Health equity 25

Health equity is when everyone has the opportunity to be as healthy as possible. To achieve health equity, multi-sectoral efforts are needed to address the severe and far-reaching health disparities that plague our nation by expanding access and removing the social and economic obstacles that lead to poor health outcomes.

These barriers include poor housing, as well as lack of access to good jobs, quality education, and comprehensive health care.

Driven by structural racism, discrimination, stigma, and longstanding disenfranchisement, these obstacles overwhelmingly impact communities that are underserved like people with disabilities.

These inequities do not just affect us all. The COVID-19 pandemic is the most recent and glaring example. By diminishing the economic, health, educational, and overall human potential of millions of people in this country, health inequities and disparities weaken our entire society and leave us unprepared for public health threats.

As an agency, CDC is transforming its public health research, surveillance, and implementation science efforts to shift from simply listing the markers of health inequities to identifying and addressing the drivers of these disparities.

How Physicians See Us (Quads especially) And How They Treat Us

There have been countless studies and reports over the past 30 years that well-document the recurring theme—people with disabilities in the US are in significantly poorer health and receive significantly poorer care and treatment than those who are not disabled.

The existence and extent of those health disparities often have nothing to do with disability?per se?and are often preventable. They have everything to do with a broken system that focuses its attention from a political stance causing division, not just amongst minorities but general division in our country.

We as people with disabilities have been left out of the diversity and inclusion push by most major industries, agenda setters and our political advocates. People with disabilities make up the largest most diverse minority in the country and yet we are forgotten, abandoned and taken advantage of.

The COVID-19 pandemic has unmasked the extent to which explicit and implicit bias against people with disabilities affects treatment decisions.

States such as?Alabama,?Arizona,?Kansas,?Pennsylvania,?Tennessee,?Utah, and?Washington?established crisis-of-care standards that would expressly base triage decisions on normative quality-of-life judgments or?exclude from treatment?patients requiring assistance with activities of daily living or those with certain conditions such as severe or profound mental retardation, moderate to severe dementia, and preexisting conditions that are disabilities.

In June 2020, people throughout the country were horrified as they listened to an audio recording between a physician and the spouse of a severely disabled man who, in a hospital in Austin, Texas, was denied treatment for a urinary tract infection, sepsis, pneumonia, and suspected COVID-19.

His physician explicitly stated a preference to treat patients who can walk and talk. All life-sustaining treatment, including artificial nutrition and hydration were withdrawn; six days later Mr. Hickson died.

Alarming to the disability community was the fact that those decisions were made by a person physicians in the normal course of business.

?Medical rationing and crisis standards of care did not factor into those decisions as, at the time, the hospital was not overwhelmed with COVID-19 cases.

Negative attitudes, stereotypes, misconceptions, and outright discrimination by physicians against people with disabilities has been well-documented. In 1994,?a study?of 238 emergency care providers’ attitudes toward patient quality of life after a spinal cord injury (SCI) showed that 28 percent believed that, if they sustained a severe SCI themselves, future quality of life should be a factor in determining what interventions should be provided; 22 percent would want nothing done to ensure their survival; and only 18 percent imagined they would be glad to be alive with a severe SCI, compared with 92 percent of a SCI comparison group.

More than 82 percent of?physicians in this country believe?that people with significant disabilities have worse quality of life than nondisabled people.

As someone who lives with the effects of a spinal cord injury resulting in quadriplegia, I can say that this figure is shocking but not surprising.

For decades, millions of people with significant disabilities and those who love them have fought individual battles with physicians, hospitals, health care systems, and health insurers to receive basic medical services, thorough examinations, life-sustaining treatment, and medical equipment and supplies necessary to live independently.

To people such as me with such experiences, the results—such as the statistic cited above—presented in the February 2021 issue of?Health Affairs?by Lisa Iezzoni, MD, and her colleagues are, indeed, not surprising.

Today, in the United States, if you are a person with a physical, intellectual, or developmental disability,?your life expectancy is less than that of someone without disabilities.

You are at a?higher risk factor?for early onset of cardiovascular disease than those without disabilities. You are more than?twice as likely?to be obese than people without disabilities.

You are more than?three times likely?to have diabetes than those without disabilities.

You are significantly more likely to have?unmet medical, dental, and prescription needs?than those without disabilities. And, if you are a woman with a disability, you are likely to receive poorer maternity care and?less likely?to have received a Pap smear test or a mammogram than those without disabilities.

I have fought this battle for over 40 years and I am not done but I cant do it alone. The proper resources are not out there and giving this ‘’social injustice’’ lip service is not enough. We need your support.

Brian P Swift J.D. Coach, Speaker, Business & Personal Strategist? ?https://www.brianpswift.com?[email protected]???????????????????????????????????????????????????????????????????

Brian Swift Inspired & Unbreakable@brianswift2654?? https://www.youtube.com/@brianswift2654???