Authors

  1. Lancaster, Jeanette

Article Content

This issue (27:1) of Family & Community Health, Crossing Barriers to Health: Disability Issues Within the Family and Community, provides an interesting and timely series of articles dealing with a topic that is too often overlooked. For a wide range and variety of reasons that are well explained in the issue, we do not often think carefully and thoughtfully about what constitutes a disability; how the affected person views his or her situation; what the posed barriers are and how they could be avoided; and what our roles and responsibilities are as health care professionals who want to provide the most beneficial care and services to persons who have disabilities that do interfere with their normal physical or mental health functioning.

 

There are a variety of ways to look at the term and state of "disability." For example, in the foreword, the issue editors note that a "disability is defined as a person's perception of their (in)ability to function with an impairment." Another way to view disability is as a restriction, limitation, or lack of an ability to perform an activity in what is generally viewed as the normal range of functioning. Personally, I like the first view. As I reflected on the articles in this issue, I recalled vividly my own experiences in graduate school in a course entitled "Ecology of Health." The instructor was markedly physically altered by average standards. However, as we discussed, debated, and argued about "what health is" and how to get and keep it, it was clear, through his words and actions, that he did not see himself as a person with a disability. Granted, he had some physical limitations that made getting around more difficult, but, as he said, "he was actively engaged in being a healthy person." Hence, disability is often in the minds of those with the condition, rather than in the minds of those who come into contact with the person.

 

Also, as noted in Mulvhill, Cotton, and Gyaben's article (Best Practices for Inclusive Child and Adolescent Out-of-School Care: A Review of the Literature) in this issue, there are two pieces of federal legislation that ensure protection of the civil and educational rights of people with disabilities: 1) The Americans with Disabilities Act (ADA) and 2) the Individuals with Disabilities Education Act (IDEA). The former was signed into law in 1990, to protect people with physical or mental disabilities from discrimination in employment, state and local government services, public transportation, telecommunications, and public accommodations. The IDEA extends protection by ensuring that children with disabilities have the same right to free, appropriate public education as children without disabilities.

 

Similarly, Healthy People 2010: Understanding and Improving Health, 1 is a national agenda to promote health and prevent disease. This widely used document cites a series of goals with specific objectives about how to achieve this aim. Goal 6 deals with disability and secondary conditions: "Promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population." 1(p54)

 

Perhaps the first step for each of us is to think carefully about how we define disability and how we view people who have obvious disabilities. If we are not comfortable engaging persons with disability conditions in discussions regarding how they view their own state of health, can we observe them to make some inferences? Do we place barriers in their way without even knowing we are doing so? If yes, how can we modify our own behavior to be more inclusive? The modifications may go much further than our observation, attitudes, and comments. Modifications may take effort and cost money. I would suggest the place to start is to try to put ourselves in their places. How would we feel and what would we think if we came to a luncheon in a wheelchair or on crutches, and all the places were set with chairs and there was no easy way to move a chair to replace it with a wheelchair? Often for a person with a disability, what is viewed by a nondisabled person as a simple task or act is much more strenuous and tiring. Are there things we can do to be helpful without offending? The articles in this issue provide a range of examples of how persons with disabilities manage their lives. Several authors discuss the strain of doing what seems so ordinary to others (eg, going to a swimming pool). My hope is that these articles will provoke each of us to think more carefully about removing barriers for those among us with disabilities, even if they do not view themselves as disabled.

 

REFERENCE

 

1. U. S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health, 2nd ed. Washington DC: Government Printing Office; 2000. [Context Link]