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Vulnerable Populations Vulnerable populations are groups that are not well integrated into the health care system because of ethnic, cultural, economic, geographic, or health characteristics. This isolation puts members of these groups at risk for not obtaining necessary medical care, and thus constitutes a potential threat to their health. Commonly cited examples of vulnerable populations include racial and ethnic minorities, the rural and urban poor, undocumented immigrants, and people with disabilities or multiple chronic conditions. The reasons for disparities are varied. For example, in access to health care, racial and ethnic minorities may lag behind non-Hispanic whites because patterns of residential segregation separate minorities from the supply of providers, because of language and cultural barriers between doctors and patients, or because of differences in employment patterns that lead to lower rates of employer-based insurance coverage for some groups. Persons with disabilities and multiple chronic conditions may find it difficult to obtain insurance coverage because small employers cannot afford to add workers to their health plans who are likely to have high medical costs, and finding an affordable insurance plan as an individual with pre-existing conditions is very difficult. The geographic and economic isolation of some poor rural residents may make access to specialty care difficult, even if they are covered by insurance. Finally, prohibitions against public insurance coverage, fear of being discovered, and language barriers are all factors that may keep undocumented immigrants from seeking care. At The Urban Institute, the study of disparities intersects with many other areas of our research, including private insurance, the uninsured, long-term care, public health, and Medicaid/SCHIP. Recent examples of our work include studies of:
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