Citation

Sussman S, Sinclair DL. Int. J. Environ. Res. Public Health 2022; 19(10): e6163.

Copyright

(Copyright © 2022, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph19106163

PMID

35627700

Abstract

“Vulnerable populations” in health behavior research, practice and policy is generally used to refer to groups that, due to their life circumstances, may require extra consideration, reasonable accommodation, and legitimized protection [1,2]. Other terms have been used, such as “special populations”, “at risk”, “disadvantaged”, “marginalized” and “underserved”, although any such term risks stigmatizing the group in question [3] (p. 198). How vulnerability is conceived of by researchers, practitioners, and policymakers determines who is considered vulnerable: defining its parameters too narrowly may exclude or stereotype group members, while too broadly extending it may trivialize the utility of the concept [4]. However, the term “vulnerable populations” may be ambiguously defined or undefined, leaving “who is vulnerable, why they are vulnerable, and what they are vulnerable to” open to interpretation [2] (p. 601). To attempt to clarify this term, one multifaceted definition defines a vulnerable population as an outcome of other variables, which concurrently represents a potentially preventable, reversible process, and is also a condition or conditions attached to a specific group [5]. A vulnerable population may refer to individuals with disabilities (physical or mental impairment that substantially limits major life activities), or individuals who represent socially or economically disadvantaged demographic populations, such as homeless individuals, rural families, foster children and those who have aged out of that system, as well as single parents, the elderly, racial/ethnic minorities, gender minorities, religious minorities, children with parents who are active-duty members of the Armed Forces, and veterans, among others. Vulnerability lies on a continuum of severity [6], and the intersections between various characteristics and circumstances may render some groups more vulnerable than others (i.e., a matter of degree, combinations of factors). Conceptions of vulnerability are important in public health practices and can shape public perceptions and responses.
In response to toxic life experiences, vulnerable persons may seek out alternative means of coping with stressors or may be subject to non-normative routes of socialization [7]. They may be at particular risk (vulnerable) of experiencing any number or type of substance or behavioral addictions [8]. Discourses on the etiology of addiction have historically emphasized the disproportionate vulnerability of specific groups. For example, children may be at heightened vulnerability for drug misuse in the context of familial or parental substance use (e.g., [9]), there are genetic and neurobiological markers of vulnerability that have been isolated [10,11], and unemployment, poverty, social position, available substances, and poor connection to one’s community [12,13] may confer heightened vulnerability. Contemporary models have distinguished between an individual-level oriented approach, characterized by one’s vulnerability versus resiliency, and an ecologically oriented approach rooted in the interactions between individuals nested within family systems and community-level factors [14]. As White [15] contends, “addiction is a disease of exposure—a collision between personal vulnerability and social opportunity. And that opportunity is often bred within psychological and social circumstances that made picking up again and again an attractive choice” (p. 1). One may attempt to cope with difficult life circumstances through entrenchment in an addiction, and entrenchment in the addiction may lead to increased vulnerability (downward drift [16]). The negative consequences resulting from entrapment by an addiction tend to interfere with aspects of one’s quality of life (QoL), and may diminish personal, family/social and community recovery capital, including the maximal performance of daily activities such as engaging in full-time work, the development of chronic impairment (e.g., peripheral neuropathy or vision loss with alcohol misuse), loss of energy, anxiety, depression, regret, lifestyle dissatisfaction, sense of meaninglessness, and loss of self-fulfilling leisure ...

Language: en