Weeks 2 & 3 Objectives & Required Readings
1. Examine the epidemiology of disability.
•Populations are ageing – older people have a higher risk of disability
•Global increase in chronic health conditions associated with disability, such as
diabetes, cardiovascular diseases, and mental illness
•Patterns of disability in a particular country are influenced by
–Trends in health conditions and trends in environmental and other factors
– such as
–Road traffic crashes, natural disasters, conflict, diet, and substance abuse
2. Discuss relevant factors that can impact disability, e.g., environment, levels of
prevention, development, human rights etc.
Environment:
•A person’s environment has a huge impact on the experience and extent of
disability.
•Inaccessible environments create disability by creating barriers to participation
and inclusion
•Health is also affected by environmental factors, such as safe water and sanitation,
nutrition, poverty, working conditions, climate, or access to health care.
•The environment may be changed to improve health conditions, prevent
impairments, and improve outcomes for persons with disabilities.
•Such changes can be brought about by legislation, policy changes, capacity
building, or technological developments leading to, for instance:
■■ accessible design of the built environment and transport;
■■ signage to benefit people with sensory impairments;
■■ more accessible health, rehabilitation, education, and support services;
■■ more opportunities for work and employment for persons with
disabilities.
Levels of Prevention
•Primary prevention – actions to avoid or remove the cause of a health problem
in an individual or a population before it arises. It includes health promotion and
specific protection (for example, HIV education)
•Secondary prevention – actions to detect a health problem at an early stage in an
individual or a population, facilitating cure, or reducing or preventing spread, or
reducing or preventing its long-term effects (for example, supporting women with
intellectual disability to access breast cancer screening)
•Tertiary prevention – actions to reduce the impact of an already established
disease by restoring function and reducing disease related complications (for
example, rehabilitation for children with musculoskeletal impairment)
Development
•Disability is a development issue, because of its bidirectional link to poverty:
disability may increase the risk of poverty, and poverty may increase the risk of
disability
•A growing body of empirical evidence from across the world indicates that people
with disabilities and their families are more likely to experience economic and
social disadvantage than those without disability
Human Rights
Disability is a human rights issue because:
•People with disabilities experience inequalities
•People with disabilities are subject to violations of dignity
•Some people with disability are denied autonomy
3. Examine barriers, outcomes and strategies for the self-management of disability.
Barriers
•Inadequate policies and standards
•Negative attitudes
•Lack of provision of services
•Problems with service delivery
•Inadequate funding
•Lack of accessibility
•Lack of consultation and involvement
•Lack of data and evidence
Outcomes
•Poorer health outcomes
•Lower educational achievements
•Less economic participation
•Higher rates of poverty
•Increased dependency and restricted participation
Strategies
•Understanding the numbers of people with disabilities and their circumstances can
improve efforts to remove disabling barriers and provide services to allow people
with disabilities to participate
•For example, better measures of the environment and its impacts on the different
aspects of disability need to be developed to facilitate the identification of cost-
effective environmental interventions
•Making all levels of existing health care systems more inclusive and making public
health care programs accessible to people with disabilities will reduce health
disparities and unmet need.
•Rehabilitation is a good investment because it builds human capacity. It should be
incorporated into general legislation on health, employment, education, and social
services and into specific legislation for people with disabilities
•Policy responses should emphasize early intervention, the benefits of
rehabilitation to promote functioning in people with a broad range of health
conditions, and the provision of services as close as possible to where people live
•Transitioning to community living, providing a range of support and assistance
services, and supporting informal caregivers will promote independence and enable
people with disabilities and their family members to participate in economic and
social activities