. lack of access to primary care services, . poor economy, high unemployment rates, and limited economic resources; . high rates of un-insurance and underinsurance; . cultural differences that may pose challenges, such as social, cultural, and linguistic barriers that may prevent patients from accessing care; . low education or health literacy levels; and . environmental challenges, which include unsafe streets; asthma exacerbated by air pollution, leading to unnecessary hospitalizations; housing instability, leading to environmental allergens causing symptoms that may result in inappropriate testing and minimal or no spaces for physical activity or exercise. Bhatt, J., & Bathija, P. (2018). Ensuring Access to Quality Health Care in Vulnerable Communities. Academic medicine: journal of the Association of American Medical Colleges, 93(9), 1271-1275. https://doi.org/10.1097/ACM.0000000000002254 Case Study Paul is the unit support clerk on an obstetrical unit. As a male in an OB unit, he has had to work to be accepted and there are still instances where an OB patient does not want him around. He understands that patient needs come first and does his best to fit in with the nurses and aides. Arriving at work one day, he sees most of the nurses sitting in the break room which is unusual. One nurse is talking about a patient admitted to labor the day before. She states; "I know I should be in there giving the usual newborn education, bu really seeing the two of them hugging and kissing just freaks me out. I think it is creepy. A man and a woman ought to be having a baby not two women. I just am not going to do it, they will have to read the literature." Everyone else is nodding in apparent agreement and then they notice you. Personalize your response concerning this vulnerable population. . Include each of the following points in your assignment: . Reflect on if you support the Guiding Principles #7 . Do you apply this Guiding Principle to this situation?You Be the Judge This week we continue to explore a variety of associated ethical issues using the National Association of Healthcare Advocacy (NAHAC) Code of Ethics. This week we shall explore Guiding Principle 7: Avoidance of Discriminatory Practices. Essential to the Profession ofAdvocacy is the beliefthat equal access to appropriate healthcare and treatment is the right of each individual. NAHAC Advocates are committed to striving for equal access without regard to age; race; ethnicity, sexual orientation, or socialeconomic status. NAHAC Advocates are committed to assisting clients ofall cultural and ethnic backgrounds. Advocates shall be mindful of the cultural context of clients: respect their individual perspectives: and employ effective cross-cultural communication techniques. This Guiding Principle aligns well with the general ethical responsibility of healthcare workers to protect vulnerable populations. Example You are a health care worker for a small medical office. Once a week you volunteer at the inner city free clinic for the poor. Elisa is a twoyearold whom you have seen multiple times. Elisa's mother brings her in with a variety ofailments: colds: coughs, difficulty breathing, and delay in meeting developmental milestones. The Nurse Practitioner usually prescribes what she can for each specic ailment and sends the mother and child on their way. Like all free clinics: resources are scarce. You are concerned about multiple aspects of Elisa's health and feel you should advocate for her as a vulnerable population. She is a small child; she is a minority; she lives in poverty; she lives in an inner city area where there is a food desert and a housing containing lead. You obtain a medical history and list of risks from the Nurse Practitioner. You spend time with Elisa's mother educating her on the multiple risks her daughter has and obtain permission for a consult with the low-income public health program that is available. You didn't really have the time; but as a health care worker you know it is an ethical responsibility to protect all vulnerable populations. Characteristics and Parameters of Vulnerable Communities There is no defined set of factors that can determine whether a community is vulnerable. The AHA task force created a list of characteristics and parameters of vulnerable rural and urban communities. One or more ofthese characteristics or parameters may be sufficient to identify a vulnerable community