Disability Awareness For Future Health Care Providers GEORGE CHANG CHIEN WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF OSTEOPATHIC MEDICINE NATIONAL DISABILITIES COORDINATOR AMERICAN MEDICAL STUDENT ASSOCIATION Topics to study What is disability? Barriers to care
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GEORGE CHANG CHIEN
WESTERN UNIVERSITY OF HEALTH SCIENCES
COLLEGE OF OSTEOPATHIC MEDICINE
NATIONAL DISABILITIES COORDINATOR AMERICAN MEDICAL STUDENT ASSOCIATION
the role of rehabilitation medicine?
In 2002, nearly 1 in 5 Americans said they had some level of disability, while 1 in 8 -- 33 million -- reported they had a severe disability.
Steinmetz E. Americans with disabilities: 2002. Current population reports. Washington, DC: US Census Bureau; 2006. Available at http://www.census.gov/prod/2006pubs/p70-107.pdf.
There are over 54 million people with diagnosed disabilities in the United States today.
This population is the fastest growing demographic in this country.
Disability: a condition caused by an accident, trauma, genetics or disease, which can affect or limit a person’s ability.
Any loss or abnormality of body structure, or of a physiological or psychological function.
Surgeon General Richard H. Carmona, M.D., M.P.H., FACSU.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities. U.S. Department of Health and Human Services, Office of the Surgeon General, 2005.
Environment and attitudes cause the handicap that limits participation, productivity, integration, independence, and equality
Impairment: Retinitis pigmentosa
Disability: sensory, (vision)
Handicap: living in a building that does not have signs in Braille
People who are blind are not handicapped in jobs where they use computers with screen readers (voice input) and in buildings where signs are designated with Braille.
“ Whatever the social setting and whatever the disability, people with disabilities share a common experience of social oppression.”
- Paul Longmore, historian
Until the passage of the ADA, there were no federal protections against discrimination in the private sector for people with disabilities. Even the Civil Rights Act of 1964 did not cover people with disabilities.
IT IS ONLY 19 YEARS OLD!
1 a: a usually traditional story of ostensibly historical events that serves to unfold part of the world view of a people or explain a practice, belief, or natural phenomenon b:parable, allegory
2 a: a popular belief or tradition that has grown up around something or someone; especially: one embodying the ideals and institutions of a society or segment of society <seduced by the American myth of individualism — Orde Coombs> b: an unfounded or false notion
3: a person or thing having only an imaginary or unverifiable existence
“Words can inform our mind, caress and comfort our
feelings, excite and thrill our spirit, or warm and kindle
the flame of our hearts. They can also slap our face,
punch us in the stomach, rattle our nerves, kill our
desire, or destroy our self-confidence. Of course this is
metaphorical, but these metaphors capture in words our
physical reactions to what is said, and that is the power
of language. It can emotionally move and affect us as
powerfully as physical actions.” (Toomey, 1999)
Congestive heart disease
Can you think of other disabilities?
How can disability impact a person?
Aging with disability
There is a high prevalence of substance abuse in people with disabilities
Assistive Technology (AT) is a generic term that includes assistive, adaptive, and rehabilitative devices
AT promotes greater independence for people with disabilities by enabling them to perform tasks that they were formerly unable to accomplish, or had great difficulty accomplishing
“A day in the life of Richard Devylder”
Breast Cancer screening
- Digital rectal exam, PSA follow up
Dental? Exercise? Environmental? Attitudes? Prejudice?
Society’s attitudes are often the greatest barrier to the inclusion of people with disabilities. In spite of significant cultural changes, negative stereotypes still exist.
People living with long-term with disabilities are at increased risk for “secondary conditions,” defined as preventable physical, mental, and social disorders resulting directly or indirectly from an initial disabling condition.
What should every PCP know about disability?
The Centers for Disease Control and Prevention in their Healthy People 2010 Report targeted prevention of secondary conditions as a major component of health promotion for people with disabilities.
This list continues… depending on the type of disability
Do you only see the wheelchair?
Photo: courtesy of Cleveland clinic
What does “independent living” mean, and why is it important?
Access Living, Chicago
drop-off ramps at curbside and the outside sidewalk ease movement. The doorway had to be automatic and at street-level.
What is the role of rehabilitation?
How does PT/OT/ST/RT affect functional outcomes?
How does chronic disease contribute to disability?
When should a consult be made to a physiatrist?
Who are the other team members?
Does your medical curriculum prepare you for your future patients with disabilities?
How will you be a future advocate for your patients with disabilities, and what can you take back to your home school?