About one in four adults in the United States, or 61 million people, lives with a disability that impacts their everyday life. Yet despite the passage of the Americans with Disabilities Act (ADA) in 1990, at times people with disabilities still experience barriers to good health and financial security. Efforts to advance health equity must include people with disabilities, for whom simply seeing a doctor or getting a health exam can be a challenge.
The CDC defines a disability as “any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).”
People with disabilities experience a range of inequities. Studies show that they are twice as likely to live in poverty compared to individuals without disabilities. This partly stems from barriers they experience in accessing education, employment, transportation, and housing. People with disabilities graduate from high school at rates that are 20 percentage points lower than people without disabilities, and only 32% of working-aged people with disabilities have jobs, compared to 73% of those without disabilities. People living in poverty also tend to experience healthcare challenges — and transportation barriers — and therefore may sacrifice seeing a doctor when they are ill.
These statistics are further explained by emerging data that shows that people with disabilities have:
- Greater challenges receiving recommended preventive healthcare services like cancer screenings
- Higher risks for health conditions such as obesity, high blood pressure (hypertension), and mood disorders
- Higher susceptibility to unhealthy behaviors such as cigarette smoking
In addition, people with disabilities also tend to have secondary conditions that affect their overall health, including bowel or bladder issues, chronic fatigue, gastroesophageal reflux disease (GERD), pressure sores or ulcers, injuries, depression, and more.
Barriers to Healthcare
People with disabilities confront many barriers to healthcare; they are four times more likely to report their health as fair or poor compared to people without disabilities (40% v. 10%). A significant part of the problem is lack of access: According to the CDC, one in three people ages 18 to 44 with disabilities did not have a usual healthcare provider and also had a healthcare need that went unmet in the last year due to cost. But expense isn’t the only obstacle getting in the way. People with disabilities also encounter attitudinal, behavioral, and physical barriers.
Per the World Health Organization, the rights and needs of people with disabilities are not always well understood. Examples of accommodations include allowing longer and more flexible appointment times or having accessible exam tables for patients to access. Other physical barriers include clinics located in areas that are not located on accessible public transport routes, poorly lit facilities with no clear signage, and steps without a ramp or elevator. Lack of attention to these accommodations can result in disability discrimination in healthcare, even though it’s not intentional.
Communication can also be a barrier to health services. Consider someone with a hearing disability who cannot communicate effectively with the physician during the appointment, or a person with a visual disability receiving a prescription that’s not provided in an accessible format like Braille or larger print. And for people with intellectual or developmental disabilities, providing additional support, such as plain language or easy read, to help ensure that they get the care and services that they need.
Striving for Change
Attitudes are evolving, and barriers are slowly coming down. Health equity has been identified as a goal across much of the healthcare community — for care providers, medical schools, payers, the government, and beyond. A first step is understanding the unique barriers that people with disabilities experience and why; that means ensuring they are represented in planning, discussion, health surveys and medical research.
No two people are the same, but health companies can take steps — in tandem with community partners — to work toward equity so that that people with disabilities can achieve their health and well-being goals.