Caring for Structurally Vulnerable Populations: What Equity-Oriented Palliative Care Teaches Us About Radical Love, Loss and Leadership in Healthcare – Part 1: What is Structural Vulnerability?
Waterloo-Wellington was fortunate to host Dr. Naheed Dosani, PEACH Program, and Dr. Nadine Persaud, Kensington Health, at our Fall Palliative Education Evening Conference entitled: “Caring for Structurally Vulnerable Populations: What Equity-Oriented Palliative Care Teaches Us About Radical Love, Loss and Leadership in Healthcare”.
Many individuals and groups experience inequities for varied reasons. The experience of the homeless population demonstrates the serious outcomes of health inequities on the human experience:
- Life expectancy: 34–47 years
- Mortality rate: 2.3–4x higher than general population
- 28x more likely to contract Hepatitis C
- 5x more likely to die from heart disease
- 4x more likely to die from cancer
- Most die without access to care
While many who hear the term “structurally vulnerable” may be quick to think of the homeless or vulnerably-housed population, structural vulnerability speaks beyond just housing to the structural inequities that individuals face and the impact these factors have on one’s health.
Examples of Additional Structural Vulnerabilities
- Poverty
- Social isolation
- Substance use disorders
- Trauma
- Racialized communities
- Mental illness
- New Canadians, immigrants, and refugees
- Non-status populations
We must examine the negative health outcomes resulting not only from the social determinants of health, but from the underlying systems that impose and perpetuate them.
- Risk is built into systems, not just individual choices
- People carry layers of inequity: poverty, racism, trauma, etc.
- Healthcare assumes stability — address, phone, health card, etc.
- When excluded by design, suffering multiplies
- Health is a justice issue: how we let people live and die reflects how we care
Health Equitree1+
The Health Equitree maps our understanding of the relationships among health outcomes and systems. The elements of the tree that are above ground represent the components of health that are visible.
Resource
- Palliative Education and Care for the Homeless (PEACH) Program
- Kensington Health – Radical Love: Redefining Hospice Care
- The Health EquiTREE (2022), illustration by Health Resources in Action for the Massachusetts Community Health and Healthy Aging Funds.
Download Tip of the Month
PDF – What is Structural Vulnerability?
Upcoming Tip
Excerpt from the Sep 16, 2025, Fall Palliative Education Evening Conference with Drs. Naheed Dosani & Nadine Persaud
January 2026
Part 2 – Radical Love in Palliative Care
