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Identify population groups facing greater challenges and barriers in accessing healthcare services

Providing quality health care and improving on current access to the entire population is the primary goal for Healthy People 2020 (Office of Disease Prevention and Health Promotion [ODPHP], 2017).This became a necessity due to the disparities in health care services experienced by certain population groups which include those with mental illness, those living in rural communities, the homeless, the chronically ill, the disabled, uninsured women and children, those with HIV and AIDS and racial and ethnic minorities DeNisco and Barker (2016).

The dilemma of physical distance faced by those in rural communities is obvious, lack of transportation, poverty and being uninsured makes this an issue of several dimensions compounded by a shortage in health care providers in those areas. Additional challenges of potential lack of trust, lack of interest or believe in prevention of and treatment for certain illnesses should not be underemphasized and as stated byBlumling, Thomas & Stephens (2013) “…overcoming these challenges is essential because of the fact that these groups of individuals continue to suffer higher than normal rates of various morbidities…” (pp. 123). The master’s prepared nurse understands that respecting the value of that rural community, communicating openly and gaining an understanding of the unique dynamics of the culture allows development of strategies needed to encourage, educate, treat and improve health care access specific to that area.

The needs of the vulnerable population are multidimensional and therefore requires coordination of a multidisciplinary team. Looking specifically at the homeless population, providing shelter is a small part of the care and the likelihood of return to same situation increases if that individual’s needs for possible mental health, substance abuse, a job and chronic illness treatment is not addressed and as such care coordination is essential. The Center for Disease Control (CDC, 2015) describe population health ethics as understanding and clarification of the principles and values for the greater good of the public health.

This framework is then used to guide the actions or decisions of government regulators such as decisions associated with recent Zika virus in specific area in Miami. The population health ethics differs from that of medical ethics as medical ethics focuses on an individual preferences or perspectives, based on a code of behaviors or principles rather than government or legislator regulations. However, similarities also exist, just as in the provider-patient care relationship requires trust, so too does the population, as well as honestly, clarity and quality of information to ensure engagement and willingness in participation. Williamson (2014) theorize that the balancing of autonomy from private perspective with the need of the population require careful management and support of self-interest and well-being of the public when they conflict.

DeNisco and Barker (2016) describe justice as an equal and fair allocation of services to everyone and a master’s prepared nurse bears the understanding that this encompasses those of opposing views toward health care treatment, those with no payment plan and those undeserved by the health care industry. ODPHP (2017) has one objective of increasing portions of the population with access to necessary medical care, dental care and prescription drugs. Focusing on health care access to those within rural communities by educating, preparing and providing incentives to the master’s prepared nurse is a concrete plan towards meeting this objective.


Blumling, A. A., Thomas, T. L., & Stephens, D. P. (2013). Researching and respecting the intricacies of isolated communities. Online Journal of Rural Nursing & Health Care, 13(2), 122-148

Centers for Disease Control and Prevention (2015). Public health ethics. Retrieved from https://www.cdc.gov/od/science/integrity/phethics/

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession. Burlington, MA: Jones and Bartlett Learning

Office of Disease Prevention and Health Promotion. (2017). Genomics. In Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/genomics

Williamson, L. (2014). Patient and citizen participation in health: The need for improved ethical support. American Journal of Bioethics, 14(6), 4-16. doi:10.1080/15265161.2014.9001391

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