_________________________________________________________ Cultural Humility in Behavioral Health
According to the Equal Employment Opportunity Commis- sion’s (EEOC; 2021) Enforcement and Litigation Statistics and Agency Financial Report for Fiscal Year (FY) 2020, retaliation was the most frequently alleged discriminatory claim, account- ing for 55.8% of all charges. Disability (36.1%) was the next most alleged category of dis- crimination, followed by race and sex. The percentage of each category decreased or remained stable compared to FY 2019 except for claims of retaliation, disability, color, and genetic information (EEOC, 2021). Table 5 shows the percentage of adults with specific categories of disability in the U.S. PERCENTAGE OF ADULTS WITH FUNCTIONAL DISABILITY TYPES IN THE US FUNCTIONAL DISABILITY DESCRIPTION PERCENTAGE Mobility Serious difficulty walking or climbing stairs. 13.7%. Cognition Serious difficulty concentrating, 10.8%.
The CDC (2020) points out that: • Two in five adults age 65 years of age and older have a disability. • One in four women have a disability. • Two in five non-Hispanic Native American Indians/Alaska Natives have a disability. People with disabilities face several barriers to accessing healthcare. These include the following (CDC, 2020): • One in three persons does not have a primary healthcare provider (Age group: 18-44 years). • One in three people has an unmet healthcare need because of cost in the past year (Age group: 18-44 years). • One in four people did not have a routine check-up in the past year (Age group: 45-64 years). Disability often compounds issues of poverty and access that can lead to an array of health consequences such as substance abuse, domestic violence, malnutrition, and even chronic mental and behavioral health conditions. Today, those with physical, developmental, mental and behav- ioral health, and other disabilities are more likely to experience inclusive practices within educational, work, and social institu- tions. Despite this increased inclusivity, many with disabilities are still confronted with discriminatory practices within those same institutions. Although there is protective legislation in the schools guaranteed by the Individuals with Disabilities Education Act (IDEA), and within society as a whole via the Americans with Disabilities Act (ADA) of 1990, those with disabilities are more likely to not finish high school and are more likely to be underemployed or unemployed than their typically developing peers. More specifically, individuals with disabilities experience a full-time, full-year employment rate of 6%, whereas individuals without disability experience a 72% employment rate (Almalky, 2019). Similarly, 21.3% of individu- als with disabilities have not completed high school, whereas only 10% of individuals without disabilities have not finished high school (Bureau of Labor Statistics, 2022). Individuals with disabilities often experience social isolation. Society’s difficulty in accepting and accommodating those with intellectual, physi- cal, and other differences, combined with the difficulties that accompany some intellectual and/or mental and behavioral health disabilities (e.g., communication, understanding, and navigating social experiences), result in an increased risk for experiencing chronic loneliness (Tarvainen, 2021).
remembering, or making decisions. Difficulty doing errands alone. Deafness or serious difficulty hearing. Blindness or serious difficulty seeing. Difficulty bathing or dressing.
Independent Liv- ing
6.8%.
Hearing
5.9%.
Vision
4.6%.
Self-Care
3.7%.
From CDC, 2020.
Table 5
Research shows that adults living with disabilities are more likely to smoke, have obesity, have heart disease, and/or have diabetes (CDC, 2020). Healthcare professionals must be alert to diseases that are linked to disability. These diseases can compound the challenges that people with disabilities face.
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