“They Didn’t Ask.” Rural Women With Disabilities and Experiences of Violence Describe Interactions With the Healthcare System

Abstract

Women with disabilities are at risk of experiencing multiple forms of severe and prolonged violence, yet guidelines for screening this population are unclear, screening rates are historically low, and screening tools may be inadequate to capture disability-related aspects of abuse. We conducted qualitative in-depth interviews with 33 rural women in the United States with diverse disabilities and experiences of violence. They described overarching healthcare provider and system factors that influenced their trust and confidence in healthcare delivery as an avenue to support their safety. Women described interactions with the healthcare system during their experience of violence as a missed opportunity for identifying and responding to their abuse and connecting them with resources. We conclude with policy and practice recommendations based on women with disabilities’ perspectives and insights.

Reproductive Coercion Among Women With Disabilities

“…Our results show that nurses must be aware of the unique risks that place women with disabilities at a heightened risk for all forms of abuse. Patients with disabilities have heightened, although warranted, concerns for privacy and confidentiality (Aguillard et al, 2022). For women with physical or sensory disabilities, forensic nurses should ensure they understand and have access to resources and tools that ensure privacy and comfort, such as physical space that is accessible.…”

Violence in rural areas against disabled people from the perspective of their families

“…However, in this case, the professional was the aggressor. This type of violence causes damage to individual and collective health ( 35 ) , and can worsen in the DP population, as many cases are not recognized as abuse, since this information comes from a marginalized group, often remaining invisibility ( 36 ) .…”

“…Another study indicated that the architectural design of health services was an important barrier to access and accessibility, especially for those with physical disabilities ( 13 ) . Furthermore, investigations revealed that there are few health services located in rural areas to meet the health care demand of DP residing in these areas, and the few that are accessible have poorly trained professionals ( 31 , 36 ) .…”

Inequitable care delivery toward COVID-19 positive people of color and people with disabilities

“…Studies examining provider bias concerning people with disabilities have found provider misconceptions regarding supports needed to access care or fill out forms; reports of providers ignoring or minimizing patient concerns; as well as assumptions that certain services were unnecessary, such as an accessible parking pass [11][12][13]. One study found discriminatory practice against people with disabilities such that more than half of physicians reported not being likely to welcome people with disabilities into their practice [11].…”