal identity and acceptance. However, it is believed that 3.5% of United
States adults identify as lesbian, gay, or bisexual and that 0.3% of adults are transgender. This
amounts to approximately 9 million adults in the United States today (Ard & Makadon, 2015, p.
There are several possible health concerns facing the LGBT community. Members of the
LGBT community are more likely than heterosexuals to have difficulty accessing health care.
They are also less likely than heterosexuals to have health insurance, and their health needs are
less likely to be met. Preventative screening tests are less likely to be completed. Sexually
transmitted diseases (STDs) are also of greater precadence amongst the LGBT community.
Homosexual males as well as male to female transgenders are at greater risk for contracting
human immunodeficiency virus (HIV). Specifically, young, black, homosexual males represent
the only demographic in which the incidence of HIV is increasing (Ard & Makadon, 2015, p.


3). This is largely due to the inability to acquire antiretroviral medications rather than unsafe sex
practices. Syphilis, gonorrhea, and anal cancer causing strains of human papilloma virus are also
more prevalent in homosexual males than heterosexual persons. Lesbians are more likely to be
overweight or obese than heterosexual women, and they also experience higher rates of breast
cancer and cervical cancer. In general, members of the LGBT community are more likely to
suffer from depression, substance abuse, mental health disorders, addictions, and suicidal
ideation (Ard & Makadon, 2015).
I was very surprised to learn that the LGBT has higher rates of certain cancers. Because,
as previously mentioned, homosexual males are more likely to develop anal cancer and lesbians
are more likely to develop breast and cervical cancers, it is crucial to consider this as a health
care provider. In this area, health care delivery could be improved in a number of ways. I think
the number one way is to consider the clients lifestyle and risk factors, increase screening and
preventative tests for cancers prevalent to this demographic. Ensuring that tests and procedures
are completed and followed up on is essential. Nursing care can be improved in the LGBT
community by maintaining sensitivity to the patients lifestyle and keeping in mind the struggles
they may face, like depression, negative image of self, or other mental health issues. Nursing
care can be improved toward this community mainly by education. Educating oneself and
coworkers about the disparities and vulnerability of the LGBT community, and taking an active
role in ensuring equal and fair treatment (National LGBT Cancer Network, 2013).
Overall, members of the LGBT community face many issues in health care that most
heterosexuals never have to face. This includes biases and discrimination from providers,
inability to receive treatment, lower likelihood of having insurance, and increased risk of STDs
and even certain cancers. As health care providers, we can do our best to raise awareness of these

issues and take an active role in avoiding stereotypes and biases in our practice, and treating
these patients equally, fairly, and with respect.



Ard, K. L., & Makadon, H. J. (2015). Improving the health care of lesbian, gay, bisexual, and
transgender people: Understanding and eliminating health disparities. Boston, MA: The
Fenway Institute.
Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing. Philadelphia,
PA: Lippincott Williams & Wilkins.
Lambda Legal. (2010). When health care isn't caring: Lambda legal's survey on discrimination
against LGBT people and people living with HIV. New York, NY.
National LGBT Cancer Network. (2013). The LGBT community's disproportionate cancer
burden. New York, NY: Liz Margolies.