National Assessment of the Knowledge, Awareness, and Inclusion of People with Disabilities in Local Health Departments’ Public Health Practices
Approximately 56 million people in the United States live with a disability, which is equivalent to approximately 20% of Americans living with a congenital or acquired disability. The number of people living with a disability is likely to increase as the population ages. Research suggests that people with disabilities have complex healthcare needs and are disproportionally affected by health disparities; consequently, people with disabilities experience poorer health status and a poorer quality of life when compared to people without disabilities.
One way to address and mitigate these health disparities is through including people with disabilities in public health programs offered by local health departments (LHDs). To explore and better understand how LHDs are including people with disabilities in their programs, products, and services, the National Association of County and City Health Officials (NACCHO) conducted a quantitative assessment of randomly selected LHDs from across the United States. A total of 159 LHDs completed a brief nine-item questionnaire. The key findings from this assessment suggest the following:
- LHDs do not intentionally exclude people with disabilities from their activities;
- LHDs tend to be unaware of the prevalence rates of people with disabilities in their LHDs’ jurisdictions;
- LHDs report a general lack of knowledge about the health disparities experienced by the population of people with disabilities; and
- LHDs are more likely to include people with disabilities in emergency preparedness/planning activities than in any other type of public health program or activity.
NACCHO will use the quantitative data obtained from this assessment to develop a general framework for creating comprehensive education, training, and outreach materials/activities to raise awareness among LHDs of the health inequities and poor health outcomes experienced by people with disabilities. LHDs can use the information presented in this report to become familiar with the inequities in health experienced by the population of people with disabilities and to better understand the ways LHDs are including people with disabilities in public health programs and services. Click here to download the research brief developed by NACCHO’s Health and Disability team.
Special Olympics has implemented a new program, Healthy Communities, where Special Olympics athletes and others with intellectual disabilities have the same access to health and wellness resources – and can attain the same level of good health – as all community members. Special Olympics has shared the latest Healthy Community updates from the global program.
Healthy Communities Recognition Program Launched: In November, Special Olympics CEO, Janet Froetscher, and Chairman, Tim Shriver, launched the Healthy Communities recognition program and challenged Programs around the world to join the health revolution. Since then several Programs have expressed an interest with Special Olympics Minnesota, Special Olympics Czech Republic, and Special Olympics Washington being the first to apply for Healthy Community recognition.
Special Olympics Mexico Secures Free Health Insurance for all Athletes: Recognizing that lack of affordable health insurance is a barrier for many people with Intellectual Disabilities (ID), the Mexican Health Department, with the urging of Special Olympics Mexico, recently approved the eligibility of all Mexico’s 29,000 athletes to receive Seguro Popular (‘popular health insurance’) including medical and surgical care free of charge. Special Olympics Mexico is now working to register every athlete in each state. Seguro Popular is a government-funded program aimed to ensure that even the poorest Mexican citizens have access to an adequate standard of health care – from treatment for the most pressing chronic and catastrophic illnesses, to preventative healthcare such as vaccination and diabetes screening.
Special Olympics Florida Opens Second Healthy Community Site: A second site focused on Healthy Communities in Florida was opened in Tampa Bay in January 2015. Located within the MacDonald Training Center for people with disabilities, the site offers health classes and health examinations for people with ID. The site hosted their first wellness and nutrition class on January 20th with support from interns from the University of Tampa and University of South Florida. Upcoming events include MedFest, Health Promotion and Special Smiles clinics.
Thailand Ministry of Public Health Adopts Healthy Community Model: As part of the Healthy Community pilot, Special Olympics Thailand provided multiple health assessments for 996 children with intellectual disability at 6 special schools. The results, showing multiple gaps and weaknesses in the health system, were recently shared with the government along with recommendations to improve healthcare access by strengthening the collaboration between government agencies related to healthcare, education & social services, in order to deliver holistic healthcare services for people with ID. As a result, the government has agreed to expand the Healthy Community health assessment model to 14 additional special schools nationwide benefiting over 5,000 children with ID. The program, launched in January, involves a first ever collaboration between the Ministries of Public Health, Education and Social Services at the provincial level and will provide health assessments, implementation of a new patient tracking database, training of health care professionals and families as well as follow up care services. The results of the expanded pilot will provide significant data to guide the necessary government policy changes needed to address the identified health gap and demonstrate the impact of the Healthy Communities model.
Malaria/HIV Pilot Set to Begin in Nigeria: Upon securing a $270,000 grant from Exxon Mobil, Special Olympics Nigeria and Grassroot Soccer have teamed up to deliver an interactive Malaria/HIV health education program through the popular game of soccer in order to improve access to Malaria and HIV/AIDS prevention, education and health services for people with ID and improve district-level coordination to offer these services to people with ID. They will train up to 100 coaches to deliver the curriculum culminating in Voluntary Counseling and Testing (VCT) soccer tournaments for hundreds of athletes. The development of specialized curriculum will begin in February.
