A Systematic Review of the Health of Vulnerable Populations within US Rural Societies

摘要

Purpose: To synthesize the recent research on vulnerable populations within United States (US) rural society regarding healthcare, healthcare policy, and health systems. Additionally, a healthcare disparity model was utilized to organize the findings as a means of evaluating the current state of the science regarding vulnerabilities research in the field of rural health. Methods: A systematic review of literature was conducted covering 46 articles published in the last five years on vulnerability within rural populations in the US and its territories. Instruments to evaluate both quantitative and qualitative scientific merit were utilized in this review. Findings: Analysis of the state of the science indicates that studies that scored well on measures of scientific merit were conducted on some of the most vulnerable populations within rural society. Most of this work remains at a descriptive level, rural is only operationally defined approximately 1/3 of the time, and seldom is there a clear definition of the term vulnerable. The findings of this review support the model depicting how healthcare accessibility and quality, along with healthcare needs can reflect the level of vulnerability of rural populations. Conclusions: Using the combination of the search terms “vulnerable” and “rural” failed to produce any studies on the subject of telehealth. Telehealth is an area that needs to be specifically studied for vulnerable populations in rural society. There is a need for rural health research that provides interventions and includes measurement of social determinants of health.