[insightsa] Re: Disability and health: Can you relate to this? | Beyond Disability

From: "William McKennariey" <billmcken@xxxxxxxxxxx>
To: <insightsa@xxxxxxxxxxxxx>
Date: Mon, 26 Oct 2015 15:22:20 +1100

Hello Elina

Yes I can relate to this

I can also relate to some of the barriers that face people with disability

When they try to access health services, this is more the case for Blind people
over the age of 65 years of age
Regards
Bill Mc Kennariey

From: Elina Dalziel
Sent: Thursday, October 22, 2015 8:07 AM
To: insightsa@xxxxxxxxxxxxx
Subject: [insightsa] Disability and health: Can you relate to this? | Beyond
Disability

http://beyondisability.org/archives/3620

Disability and health: Can you relate to this?

Key facts

- Over a billion people, about 15% of the world's population, have some form of
disability.
- Between 110 million and 190 million adults have significant difficulties in
functioning.
- Rates of disability are increasing due to population ageing and increases in
chronic health conditions, among other causes.
- People with disabilities have less access to health care services and
therefore experience unmet health care needs.

Disability and health

The International Classification of Functioning, Disability and Health (ICF)
defines disability as an umbrella term for impairments, activity limitations
and participation restrictions. Disability is the interaction between
individuals with a health condition (e.g. cerebral palsy, Down syndrome and
depression) and personal and environmental factors (e.g. negative attitudes,
inaccessible transportation and public buildings, and limited social supports).

Over a billion people are estimated to live with some form of disability.
This corresponds to about 15% of the world’s population. Between 110 million
(2.2%) and 190 million (3.8%) people 15 years and older have significant
difficulties in functioning. Furthermore, the rates of disability are
increasing in part due to ageing populations and an increase in chronic health
conditions.

Disability is extremely diverse. While some health conditions associated with
disability result in poor health and extensive health care needs, others do
not. However all people with disabilities have the same general health care
needs as everyone else, and therefore need access to mainstream health care
services. Article 25 of the UN Convention on the Rights of Persons with
Disabilities (CRPD) reinforces the right of persons with disabilities to attain
the highest standard of health care, without discrimination.
Unmet needs for health care

People with disabilities report seeking more health care than people without
disabilities and have greater unmet needs. For example, a recent survey of
people with serious mental disorders, showed that between 35% and 50% of people
in developed countries, and between 76% and 85% in developing countries,
received no treatment in the year prior to the study.

Health promotion and prevention activities seldom target people with
disabilities. For example women with disabilities receive less screening for
breast and cervical cancer than women without disabilities. People with
intellectual impairments and diabetes are less likely to have their weight
checked. Adolescents and adults with disabilities are more likely to be
excluded from sex education programmes.
How are the lives of people with disabilities affected?

People with disabilities are particularly vulnerable to deficiencies in
health care services. Depending on the group and setting, persons with
disabilities may experience greater vulnerability to secondary conditions,
co-morbid conditions, age-related conditions, engaging in health risk
behaviours and higher rates of premature death.
Secondary conditions

Secondary conditions occur in addition to (and are related to) a primary
health condition, and are both predictable and therefore preventable. Examples
include pressure ulcers, urinary tract infections, osteoporosis and pain.
Co-morbid conditions

Co-morbid conditions occur in addition to (and are unrelated to) a primary
health condition associated with disability. For example the prevalence of
diabetes in people with schizophrenia is around 15% compared to a rate of 2-3%
for the general population.
Age-related conditions

The ageing process for some groups of people with disabilities begins earlier
than usual. For example some people with developmental disabilities show signs
of premature ageing in their 40s and 50s.
Engaging in health risk behaviours

Some studies have indicated that people with disabilities have higher rates
of risky behaviours such as smoking, poor diet and physical inactivity.
Higher rates of premature death

Mortality rates for people with disabilities vary depending on the health
condition. However an investigation in the United Kingdom found that people
with mental health disorders and intellectual impairments had a lower life
expectancy.
Barriers to health care

People with disabilities encounter a range of barriers when they attempt to
access health care including the following.
Prohibitive costs

Affordability of health services and transportation are two main reasons why
people with disabilities do not receive needed health care in low-income
countries – 32-33% of non-disabled people are unable to afford health care
compared to 51-53% of people with disabilities.
Limited availability of services

The lack of appropriate services for people with disabilities is a
significant barrier to health care. For example, research in Uttar Pradesh and
Tamil Nadu states of India found that after the cost, the lack of services in
the area was the second most significant barrier to using health facilities.
Physical barriers

Uneven access to buildings (hospitals, health centres), inaccessible medical
equipment, poor signage, narrow doorways, internal steps, inadequate bathroom
facilities, and inaccessible parking areas create barriers to health care
facilities. For example, women with mobility difficulties are often unable to
access breast and cervical cancer screening because examination tables are not
height-adjustable and mammography equipment only accommodates women who are
able to stand.
Inadequate skills and knowledge of health workers

People with disabilities were more than twice as likely to report finding
health care provider skills inadequate to meet their needs, four times more
likely to report being treated badly and nearly three times more likely to
report being denied care.
Addressing barriers to health care

Governments can improve health outcomes for people with disabilities by
improving access to quality, affordable health care services, which make the
best use of available resources. As several factors interact to inhibit access
to health care, reforms in all the interacting components of the health care
system are required.
Policy and legislation

Financing

Where private health insurance dominates health care financing, ensure that
people with disabilities are covered and consider measures to make the premiums
affordable. Ensure that people with disabilities benefit equally from public
health care programmes. Use financial incentives to encourage health-care
providers to make services accessible and provide comprehensive assessments,
treatment, and follow-ups. Consider options for reducing or removing
out-of-pocket payments for people with disabilities who do not have other means
of financing health care services.
Service delivery

Provide a broad range of modifications and adjustments (reasonable
accommodation) to facilitate access to health care services. For example
changing the physical layout of clinics to provide access for people with
mobility difficulties or communicating health information in accessible formats
such as Braille. Empower people with disabilities to maximize their health by
providing information, training, and peer support. Promote community-based
rehabilitation (CBR) to facilitate access for disabled people to existing
services. Identify groups that require alternative service delivery models, for
example, targeted services or care coordination to improve access to health
care.
Human resources

Integrate disability education into undergraduate and continuing education
for all health-care professionals. Train community workers so that they can
play a role in preventive health care services. Provide evidence-based
guidelines for assessment and treatment.
Data and research

Include people with disabilities in health care surveillance. Conduct more
research on the needs, barriers, and health outcomes for people with
disabilities.

Courtesy of WHO

References:
- [insightsa] Disability and health: Can you relate to this? | Beyond Disability
  - From: Elina Dalziel

[insightsa] Re: Disability and health: Can you relate to this? | Beyond Disability

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