Bridging the Gap: Addressing Unmet Healthcare Needs of Individuals with Disabilities
By: David Ellsworth, OSU Nisonger Center
If you think about what it might be like to have a disability, what comes to mind? Often, the term “disability” brings up thoughts about limitations, impairments, health conditions or certain diagnoses. Public health officials and medical professionals tend to think of disability as something to avoid, treat, or to help cure. However, when we shift our thinking to include people with disabilities as a demographic, something that is not rare or tragic, but instead is a natural part of the human experience that contributes to diversity, our ability to serve this population expands significantly.
People with disabilities benefit from the same public health resources, clinical services, and opportunities for community engagement as people without disabilities. Over 1 in 4 people in the state of Ohio report having a disability, a significant and often-overlooked population. In fact, people with disabilities are the largest minority demographic in the United States. If our clinical services and health programs aren’t accessible to people with disabilities, then we are missing a quarter of our population. The best way to ensure that services are accessible to people with disabilities is to ensure that they are represented in our work and fill meaningful roles when decisions are made that impact them.
In the US, people with disabilities tend to experience worse health outcomes than people without disabilities. For example, people with disabilities experience higher rates of chronic conditions like cancer, asthma, diabetes, and obesity, and are less likely to receive routine screenings. There are a variety of factors that contribute to the health disparities experienced by people with disabilities, including gaps in health policy, a lack of healthcare professional training and practice, and physical, structural, attitudinal, and communication barriers.
There are several programs and state resources that focus on creating opportunities to improve health outcomes for people with disabilities. The Ohio Disability and Health Partnership (ODHP) is a partnership between the Ohio State University Nisonger Center, the Ohio Department of Health, the University of Cincinnati UCEDD, and the Ohio Colleges of Medicine Government Resources Center. ODHP is a CDC-funded project that broadly aims to improve the health and well-being of Ohioans with disabilities. ODHP works towards this goal through building partnerships with people with disabilities, conducting needs assessments to identify opportunities to improve health, implementing inclusive health promotion, and identifying policy, systems, and environmental change strategies to create opportunities for better health outcomes.
In an effort to better understand the barriers and the health needs of Ohioans with disabilities, ODHP conducted a needs assessment of Ohio adults with disabilities in 2022. The full report can be accessed here. Our team analyzed existing public health survey data, hosted listening sessions with disabled Ohioans, and spoke with key informants. The results of the needs assessment suggest mental health is the biggest unmet healthcare need for Ohio adults with disabilities. Adults with disabilities have worse mental health, physical health, and chronic condition outcomes compared to adults without disabilities which suggests a need for more mental health services that are accessible to people with disabilities.
Ohio adults with disabilities also report being treated unfairly by healthcare providers because of disability bias. The most common barriers to healthcare for people with disabilities include:
A lack of healthcare provider understanding about disability, being denied accommodations
Physical inaccessibility of buildings and places
Inaccessibility of equipment like exam tables
Inadequate insurance coverage
A lack of accessible transportation options
Ohio adults with disabilities and the statewide advisory group of people with disabilities, family members, support staff, and other disability experts said that healthcare professionals need better training on caring for people with disabilities. This includes knowledge about disability and skills for interacting with patients with disabilities. We designed several training sessions for medical professionals to help provide opportunities for education on this topic, all of which can be found on our website.
Part of ODHP’s work is to directly work with adults with disabilities to discuss their healthcare needs and refer them to appropriate services that meet their needs. We call this the Linkage Project.
The purpose of the Linkage Project is to connect people with Intellectual/Developmental Disabilities (IDD) to health resources in their community based on their individual needs and personal goals. The Linkage Project has three goals for serving enrolled participants.
Goal 1) Increased knowledge and awareness of the importance of recommended health check-ups. Examples include primary care, mental health screenings, dental, vision, and hearing healthcare, vaccinations, and healthy lifestyle behaviors.
Goal 2) Increased knowledge of barriers to recommended health check-ups and how to overcome barriers.
Goal 3) Increased health linkages amongst enrolled participants with unmet health care needs, to accessible recommended health care and preventative care resources. Special emphasis on linkages to mental healthcare services among enrolled participants who are at elevated risk for mental health conditions.
In order to be part of this program, participants must:
Have a disability (including intellectual disabilities, developmental disabilities, learning disabilities, etc)
Be 18+ years old
Live in Central Ohio (Counties: Franklin, Delaware, Fairfield,
Pickaway, Madison, Licking, Union)
Clients can be referred to our program by following the steps below. This program is free to clients.
How it works:
Clients will meet with our Linkage Coordinator in person, virtually or over the phone. Our Linkage Coordinator serves as a health coach and will discuss the client’s health, health education, and health goals.
Our Linkage Coordinator will help connect the client to resources that meet their health needs.
They will check in with the client to make sure their needs are met and to address any other health concerns.
Addressing the needs of people with disabilities is an essential part of striving toward achieving equity in our health system. Charlie Swinbourne, is a Deaf scriptwriter, director and journalist. He summarizes it best by saying,
“It’s not that disabled people don’t have to battle with all kinds of barriers in life – of course we do. It’s the fact that society seems to forget that it’s often the world around us – physical barriers, communication issues, or attitudes – that are far more “disabling” than the disability itself. Non-disabled people may feel inspired by the idea of us “overcoming” or “beating” our disability, but we wouldn’t have much to overcome if society treated us more equally.”
We must all play a role to move toward, equity, accessibility, and inclusion to achieve this.