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Health Promotion Among Adults with Disabilities

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Health Promotion among Adults with Disabilities
Stacy Jinks
Grand Canyon University: NRS-429V0506
October 4, 2015

Health Promotion among Adults with Disabilities The U.S. Census Bureau has found that nearly 1 in 5 individuals in the U.S. live with a disability. That translates into over 54 million people in the United States alone. Disability has often been associated with poor health. Adults with disabilities should have the same opportunity for good health as those living without. People living with disabilities are more likely to smoke, have greater issues with obesity and have more difficulty accessing preventive health services (CDC, 2014). This paper will look at some of the disparities among adults living with disabilities, why this may be occurring and what can be done to help decrease the disparities and increase positive outcomes for this group.
Review of Health Status, Disparities and Barriers to Good Health
Disability has been defined in many different ways and pinpointing one definition that everyone agrees on can be difficult. In the Surgeon General’s Call to Action report (2005) it is generally defined as “a feature of the mind, body or senses that can affect a person’s daily life”. Until very recently people with disabilities have gone mostly unrecognized as a group facing health disparities but when surveys are taken from both groups, adults with disabilities versus those without, the gap between how each group views their personal health status is vast. Those living with disabilities are describing themselves to be in fair or poor health four times (40.3% vs 9.9%) more often than adults without any noted disability (Krahn, Walker & Correa-De-Araujo, 2015). This fact alone shows the need for providing better healthcare to those with disabilities. Education and economic factors also play a factor when it comes to this particular group. People with intellectual and developmental disabilities (I/DD) are still being segregated more often than not in the school environment and the lack of interaction and integration into the “normal” classroom creates dissatisfaction and low graduation rates. Approximately 52% leave high school without receiving a diploma and even fewer individuals with I/DD (8%) have any college experience at all (The Arc, 2011). This creates a situation as this group become adults, where their lack of education makes it very difficult for them to understand where to even locate help if they do not have other family members involved in their care. Lack of employment is another barrier to health and health care. It is not that individuals with disabilities do not want to work or cannot work. Jobs that integrate these individuals into their community are just not available. The Arc (2011) reports that 85% of I/DD adults are not employed and of the 15% that are employed, only 57% report making minimum wage. Without government assistance or family support, this group finds themselves unable to afford much if any type of health care. It is not just the I/DD group affected by these barriers. Physical, mental, sensory disabilities are all included and no matter what group of disabilities an induvial may be categorized into they all face similar barriers and disparities and are more vulnerable to receiving substandard health care. Adults with disabilities are expected to have more difficulties with obesity (36.2% vs 21.5%) and smoke more often (27.8% vs 19.5%) than those without disabilities. For a variety of reasons, including fear and lack of equipment, they also find themselves less physically active (79.2% vs 65.9%) (Lezzoni, 2011). Lizzoni (2011) found that 13% of people with a disability reported not being treated fairly in the office setting and 18% with a severe disability felt similarly. She also documented that 22% of adults with sensory or physical disabilities were unable to access their doctor’s offices. When they could access the office, there was often a lack of specific adaptive equipment to help them within the office setting. Although there are not as many studies and research on actual issues with health care accessibility as there are in other minority groups, the few that are available show disparity.

Approaches to Decrease Health Disparities
The disabled as a minority covers a wide array of individuals and situations. Using any one approach effectively can be difficult as there are so many differences and factors among this group and not enough evidence based research (Must, Curtin, Hubbard, Sikich, Bedford & Bandini, 2014). Many of the interventions being used are those used for all communities and groups, with only a few primary interventions that are focused at the disabled specifically (Must et al., 2014). The approach has to begin at the level of the barriers themselves, which in some instances will help eliminate disparities at the health and health care levels. Begin eliminating barriers using the primary, secondary, tertiary intervention approach. Primary interventions would include integrating the disabled into the regular classroom setting as much as possible and providing the smaller classroom settings for customized education regarding health and health care opportunities related to their individual needs. Secondary interventions such as encouraging employers to hire at least one employee a year with a disability at minimum wage or higher and for communities to provide parks and areas for physical activities that include adaptive equipment for those with a variety of disabilities will decrease economic barriers and increase physical limitation barriers. Tertiary interventions include enforcing the Americans with Disabilities Act and introducing new legislature in Congress to support education, workplace opportunities and affordable health care for those with disabilities (The Arc, 2011).
Conclusion
It has only been very recently that individuals with disabilities have been recognized as a minority group with disparities regarding health and health care in the United States. Due to this lack of recognition much more research and in depth study needs to be completed to get a real idea on how to move forward to reduce these disparities. As this group becomes more recognized and supported these disparities will decrease and more people with disabilities will have access to education, economic opportunities and health care to increase positive outcomes and decrease the noted disparities.

References
Centers for Disease Control and Prevention [CDC] (2014). Disability and health data system basic information. Retrieved from http://www.cdc.gov/ncbddd/disabilityandhealth/dhds-basic-info.html.
Krahn, G.,Walker, D., & Correa-De-Araujo, R., (2015). Persons with Disabilities as an Unrecognized Health Disparity Population. American Journal of Public Health: 105(S2), pp 198-206. Retrieved from http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2014.302182.
Lezzoni, L. (2011). Eliminating health and health care disparities among the growing population of people with disabilities. Health Affairs. 30(10). 1947-1954. Retrieved from http://content.healthaffairs.org/content/30/10/1947.long.
Must, A., Curtin C., Hubbard, K., Sikich, L., Bedford, J., Bandini, L. (2014). Obesity prevention in children with developmental disabilities. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267572/.
The Arc (2011). Still in the shadows with their futures uncertain; a report on family and individual needs for disability supports (FINDS). Retrieved from http://www.thearc.org/document.doc?id=3672.
Surgeon General (2005). The 2005 surgeon general’s call to action to improve the health and wellness of persons with disabilities. Retrieved from http://www.cdc.gov/ncbddd/disabilityandhealth/pdf/whatitmeanstoyou508.pdf.

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