Welcome to part 2 of a new series from the American Association on Health and Disability (AAHD). The mission of AAHD is to advance health promotion and wellness interventions for children and adults with disabilities. AAHD accomplishes its mission through advocacy, education, public awareness and research efforts at the federal, state and community levels. AAHD staff has written a 4-part series of articles on "Health Promotion and Wellness" for EP readers. We hope you enjoy these articles and consider joining AAHD to receive the Disability and Health Journal and have access to current research, policy and programmatic information on disability and health via AAHD updates. Visit www.aahd.us to learn more about AAHD and membership.
According to the U.S. Census Bureau, more than 54 million people--one in five Americans--have a disability, (1) and these Americans are more likely to report:
* Being in poorer overall health (2)
* Having less access to effective health care (3)
* Engaging in risky health behaviors, such as smoking and physical inactivity (4, 5)
According to the Institute of Medicine (IOM) report, "If we consider people who now have disabilities, people who are likely to develop disabilities, and people who are or will be affected by the disabilities of family members and others close to them, then disability will affect the lives of most Americans." (6)
While health promotion interventions commonly target those health risks for everyone, people with disabilities are often left out of healthy people/community health initiatives. Barriers to participation include inadequate public transportation, inaccessible health care facilities or health screening equipment, discriminatory attitudes, poverty, and lack of knowledge. Health promotion programs for people with disabilities need to be designed to eliminate or at least minimize the barriers keeping them out.
BETTER HEALTH PROMOTION PROGRAMS
While people with disabilities are more vulnerable to the development of secondary conditions such as obesity, pain, social isolation and depression, too often they are underserved by health promotion and physical activity programs. (7) "The poorer health status of persons with disabilities has moved form being largely invisible to being recognized as an intolerable state that requires action." (8)
In addition to being educational and accessible, health promotion materials and programs for people with disabilities need to provide supports to help participants overcome barriers to healthier living. Specific disabilities that require different program or material design include visual, hearing, mobility, cognitive and emotional impairments, as well as learning disabilities. To help people with disabilities learn and practice key health-promoting behaviors, programs must be offered in a supportive environment. So health professionals need to be aware of existing barriers and work to remove them and/or help people work around them.
Effective programs should collect data on the prevalence of disabilities and secondary conditions, and the health status of people with disabilities. Health providers and public health professionals may need training on the care and health promotion of people with disabilities.
Local disaster preparedness and emergency response programs must address disability issues.
The U.S. Surgeon General's 2005 Call to Action, To Improve the Health and Wellness of Persons with Disabilities, states that "persons with disabilities can promote their own good health by developing and maintaining health lifestyles. People with disabilities need healthcare and healthy programs the same reasons anyone else does--to stay well, active and a part of the community.. (9)
According to the World Health Organization (WHO), "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. …