Session: Examining Burden and Health Inequalities Among Vulnerable Populations Facing Serious Illness (Society for Social Work and Research 24th Annual Conference - Reducing Racial and Economic Inequality)

Background and Purpose: Attention to health inequalities and consequences of having a chronic illness is increasing, especially among vulnerable populations. Little is known about the factors that intensify emotional suffering and negatively impact quality of life among patients and their caregivers with a chronic illness. Economic disparities can place limits on how individuals and caregivers manage their healthcare (Ell et al., 2008). Individuals with one or more chronic conditions can experience an increase in out-of-pocket expenses (Hwang, Weller, Ireys, & Anderson, 2001), which is especially impactful for low-income or disadvantaged older adults and minority populations. Data suggest that economic stress may negatively influences emotional symptoms, such as anxiety, depression, or grief and impacts overall quality-of-life (QOL) (Delgado-Guay et al., 2015). Limited data exists to help better understand the effects of managing a chronic illness limiting a providers' ability to intervene.

This symposium brings together three researchers examining distinct aspects of burden and economic disparities that influence quality of life for vulnerable populations. The aim of this symposium is to examine the issue from diverse perspectives: 1) examining economic stress among older Latinos living near the United States/Mexico Border Region and dealing with chronic illness, 2) exploring the psychological and financial consequences of grief among spousal caregivers of patients with early-onset dementia, and 3) reviewing interventions that address health inequality in advance care planning and palliative/end-of-life care among racial/ethnic minority populations.

Methods: The studies presented in this symposium employ various methodologies to examine aspects of burden and economic disparities influencing quality of life, especially important for developing interventions in end-of-life and palliative care. Examining factors related to economic stress and quality of life provides an understand of the complexity surrounding the economic impact of chronic illness. Thematic analysis of qualitative interviews with spousal caregivers helps us understand the psychological and financial impact of early-onset dementia. Additionally, a systematic review provides a detailed examination of interventions useful for these populations. All studies in this symposium contribute to a nuanced and multi-level understanding of the challenges of burden when dealing with serious illness.

Finding: Findings from these studies indicate that psychosocial and economic factors contribute to health disparities for vulnerable populations. From ethical and organizational perspectives, there is still great discomfort and much room for improvement needed to address the inequalities that disproportionally impact some individuals and their families.

Conclusion: It is incumbent upon social work scholars to embrace much needed research that addresses both practice change and health policy advocacy in order to address health inequalities. Because of the bio-psychosocial approach and scope of practice in social work training, social workers are uniquely positioned to create change and improve care, especially for those individuals and caregivers dealing with advanced, chronic illnesses. Leadership in this arena is more salient than ever.