AUCD recently attended the Summit and Research Forum on Improved Health and Fitness for Americans with Disabilities. The event was co-sponsored by the President’s Council on Fitness, Sports, and Nutrition and the National Institute of Child Health and Human Development and featured two members of CDC’s Friends of NCBDDD, Jim Rimmer, PhD, principal investigator of the NIDRR-funded Rehabilitation Engineering Research Center on Interactive Technologies and Exercise Physiology Benefiting People with Disabilities (RecTech), and Amy Rauworth, the Director of Policy and Public Affairs at the Lakeshore Foundation and is the Associate Director of the National Center on Health, Physical Activity and Disability (NCHPAD). Success stories from the I Can Do It, You Can Do It! (ICDI) Program were shared, along with innovative approaches based on emerging research findings. With obesity rates being 38% higher for children with a disability, this school-based ICDI effort is critical to engage communities in inclusive physical activity. Team science, a way of learning from multiple disciplines, testing out strategies and implementing what is learned, was highlighted during the research discussion as a way to build relationships and develop methods. One of the key messages of the summit was that exercise is medicine for everyone, including people w/ a disability. To continue this discussion and increase inclusion of people with disabilities in health and fitness efforts, the Commit to Inclusion initiative was launched at the summit. To learn more, visit: committoinclusion.org.
The NY State Department of Health Disability and Health Program is an example of how other states commit to including people with disabilities as an explicit target population in all state public health programs. NY started by looking at the NIH policy on inclusion. Then they moved onto create an inclusion policy for NY State Department of Health efforts. This inclusion policy was used as a guide to tailor specific requests for proposals, such as the Comprehensive Adolescent Pregnancy Prevention effort or the Pediatric Obesity in Health Care Settings program. When you are looking through these RFPs, search “disab” to pick up all instances of how people with disabilities are included as an explicit target population.
We are excited to announce that the Society for Developmental and Behavioral Pediatrics has endorsed the Six by ’15 campaign! The SDBP is the first health professional association to endorse the campaign.The board of SDBP voted to endorse the campaign at their annual meeting on September 20 in Nashville, TN.
Dr. John Duby, outgoing SDBP President and Director of Developmental-Behavioral Pediatrics at Akron Children’s Hospital said, “The Board of Directors of the Society for Developmental and Behavioral Pediatrics is excited to endorse Six by 15. As an interprofessional association whose members work with families affected by developmental disabilities on a daily basis, we see the vital importance in providing the broad-based supports that will assure that our young people with disabilities have healthy, happy, and product adult lives. This initiative will move our country closer to reaching this goal.”
About the SDBP:
The Society for Developmental and Behavioral Pediatrics (SDBP) is an international membership organization of professionals dedicated to improving the health of infants, children, and adolescents by promoting research, teaching, and evidence-based clinical practice and advocacy. The Society’s vision is to be the interdisciplinary leader in optimal developmental and behavioral health for all children.
Over the past few weeks as part of the launch of this campaign, we have been highlighting the kind of work that will move us forward on achieving these six goals by the end of 2015. We have shared stories from our founding partners, federal initiatives, advocacy resources, data, and work in Congress and the States. Each week, we focused on one of our goals. Read more about Employment, Transition, Healthy Living, Community Living, Education, and Early Childhood.
How can YOU get involved?
Despite a mistaken belief that people with disabilities receive the same or better health care than others, they typically receive less care, sub-standard care, or no health care at all.
This has led Special Olympics to become not just a global inclusive sports organization but also the largest global public health organization dedicated to serving people with intellectual disabilities. People with disabilities should have access to the same health and wellness services and be able to achieve the same good health as the general population.
Many of our athletes come to us with neglected health problems. We offer a wide range of free health examinations and care through the Healthy Athletes ® program. At more than 1.4 million free health screening clinics in more than 100 countries, the Healthy Athletes program offers health services and information to athletes in dire need. Through Healthy Athletes, more than 100,000 health care professionals have been trained to treat people with intellectual disabilities, and these health care professionals in turn provide improved care to millions. Special Olympics has also built the world’s largest database of health data for people with intellectual disabilities and its health work is not just helping individuals, it is improving health systems and policies for people with disabilities. Learn more about Healthy Athletes.
The success and impact of Healthy Athletes led to the creation of the Healthy Communities initiative, which provides comprehensive, community-based health and wellness and is generously supported by the US Centers for Disease Control and Prevention and the Golisano Foundation. Read more about Healthy Communities.
Sports and Physical Activity Resources
We provide extensive free information on sports and fitness tailored to people with intellectual disabilities through our Sports and Physical Activity Fact Sheets and Coach Guides.
