Poor health among marginalized population often results from indirect or direct pathways. Direct pathways are those that directly affect an individuals or family whereas indirect pathways are those whose outcomes are not obtained immediately. For instance, increased drug abuse and unprotected sexual activities exposes the user to great risk such as sexually transmitted infections, HIV/AIDS, and unwanted pregnancies. Most of the drugs abused by individuals are often administered through injection, and as such, the same needle is used by various people. In the event a single individual is suffering from HIV/AIDS. He or she gets to transmit the disease to other individuals through blood. Similarly, High levels of unprotected sex among the LGBT community exposes one to unwanted pregnancies and sexually transmitted infections that may lead to death. In most cases, these individuals fear seeking treatment due to ridicule and abuse by the public and some healthcare practitioners.
On the other hand, indirect cause of poor health is obtained when one partner in a relationship is unfaithful exposing the couple and family as a whole to a broad range of diseases. Besides the risk of infection of sexually transmitted infections, the victim is susceptible to high levels of stress and depression. In most cases, they are often in shock as to how they contracted such ailments. They also tend to avoid seeking medical care institutions together or receive counselling services since the society does not recognize and support same-sex couples. Eventually, the couples suffers from this ailments as they cannot seek treatment. Other poor health outcomes include depression and stress. In this regard, it is evident that indirect and direct pathways contribute to poor health outcomes in a marginalized population.