Public health nurses are an elite group of individuals whose purpose is to integrate themselves into their communities and act as resources and educators specifically for vulnerable and marginalized populations. Their role is all-encompassing, which also includes new Mainers and asylum seekers. These nurses bear witness to the impact of the opioid crisis and gun violence on families and their communities. These individuals fall into a category known as vulnerable populations and this is because these communities are more susceptible to violence and abuse due to low socioeconomic status. Community health nurses watch as families are torn apart and kids orphaned as parents find themselves bound to their chemical addiction. These nurses are also responders of the climate crisis. As temperatures rise, individuals find themselves struggling to not only stay cool but to also afford it. Nurses are privy to these issues because more people are seeking treatment for heat stroke, sun burns, and dehydration. 

The social determinates of health are economic and social conditions that influence the health status of individuals. From high-income to low-income communites, there is a clear disparity in health due to the ability to not only access care but to also afford it. This disparity is predominant in low-income communities comprised primarily of African Americans and is influenced by a history of racism and continues to be an issue as our past has led to a mistrust of future care. Culturally, some medical conditions are not seen as a condition at all, they are simply a spiritual connection (Hmong). Often times western medicine is regarded as the standard of care, and from this arises the issue of when medical intervention is warranted. This is because of the varying expectations of individuals of different nationalities, cultures, and religions as western medicine may not be their idea of medicine. 

Strategies for improving the health of vulnerable and marginalized populations would be adequate access to healthcare, affordable healthcare, and education. Individuals should be aware that emergency rooms cannot be utilized for check-ups and to combat this, clinics need to be made available in these areas. However, this isn’t so easy as clinics require manpower and currently there is a lack of healthcare workers. There is where education can play a powerful role in preventing recurrent healthcare visits. If these individuals can be made aware of the lifestyles that put them at risk for health conditions, they could make the changes to live a healthier life (i.e. no smoking, minimal alcohol, exercise). 

To manage the care of an individual who lives and/or has different beliefs than I do requires that I hold myself accountable and refrain from judgment. It requires that I am well-rounded and well-informed of the communities around me and that I have effective communication skills.