Disability, disparities and bias

Despite the prevalence of disability, disabled communities continue to be underserved by the health care system. People with disabilities report more difficulty with access and are less satisfied with their healthcare.  They have higher levels of unmet health needs, and are screened less frequently for preventable and treatable conditions.

Take a few minutes and think about why these disparities exist.  One major contributor is access – the difficulty getting to and from destinations, in and out of clinics, on and off exam tables.  Another contributor is difficulty with communication, which is discussed in detail later in the chapter. Yet another is bias, either conscious or unconscious.

Our culture tends to value physical perfection and conformity to a particular ideal. Our paradigms can be limiting and make us less able to meet each person as an individual. People with disabilities often tell stories about the assumptions that other people make – that somebody in a wheelchair, for example, must have a cognitive disability, or that they have some needs that must be addressed by the person whom they’re encountering.  When bias, stigma, and assumptions enter clinical encounters, it makes it less likely that a visit will have the intended outcome and that a patient will return.