WHO Healthy People 2020
- Individuals with disabilities represent 18.7% (about 56.7 million people) of the U.S. population. Disability is part of human existence, occurring at any point in life,with conditions ranging from mild to severe even among those with the same diagnosis.
- A diagnosis of impairment or disabling condition does not define individuals, their talents and abilities, or health behaviors and health status.
- Consistent with the World Health Organization’s (WHO) model of social determinants of health, Healthy People 2020 recognizes that what defines individuals with disabilities, their abilities, and their health outcomes more often depends on their community, including social and environmental circumstances.
- To be healthy, all individuals with or without disabilities must have opportunities to take part in meaningful daily activities that add to their growth, development, fulfillment, and community contribution.
- This principle is central to all objectives outlined in this topic area.
- Meeting the Disability and Health objectives over the decade will require that all public health programs develop and implement ways to include individuals with disabilities in program activities.
- Until recently, people with disabilities have been overlooked in public health surveys, data analyses, and health reports, making it difficult to raise awareness about their health status and existing disparities.
- Emerging data indicate that individuals with disabilities, as a group, experience health disparities in routine public health arenas such as health behaviors, clinical preventive services, and chronic conditions.
- Compared with individuals without disabilities, individuals with disabilities are:
- Less likely to receive recommended preventive health care services, such as routine teeth cleanings and cancer screenings
- At a high risk for poor health outcomes such as obesity, hypertension, falls-related injuries, and mood disorders such as depression
- More likely to engage in unhealthy behaviors that put their health at risk, such as cigarette smoking and inadequate physical activities
- There are many factors that determine or influence one’s health.
- Healthy People 2020 organizes the social determinants of health around5 key domains: (1) Economic Stability, (2) Education, (3) Health and Health Care, (4) Neighborhood and Built Environment, and (5) Social and Community Context.
- Within each of these domains, compared to individuals without disabilities, individuals with disabilities are more likely to experience challenges finding a job, being included in regular educational classrooms or attending college, receiving preventive health care services, being able to visit homes in the neighborhood, using fitness facilities, using health information technology, and obtaining sufficient social-emotional support.
- To address these and other health determinants, the following WHO principles of actionare recommended to achieve health equity among individuals with disabilities.
- Improving the conditions of daily life by:
- Encouraging communities to be accessible so all can live in, move through, and interact with their environment
- Encouraging community living
- Removing barriers in the environment using both physical universal design concepts and operational policy shifts
- Addressing the inequitable distribution of resources among individuals with disabilities and those without disabilities by increasing:
- Appropriate health care for individuals with disabilities
- Education and work opportunities
- Social participation
- Access to needed technologies and assistive supports
- Expanding the knowledge base and raising awareness about determinants of health for individuals with disabilities by increasing:
- The inclusion of individuals with disabilities in public health data collection efforts across the lifespan
- The inclusion of individuals with disabilities in health promotion activities
- The expansion of disability and health training opportunities for public health and health care professionals
- Improving the conditions of daily life by:
Emerging Issues in Disability and Health: The third is the need to improve environmental designs and public infrastructure. Solutions include:
- Ensuring the accessibility of technology, health information technology tools and systems, broadly defined, for people with physical, sensory, and cognitive disabilities. This includes electronic health records and personal health records as well as wearable technologies and home monitoring systems.
- Designing homes and community spaces that are fully accessible to individuals with disabilities.
- Ensuring that professional degree programs offer coursework in disability and health.