Disability is a matter of both perception and reality
Defining who have disabilities and how to meet their health needs is tricky because there is no standard formula and because disabilities can take so many forms.
Some researchers look at disability as a medical problem needing medical care.
Others take a functional view and define people with a disability in terms of the work or activities they can perform.
Still others look at disability through a social lens, considering conditions in the social environment that prevent participation in society and how to remedy that.
Add to that the general tendency to view someone who uses a wheelchair as having a disability, but to overlook those with less visible disabilities, such as deafness or psychological issues, and it becomes clear how muddled the definition of “disability” actually is.
Even people with disabilities might disagree with the term.
Studies have shown almost 75 percent of those who cannot hear and more than half of those who cannot see don‘t consider themselves as having a disability, nor do 20 percent of people who use manual wheelchairs or 16 percent who use powered wheelchairs. Many people with an impairment don‘t claim a disability, says Margaret Turk, MD, an Upstate professor of physical medicine and rehabilitation, pediatrics, public health and preventive medicine.
She says such varying definitions and methods of estimating the population of people with disability are among the challenges to delivering health care to this group. The federal Centers for Disease Control and Prevention report these percentages of Americans as having a disability:
- 13 percent of the total population;
- 5 percent of children ages 5 to 15 years; and
- 22 percent of adults.
Turk spoke about the challenges people with a disability face in health care in a recent lecture at Upstate. Just getting into an office for a medical appointment can be difficult. So can dealing with health insurers and health care providers, some of whom may view people with disabilities as time-consuming and complicated.
Another complicating factor is how people with disability view their health. When asked how they rate their health, people with disability report good and excellent health ratings even with a relatively large number of days of poor physical health. Seeing so many days of poor health, health care providers tend to view people with disability as having poor health and, therefore, poor quality of life – which may not be the case.
While it‘s true that people with certain disabilities generally face shorter life expectancies, Turk says that is improving. She also points out that people with disability can participate in the same wellness activities as people without disability, such as exercise and smoking cessation programs, with the same positive health effects.
This article appears in the summer 2017 issue of Upstate Health magazine.