According to Healthy People 2020:
"Although the term “disparities” often is interpreted to mean racial or ethnic disparities, many dimensions of disparity exist in the United States, particularly in health. If a health outcome is seen in a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations."
Healthy People 2020 Leading Health Indicators
According to Healthy People 2020, the 12 indicators by which we should judge our nation's health include:
[Links are to sections within this website that discuss what is known about the indicator for women with physical disabilities.]
- Access to Health Services
- Clinical Preventive Services
- Environmental Quality
- Injury and Violence
- Maternal, Infant, and Child Health
- Mental Health
- Nutrition, Physical Activity, and Obesity
- Oral Health
- Reproductive and Sexual Health
- Social Determinants
- Substance Abuse
- Tobacco
Hard Evidence of Health Disparities Experienced by Women with Disabilities
One example of health disparities experienced by women with disabilities can be seen in a study done by Herrick and colleagues on data from the North Carolina Behavioral Risk Factor Surveillance Survey of 2009. The table below shows that women with physical and cognitive limitations are significantly more likely to experience diabetes, obesity, high blood pressure, high cholesterol, smoking, physical inactivity, and poor sleep. Any three of these conditions together constitute a significant risk factor for cardiovascular disease. Women with disabilities are more than twice as likely as women with no disabilities (48.3 percent versus 20.9 percent) to experience three or more of these conditions, and therefore are at significant risk for cardiovascular disease.
| Prevalence | Relative Risk | |||
|---|---|---|---|---|
| Disability Status | Disability Status | |||
| Risk factors for CVD | Yes (%) | No (%) | aRR1 | 95% C.I.2 |
| Diabetes | 15.2 | 6.7 | 2.3* | 1.9 – 2.9 |
| Obesity | 41.1 | 25.5 | 1.6* | 1.5 – 1.8 |
| High blood pressure | 39.5 | 25.9 | 1.4* | 1.3 – 1.6 |
| High cholesterol | 47.1 | 30.8 | 1.4* | 1.3 – 1.5 |
| Current smoker | 26.1 | 15.2 | 1.8* | 1.5 – 2.0 |
| Physical inactivity | 36.9 | 24.4 | 1.7* | 1.5 – 1.9 |
| Poor sleep | 49.9 | 27.8 | 1.9* | 1.7 – 2.1 |
| INDEX variable3 | 48.3 | 20.9 | 2.2* | 2.0 – 2.5 |
* p < 0.05
1aRR – age-adjusted relative risk (Mantel–Haenszel)
2C.I. – confidence interval
3INDEX variable – three or more risk factors present
Source: Herrick H, Luken K, Dickens P. Women with Disabilities and Heart Disease. North Carolina BRFSS Surveillance Update, No. 5. Chapel Hill, North Carolina: DHHS, Chronic Disease and Injury Section, State Center for Health Statistics. North Carolina Office on Disability and Health, University of North Carolina, Chapel Hill;2011.
Call for More Comprehensive Studies
The Minority Health and Health Disparities Research and Education Act of 2000 (P. L. 106-525) defines health disparity as:
"A population is a health disparity population if... there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population as compared to the health status of the general population. In addition... such term includes populations for which there is a considerable disparity in the quality, outcomes, costs, or use of health care services or access to, or satisfaction with such services as compared to the general population."
Such a comprehensive approach is needed to examine health disparities experienced by the population of women with disabilities in terms of each of the leading health indicators and the social determinants of health. Additional important determinants of health for people with disabilities include accessibility, according to the Americans with Disabilities Act, and access to assistive technology.
