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Open Access Highly Accessed Research article

Mapping the concept of vulnerability related to health care disparities: a scoping review

Cristina Grabovschi1*, Christine Loignon1 and Martin Fortin2

Author Affiliations

1 Centre de Recherche Hôpital Charles LeMoyne, Unité de Médecine de Famille HCLM, 150 Place Charles Lemoyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada

2 Unité de Médecine de Famille, 305 St-Vallier, Chicoutimi, QC, G7H 5H6, Canada

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BMC Health Services Research 2013, 13:94  doi:10.1186/1472-6963-13-94

Published: 12 March 2013



The aim of this paper is to share the results of a scoping review that examined the relationship between health care disparities and the multiplicity of vulnerability factors that are often clustered together.


The conceptual framework used was an innovative dynamic model that we developed to analyze the co-existence of multiple vulnerability factors (multi-vulnerability) related to the phenomenon of the ‘Inverse Care Law’. A total of 759 candidate references were identified through a literature search, of which 23 publications were deemed relevant to our scoping review.


The review confirmed our hypothesis of a direct correlation between co-existing vulnerability factors and health care disparities. Several gaps in the literature were identified, such as a lack of research on vulnerable populations’ perception of their own vulnerability and on multimorbidity and immigrant status as aspects of vulnerability.


Future research addressing the revealed gaps would help foster primary care interventions that are responsive to the needs of vulnerable people and, eventually, contribute to the reduction of health care disparities in society.

Vulnerability; Health care disparities; Inverse care law; Scoping review