Quality Standards for Diabetes Care Toolkit

Definitions

The term ‘vulnerable’ is broadly defined by the International Diabetes Federation (Williams et al 2006) as ‘the person, community or group is for some reason at increased risk of diabetes or is a victim of unforeseen circumstances that make their health situation precarious’(p 30).
Definitions for specific population groups are provided in the guidelines section below.

Introduction

Definitions for vulnerable people appear to be focused by topic or to be based on race or ethnicity, socioeconomic status, geography, gender, age, disability status, risk status related to sex and gender, cancer survivors, immigrants and refugees, incarcerated men and women, persons who use drugs, pregnant women and veterans (Centers for Disease Control and Prevention 2014). A further way of understanding vulnerable may be based on an analytical framework developed by CBG Health Research (2011) which considers the individual’s predisposition to health and health services, availability of services both geographically and across population groups, accessibility (distance and transport), accommodation (hours of operation of the service), affordability, acceptability (language, culture, gender, privacy) and appropriateness of the service. Additionally, vulnerable people may also encompass those ‘whose needs are not addressed by traditional service providers or who feel they cannot comfortably or safely access and use the standard resources offered’ (Central Cancer Network 2012). Thus vulnerable groups may encompass many different groups of people including Māori, Pacific peoples, older adults, the homeless, children (and those under or leaving Child Youth and Family Services’ [CYFS] care), pregnant women, those in rural areas, individuals in prison, inpatients, veterans, immigrants, refugees, those in residential care, individuals with mental/cognitive health issues, those with low literacy levels and individuals requiring advanced care planning.
In the context of Standard 18 a ‘vulnerable patient’ is a person with diabetes who falls into one or more of the following groups:

Māori and Pacific peoples

the older adult

those in residential care facilities

those with mental/cognitive health issues

those requiring advanced care planning

individuals in prison

immigrants and refugees.