ArticleAcademic medicine : journal of the Association of American Medical Colleges2017
Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care.
Article in Academic medicine : journal of the Association of American Medical Colleges, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 282 papers, 5 of them syntheses that pooled it.
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Who cites it
282 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Between duty and constraint: a qualitative systematic review of healthcare providers' ethical challenges and moral stressors in caring for undocumented migrants.International journal of qualitative studies on health and well-being · 2026Pooled it
- Structural Vulnerability in Health Research: A Systematic Mixed Studies Review.Journal of advanced nursing · 2026Pooled it
- The range of countermeasures to reduce inequalities in mental health care for socially marginalized or medically vulnerable adults: a PRISMA systematic review.BMC health services research · 2026Pooled it
- A meta-analysis of the role of neighborhood deprivation in psychotic disorders.Social psychiatry and psychiatric epidemiology · 2025Pooled it
- To what extent are vulnerability issues included and addressed in Kenya's health and immunization policy documents? A systematic review of documents.NIHR open research · 2025Pooled it
- Social risks and social needs in a health insurance exchange sample: a longitudinal evaluation of utilization.BMC health services research · 2022Trial
- Gendered ageism among women undergoing mastectomy across two life stages: early adulthood and later life in Pakistan.International journal for equity in health · 2026Article
- Disparities in Healthcare Providers' Substance Use Detection Practices for Pregnant Patients.Journal of racial and ethnic health disparities · 2026Article
- Article
- U.S. Policy as a Pathogen: A Systematic Review of Somatic and Psychological Distress Among Immigrants.Journal of immigrant and minority health · 2026Review
- 'She's surrounded by everybody, but yet seen by nobody.' Parents' experiences and priorities for neonatal developmental follow-up care.BMJ paediatrics open · 2026Article
- Institutional Factors Associated with Equitable Cancer Care Provision for Culturally and Linguistically Diverse Populations in Queensland, Australia: A Critical Race Theory Analysis.Journal of racial and ethnic health disparities · 2026Article
- Immigrant and Mistrust in the Healthcare Setting: A Thematic Review.Journal of immigrant and minority health · 2026Review
- A Community Grounded Approach to Addressing COVID-19 Health Disparities and Misinformation in Latinx and Indigenous Mexican Immigrant Communities.Journal of community health · 2026Article
- Confronting finitude and treatment adherence in older adults with chronic diseases: a qualitative study.BMC geriatrics · 2026Article
- Solidarity or Segregation? ChatGPT Health and US Health Care Disparities.Journal of medical Internet research · 2026Article
- Article
- Personalizing Approaches in International Projects Engaging Individuals with Vulnerabilities: The Lessons Learned for a Person-Centered Research.Journal of personalized medicine · 2026Article
- Perspectives and Challenges of Healthcare Professionals, Patients, and Caregivers Regarding Utilizing Antibiotics and Implementing Antibiotic Stewardship in Healthcare Facilities in Low- and Middle-Income Countries: A Systematic Review of Qualitative Studies.Antibiotics (Basel, Switzerland) · 2026Review
- "They Never, Never, Never Give Up on Me": Perspectives on an Addiction Consult Service From Hospitalized People Who Use Opioids at 6 New York City Public Hospitals.Substance use & addiction journal · 2026Article
222 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors.
Funding
Abstract
The authors propose reinvigorating and extending the traditional social history beyond its narrow range of risk behaviors to enable clinicians to address negative health outcomes imposed by social determinants of health. In this Perspective, they outline a novel, practical medical vulnerability assessment questionnaire that operationalizes for clinical practice the social science concept of "structural vulnerability." A structural vulnerability assessment tool designed to highlight the pathways through which specific local hierarchies and broader sets of power relationships exacerbate individual patients' health problems is presented to help clinicians identify patients likely to benefit from additional multidisciplinary health and social services. To illustrate how the tool could be implemented in time- and resource-limited settings (e.g., emergency department), the authors contrast two cases of structurally vulnerable patients with differing outcomes. Operationalizing structural vulnerability in clinical practice and introducing it in medical education can help health care practitioners think more clearly, critically, and practically about the ways social structures make people sick. Use of the assessment tool could promote "structural competency," a potential new medical education priority, to improve understanding of how social conditions and practical logistics undermine the capacities of patients to access health care, adhere to treatment, and modify lifestyles successfully. Adoption of a structural vulnerability framework in health care could also justify the mobilization of resources inside and outside clinical settings to improve a patient's immediate access to care and long-term health outcomes. Ultimately, the concept may orient health care providers toward policy leadership to reduce health disparities and foster health equity.
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