The challenge of assessing the needs of vulnerable populations in public health: Promoting an approach grounded in proportionate universalism principles

AIM: Health inequities persist as a pressing public health challenge, often rooted in unequal access to resources, opportunities and privileges that disproportionately affect vulnerable populations. Proportionate universalism offers a promising approach by advocating for universal health interventions that adjust in scale and intensity to meet varying levels of needs. Despite its potential, implementing proportionate universalism in health promotion remains challenging, particularly when narrowly assessing vulnerability using socioeconomic indicators alone, which can misclassify or stigmatise vulnerable groups and perpetuate inequities. This commentary reflects on these challenges in the context of developing a smoking prevention intervention for adolescents facing societal vulnerability and proposes more nuanced strategies for assessing needs within a proportionate universalism framework.

CONCLUSIONS: This article highlights the complexity of defining and assessing vulnerability in public health research and practice. By sharing insights from our research process, we advocate for a broader understanding of adolescent vulnerability that moves beyond traditional socioeconomic measures. We hope to inspire more inclusive and equitable health promotion interventions that are responsive to the diverse and intersecting forms of disadvantage individuals may experience.