determinant of health factor that can become a barrier to care for seniors (Alignment Healthcare USA, 2022). A fifth of seniors reported increased loneliness in the past year. While nearly 7 out of 10 seniors see a family member, friend, or another companion often throughout the week, 16% only see a companion every two to three weeks (Alignment Healthcare USA, 2022). Food insecurity is the third social determinant of health that often impedes seniors’ access to care and ability to adhere to treatment. The survey found that 15% of seniors expected to experience barriers to food access in the next year (Alignment Healthcare USA, 2022). An even more significant number of seniors reported that grocery assistance was their top need for support. Seven of 10 Disability Physical, intellectual, mental health, and other long-term disabilities constitute another facet of diversity within the U.S. The number of Americans reporting a disability has increased in recent years due to chronic health conditions and population aging.
seniors said they would use a monthly grocery allowance. More seniors ranked monthly grocery allowances as their most prized benefit than 24/7 telehealth or virtual care access. (Alignment Healthcare USA, 2022). Seniors have reported transportation as one of the barriers to seeking care. More than 20% of respondents note the lack of reliable transportation as a problem when seeking medical care. One in 7 say they will not have consistent transportation to medical care in the next year (Alignment Healthcare USA, 2022). Moreover, technology has also been cited as impacting health care for older adults. One in 10 (10%) seniors say their lack of access to reliable technology or difficulties using it will be an obstacle to health and medical care in the next year (Alignment Healthcare USA, 2022). In 2019, 27% of Americans reported a disability (Preidt, 2021), and 12% stated that they have more than one disability. The CDC (2020) points out that two in five adults aged 65 and older have a disability. One in four women has a disability, and two in five non-Hispanic Native American Indians/Alaska Natives have a disability.
Evidence-Based Practice : Research shows that adults with disabilities are more likely to smoke, suffer from obesity, and have heart disease and diabetes (CDC, 2020). Healthcare professionals must be alert to the diseases linked to disability. These diseases can compound the challenges that people with disabilities face. This means that mental health professionals need to become comfortable and competent in working with disabled individuals. People with disabilities tend to be in poorer health and to use healthcare at a significantly higher rate than people who do not have disabilities (The Current State of Health Care for People with Disabilities, 2022). Table 2 summarizes the percentage of adults with specific categories of disability in the U.S. Table 2: Percentage of Adults with Functional Disability Types in the U.S. Functional Disability Description Percentage Mobility Serious difficulty walking or climbing stairs 13.7% Cognition Serious difficulty concentrating, remembering, or making decisions 10.8% Independent Living Difficulty doing errands alone 6.8% Hearing Deafness or severe difficulty hearing 5.9% Vision Blindness or severe difficulty seeing 4.6% Self-Care Difficulty bathing or dressing 3.7% Note : From Centers for Disease Control and Prevention (CDC). (2020). Those with disability have experienced a history of discriminatory practices that have often resulted in exclusion
Evidence-Based Practice : Disabled workers, and especially disabled women, face a myriad of unique barriers, including masculine and able-bodied employment practices (e.g., performative expectations) and exclusionary physical spaces (e.g., access, location of required facilities), that exclude them from full employment participation. Note: F rom “I see you but you don’t see me: The “two-way mirror effect” of gender and disability in employment,” by Bend, G., et al., 2021 . Gender in Management: An International Journal. Today, those with physical, developmental, mental health, and other disability are more likely to experience inclusive practices within educational, work, and social institutions (CDC, 2020). Despite this increased inclusivity, many with a disability still face discriminatory practices within those same institutions. Although there is protective legislation in the schools guaranteed by the Individuals with Disabilities Education Act and within society by the Americans with Disabilities Act of 1990, those with disability are more likely not to finish high school and are more likely to be underemployed or unemployed than their typically developing peers. Similarly, 21.3% of individuals with a
from mainstream society. Historically, individuals with a disability have been physically segregated from others due to policies encouraging the institutionalization of people with physical, developmental, and mental health disabilities. Institutionalization prevented many individuals with a disability from meaningful education and work and limited opportunities to socialize with the broader community. At its worst, institutionalization resulted in the neglect, mistreatment, and abuse of those with disability. Deinstitutionalization was ushered in by the public exposure of the abuses of those living in Willowbrook State School in Staten Island. In 1972, Geraldo Rivera, a television reporter, was given the key to the school by one of the physicians employed there to expose the squalor of the school and the neglect of the children residing there. His reporting, a better understanding of how to effectively treat those with a disability, and the introduction of psychotherapeutic medications resulted in the beginning of the end of institutionalization and the beginning of offering those with disability community-based services.
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