Health Disparities of People with Disabilities. Introduction
Health status is critically important to experiencing quality of life, self-sufficiency, and full participation in society. For the 54 million Americans with disabilities, maintaining health and wellness is especially important to reduce the impact of impairment on functioning in these critical life areas. Yet, people with disabilities may be the largest underserved subpopulation demonstrating health status disparities that stem from preventable secondary conditions. Healthy People 2010, the nation’s blueprint for improved health, addresses this problem in its objectives. In 2002 and 2005, the U.S. Surgeon General asked for public health efforts to improve the health and wellness of persons with disabilities. This article examines the concepts of health and wellness, summarizes currently available information documenting disparities in health for people with disabilities, and provides a framework for policy recommendations to reduce health disparities among people with disabilities.
For the approximately 54 million Americans with disabilities (McNeil, 2001), maintaining health, wellness, and minimizing secondary conditions are important in reducing the impact of impairment on functioning and participation. Yet, people with disabilities may be the largest underserved population that demonstrates evidence of health disparities. The concept of having a disability and being healthy is relatively new (Krahn, 2003).
Until recently, disability was presumed equivalent to illness, and it elicited all the associations of dependence, lack of productivity, and physical and sexual inactivity that are incumbent to the notion of illness (DeJong, 1994; Nosek, 1996). As demonstrated in several Surgeon General reports — Closing the Gap: A National Blueprint for Improving the Health of Individuals with Mental Retardation (USDHHS, 2002) and The Surgeon General’s Call to Action To Improve the Health and Wellness of Persons with Disabilities (USDHHS, 2005) — and Healthy People 2010 (USDHHS, 2001), there is an increasing public health commitment to addressing the health and wellness of persons with disabilities.
The goal of this article is to provide an overview of health disparities experienced by people with disabilities. The article describes:
Defining Health and Wellness
“Health and wellness” involve physical, emotional, social, spiritual, and other factors that enable individuals to maximize their potential and fully participate in their community. For persons with disabilities, as with the rest of the population, health status is a dynamic process that changes over time. Rather than thinking of “health” and “illness” as opposite and binary categories, it is useful to consider a continuum of health and illness along which individuals move, enjoying relatively better health at some times in their lives than others. A person’s
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unique circumstances and a wide variety of contributors define his or her “optimal health” (Kailes, 2004).