This is a Special Olympics fitness screening event developed in collaboration with the American Physical Therapy Association (APTA. The goals of FUNfitness include assessing needs in flexibility, strength, balance, and aerobic fitness; teaching exercises to help athletes improve identified areas of need; and educating participants, families and coaches about the importance of flexibility, strength, balance, and aerobic conditioning in overall fitness. More information on FUNfitnesscan be found here.
This is an innovative sports play program for children ages 2-7 with intellectual disabilities and their peers, designed to introduce them into the world of sports. The benefits of Young Athletes have been proven worldwide. First and foremost, these activities help children thrive physically, cognitively and socially.
This is an education and sports based strategy powered by an engaged youth community that increases athletic and leadership opportunities for students with and without intellectual disabilities. While promoting physical activity and making it fun, Project UNIFY® also creates communities of acceptance for all.
About Special Olympics
Special Olympics is an international organization that unleashes the human spirit through the transformative power and joy of sports every day around the world. Through work in sports, health, education and community building, Special Olympics addresses inactivity, injustice, intolerance and social isolation by encouraging and empowering people with intellectual disabilities, which leads to a more welcoming and inclusive society. Visit Special Olympics at www.specialolympics.org.
More than 21 million US adults 18–64 years of age have a disability. Physical activity benefits all adults, whether or not they have a disability, by reducing their risk of serious chronic diseases, such as heart disease, stroke, diabetes and some cancers. Only 44% of adults with disabilities who visited a doctor in the past year were told by a doctor to get physical activity. Yet adults with disabilities were 82% more likely to be physically active if their doctor recommended it.
Working age adults with disabilities who get no aerobic physical activity are 50 percent more likely to have a chronic disease such as cancer, diabetes, stroke, or heart disease than their active peers, according to a Vital Signs report released today by the Centers for Disease Control and Prevention. Most adults with disabilities are able to participate in physical activity, yet nearly half (47 percent) of them get no aerobic physical activity. An additional 22 percent aren’t active enough.
The key findings of the report include:
- Working age adults with disabilities are three times more likely to have heart disease, stroke, diabetes or cancer than adults without disabilities.
- Nearly half of adults with disabilities get no aerobic physical activity, an important protective health behavior to help avoid these chronic diseases.
- Inactive adults with disabilities were 50 percent more likely to report at least one chronic disease than were active adults with disabilities.
- Adults with disabilities were 82 percent more likely to be physically active if their doctor recommended it.
Aerobic physical activity can help all adults, including those with disabilities, avoid chronic disease. Physical activity is for everybody – and everybody can help.
- Adults with disabilities can talk to their doctor about how much and what kind of physical activity is right for them.
- Doctors and other health professionals can recommend aerobic physical activity options that match each person’s specific abilities and connect him or her to resources that can help each person be physically active.
- States and communities can bring together adults with disabilities, health professionals, and community leaders to address resource needs to increase physical activity.
CDC has set up a dedicated resource page for doctors and other health professionals with information to help them recommend aerobic physical activity to their adult patients with disabilities.
Across the country, AUCD network members – University Centers for Excellence in Developmental Disabilities, Leadership Education in Neurodevelopmental and related Disabilities training programs, and Intellectual and Developmental Disabilities Research Centers – are conducting research and creating programs to improve the health of people with disabilities through improved health care and inclusive public health efforts.
The Oregon Institute on Development & Disability at Oregon Health & Science University worked with the Oregon Office on Disability and Health to improve the health of Oregonians with disabilities. Two of their specific projects include increasing access to breast cancer screening for women with disabilities and improving accessibility of smoking cessation programs.
University of Montana Rural Institute researchers are helping to set a national agenda on health and disability, contributing to the 2012 State of the Science Conference on Outcomes and Quality of Life in Community Living and Employment in Halifax, Nova Scotia and collaborating to publish an article entitled The State of Science of Health and Wellness for Adults with Intellectual and Developmental Disabilities in the Intellectual and Developmental Disabilities journal.The authors found that historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to poverty, race, gender, and aging; and lack of access to high quality medical and dental care and to public health and other wellness programs. Additionally, people with IDD need more efficient, cost-effective ways to access health and wellness activities to prevent or treat obesity and other chronic health conditions. Targeted training of health care providers to meet the specific needs of persons with IDD is also warranted.
At the AUCD Annual Meeting in November of 2013, researchers from New York, New Jersey, and Tennessee presented a symposium on the provision of appropriate and quality health care to individuals with IDD including, youth who are transitioning from pediatric to adult health care. They presented information how LENDs and UCEDDs are focusing on health care for adults and transitioning youth through their functions of research and evaluation, training and technical assistance, materials development and dissemination, and policy analysis to make a state and national impact.
Public Health is for Everyone is an inclusive planning toolkit for public health professionals. It’s an online toolkit which serves as a one-stop resource to increase the capacity of public health professionals to create programs that benefit entire communities, including people who have disabilities. The PHEtoolkit provides public health professionals with resources to enhance their planning efforts in key issue areas.