Individuals with physical disabilities are less likely to utilise primary preventive healthcare services than the general population. At the same time they are at greater risk for secondary conditions and as likely as the general population to engage in health risk behaviours. This qualitative exploratory study had two principal objectives: (1) to investigate access barriers to obtaining preventive healthcare services for adults with physical disabilities and (2) to identify strategies to increase access to these services. We conducted five focus group interviews with adults (median age: 46) with various physically disabling conditions. Most participants were male Caucasians residing in Virginia, USA. Study participants reported a variety of barriers that prevented them from receiving the primary preventive services commonly recommended by the US Preventive Services Task Force. We used a health services framework to distinguish structural-environmental (to include inaccessible facilities and examination equipment) or process barriers (to include a lack of disability-related provider knowledge, respect, and skilled assistance during office visits). Participants suggested a range of strategies to address these barriers including disability-specific continuing education for providers, the development of accessible prevention-focused information portals for people with physical disabilities, and consumer self-education, and assertiveness in requesting recommended services. Study findings point to the need for a more responsive healthcare system to effectively meet the primary prevention needs of people with physical disabilities. The authors propose the development of a consumer- and provider-focused resource and information kit that reflects the strategies that were suggested by study participants.

This retrospective study used national survey data to examine multiple effects of nine comorbid conditions—breathing problems, depression risk, diabetes, heart problems, hearing impairment, hypertension, joint problems, low back pain, and stroke—on physical functioning, participation, and health status among older adults with visual impairments. Bivariate and multivariate procedures were used to compare older adults who had neither visual impairment nor these conditions with adults of similar age who had one of the nine conditions only, visual impairment only, or both visual impairment and the condition. Findings indicate that older adults with visual impairment frequently experience comorbid conditions, and that these conditions are associated with difficulties in walking and climbing steps, shopping, and socializing, and with significantly more self-reports of declining health. Results suggest that interventions by health care and mental health providers, as well as enhanced rehabilitation services, have the potential to reduce or prevent the deleterious effects of comorbid conditions.

Older visually impaired adults with depressive symptoms are vulnerable to health decline and further disablement without timely interventions that target smoking cessation, healthy eating, and increased physical activity.