Written by Amy Early //
What people groups come to mind when I say the following words:
Health disparity?
Implicit bias?
Discrimination?
If you’re like many, your thoughts probably first turned to racial and ethnic minorities. After that, you might have considered gender, age, maybe even sexual orientation. All of these are incredibly important and valid responses, but somehow, in the fight to end health disparities for all of these groups, we lose a fourth disadvantaged group in the chaos: people with disabilities. In America, this is our forgotten minority group. These are people we send away to institutions, people we deny employment to because we define them by their disabilities rather than their abilities. These are people we pray our children do not become, people we don’t know how to serve when they come into our hospitals and clinics because they are “too complicated.” These are people.
In the profession of occupational therapy, we work extensively with these people. We believe that anyone can live a full and meaningful life, regardless of his or her physical, cognitive, and social abilities. Unfortunately, individuals with disabilities face numerous barriers to health and community living. Just as racial and ethnic minorities face disparities in healthcare and access to services, so too do people with disabilities. The literature shows this population has extremely low rates of receiving preventative care, such as screenings for breast cancer, potentially due to a lack of accessible transportation to medical facilities, or to negative past experiences with healthcare professionals. Furthermore, people with disabilities are at a significantly greater risk for overweight and obesity, as well as many mental health concerns due to social isolation, lack of community programs, and limited exercise facilities that are both accessible and trained in how to accommodate these individuals’ diverse needs.
Many of these factors are further compounded for individuals at the intersection of race and disability. For example, Latinos with disabilities face a double layer of potential discrimination due to their disability status combined with their ethnicity. Additionally, this group may struggle to find healthcare professionals they feel comfortable with because of linguistic and cultural differences, particularly if Spanish is their preferred language.
For the past year and a half, I have had the opportunity to help ameliorate this lack of services as a graduate research assistant for one of the professors in my program. We run an intervention program on Saturday mornings for Latino youth and young adults with disabilities and their families. This program promotes healthy lifestyles for this group of people by incorporating physical activity, interactive lessons on nutrition, and culturally and linguistically tailored programming. All of the sessions are run bilingually, in both English and Spanish, and conversations center around the nutritional value of common foods in their diet and ways to cut down on the consumption of less healthy foods.
Since the start of the program, we have seen many of our participants make incredible lifestyle changes. For example, at the start of the program, a father of two teenage boys with Autism Spectrum Disorder (ASD) was drinking multiple cans of soda each day, but now he has eliminated sugary drinks from his diet entirely, and consequently he and his sons have lost a significant amount of weight. Another one of the mothers told me last week that since joining the program, she and her son with ASD have walked to and from school everyday for exercise. The other day, it was colder outside and she suggested to him they drive to school instead, but he insisted on walking because he enjoys this time spent exercising in the community.
In my experience, these small victories are what create justice in the field of healthcare. There is very little I can do to change the fact that Illinois continues to cut funding for those without healthcare. But, day-by-day I can help the participants in our program who do not have access to other services due to legal status, cost, lack of trained personnel, etc. lead healthier lives. Our intervention may not change the world, but if it improves the health of one family at a time, that’s all I can ask for.
References
The following is a list of references discussing the health disparities facing individuals with disabilities.
Ben-Moshe, L., & Magaña, S. (2014). An introduction to race, gender, and disability: Intersectionality, disability studies, and families of color. Women, Gender, and Families of Color, 2(2), 105-114. Retrieved from http://www.jstor.org/stable/10.5406/womgenfamcol.2.2.0105
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as unrecognized health disparity population. American Journal of Public Health, e1-e9. doi: 10.2105/AJPH.2014.302182
Mirza, M., Luna, R., Mathews, B., Hasnain, R., Hebert, E., Niebauer, A., & Mishra, U. D. (2014). Barriers to healthcare access among refugees with disabilities and chronic health conditions resettled in the US Midwest. Journal of Immigrant and Minority Health, 16, 733-742. doi: 10.1007/s10903-013-9906-5
Reichard, A., Stolzle, H., & Fox, M. H. (2011). Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disability and Health Journal, 4, 59-67. doi:10.1016/j.dhjo.2010.05.003
This is the first article published detailing our intervention program and its effects. Other more updated articles are currently in press.
Suarez-Balcazar, Y., Hoisington, M., Orozco, A. A., Arias, D., Garcia, C., Smith, K., & Bonner. (2016). Benefits of a culturally tailored health promotion program for Latino youth with disabilities and their faimlies. American Journal of Occupational Therapy, 70, 7005180080. http://dx.doi.org/10.5014/ajot.2016.021949
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Amy Early is in her second year of occupational therapy school in Chicago. Following graduation, she hopes to work with underserved geriatric populations, particularly individuals with dementia. When she isn’t studying or working (or sleeping), Amy enjoys cooking, painting, and visiting new restaurants in Chicago. She also enjoys running, but is taking a brief hiatus from this activity to recover after running her first half marathon at the end of September. As a reward for her efforts, she is attempting to eat as much ice cream as possible this month. If you are looking for a good book to read, she strongly recommends Blue Like Jazz, by Donald Miller, or anything by Khaled Hosseini (both entirely unrelated to healthcare).
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