July 19, 2012 -- One in five adults lives with a disability – and many more are likely to acquire a disability at some point in their lives either through illness, injury or the aging process, according to numbers released by the Centers for Disease Control and Prevention. People with disabilities are two and a half times more likely than non-disabled peers to report unmet health needs, and more than four times as likely to report fair or poor (as opposed to good) health.
Despite those disparities, traditionally, disability has not been the subject of much discussion in public health circles, said Elena Andresen, PhD, a researcher at Oregon Health & Science University who’s the project officer for a CDC grant project to improve health outcomes for people with disabilities.
“Traditionally, prevention activities in public health have been directed at preventing injury and disability,” Andresen said, with the result that people with disabilities sometimes felt alienated from the system, or like “failures” of prevention efforts.
“It really requires some increased sensitivity and understanding on the part of some public health programs,” Andresen said. “In Oregon, we have a very receptive public health agency environment in which to work.”
Oregon was one of 18 states to receive the grant awards announced earlier this year, but has actually received funding from the CDC for projects on disability and health since 1994, said Conne-Ward Cameron of the CDC's Center on Birth Defects and Disabilities, who echoed Andresen's sentiment that Oregon's work in this area has been particularly strong.
“Under the previous funding arrangement, Oregon did a terrific job in building programs to serve people with disabilities,” said Jamylle A. Gilyard, a public health analyst for the CDC's Disability Policy, interventions and Programs team.
The current three-year grant, which kicked in at the beginning of this month and will end in 2015, requires states to demonstrate that people with disabilities are included in a mainstream public health program, that they receive preventive healthcare screening and are included in state-based emergency planning exercises.
Andresen said the state has already provided training specifically for people with disabilities and the agencies that serve them, but has also started to reach out to first responders and emergency management agencies such as the Red Cross to talk about how to accommodate disability in the event of an emergency.
OHSU is also working on a project to improve access to mammograms for women with disabilities, and is starting that process by reaching out to disabled women seeking mammograms to get their feedback on the process, as well as find out how clinics can make their facilities more accessible.
One of the major emphases of the grant project is on preventing secondary disability, including chronic disease, Andresen said. The state has put more effort into providing healthy lifestyles classes specifically for people with disabilities, as well as teaching people who already provide such training (including physical trainers) on how to accommodate and address disability.
Prevention can mean helping people with physical disabilities – including those that affect mobility – be more physically active to prevent heart disease and hypertension, as well as educating people and care staff about the risks involved with their specific disability. For instance, people with spinal cord injuries are more likely to experience urinary tract infections, skin breakdowns (which can lead to fatal infections) or lung infection.
“Each kind of disability might have a risk,” Andresen said.
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