Have Almost Fifty Years Of Disability Civil Rights Laws Achieved Equitable Care?

Advancing healthcare equity through dissemination and implementation science

“…Additionally, low levels of knowledge about health inequities and limited beliefs about their existence 217,218 can affect provider care 123 and policies that foster equitable solutions 214 . Dissemination research can advance understanding of how to reach and promote best practices that increase uptake of evidence‐based information by practitioners and policy makers and inform policy actions (e.g., payment reforms that will improve healthcare value and equity) 128,131,216,219,220 . Table 2 provides additional examples of actions that can be taken to foster healthcare policy making.…”

COVID-19 Reveals Longstanding Health Inequities and Discrimination Against Americans With Disabilities

“…19 In part because of visible COVID-related health disparities experienced by people with disabilities, attention is now being paid to policy actions to remedy health inequities for individuals with disabilities. [3][4][5][6]10 These recommendations include increased public funding for health and social services for individuals with disabilities, increased representation of people with disabilities in population epidemiology and federal data collection efforts, designated public health research funding at the National Institutes of Health (NIH) for improving the health and wellbeing of individuals with disabilities, including the designation of such individuals as a health disparity group, increased training of medical, public health, and social services professionals to deliver culturally competent and respectful care to individuals with disabilities, and inclusion of people with disabilities at the table with policymakers, regulators, governments, and health systems when decisions are made.…”

“…Xie and colleagues findings of large disparities in delayed and forgone care experienced by individuals with disabilities in the United States during the first year of the pandemic have been replicated elsewhere 9. Such inequities in access to needed medical care and in population health outcomes revealed by COVID-19 reflect disparities in health and health care that have persisted for decades 10. Prior to the pandemic, Medicare beneficiaries with disabilities were 33% and 49% more likely to lack needed primary and specialty care, respectively, than those without disabilities; beneficiaries with disabilities were thus more likely to experience preventable complications of chronic and acute conditions that resulted in greater emergency department use and hospital admission 8…”

“…9 Such inequities in access to needed medical care and in population health outcomes revealed by COVID-19 reflect disparities in health and health care that have persisted for decades. 10 Prior to the pandemic, Medicare beneficiaries with disabilities were 33% and 49% more likely to lack needed primary and specialty care, respectively, than those without disabilities; beneficiaries with disabilities were thus more likely to experience preventable complications of chronic and acute conditions that resulted in greater emergency department use and hospital admission. 8 Such findings are partly explained by the fact that many US physician practices are not compliant with the ADA, and many health care personnel have little-to-no knowledge of their legal obligations to make reasonable accommodations for persons with disabilities.…”

“…6 Much more commonly, the disadvantaged position of people with disabilities today is reflected in results reported by Xie and colleagues, demonstrating that people with disabilities are more likely than others to go without needed routine, preventative, and other outpatient medical care, and are thus more likely to experience worse health outcomes. 3,[6][7][8][9][10] In addition to the factors noted above, mundane organizational incentives, resource-time and appointment-time constraints also hinder health care providers' willingness and ability to treat patients with disabilities. For instance, it is well-documented that people with disabilities face frequent barriers in accessing obstetric, gynecological, reproductive, and child and family health services.…”