Chapter 9Health Promotion for People with Disabilities

Abstract

Health and wellness are the foundations that allow people to fully participate in many of the most important aspects of life. Maintaining good health is especially important for people with disabilities, both to reduce the potential impact of the disability and to ensure participation in the fabric of community life (Krahn, Hammond, and Turner 2006). Yet, people with disabilities may be the largest underserved group of Americans that demonstrates evidence of health disparities (Drum, Horner‐Johnson, and Krahn 2008). Health disparities among people with disabilities are discussed in Drum et al. (this volume), so we will forego a full discussion here. It is important to note, however, that people with disabilities do in fact experience important health differences compared to the general population. Specifically, people with a variety of physical and cognitive disabilities are more likely to experience potentially preventable secondary conditions, chronic conditions, and early mortality (Campbell, Sheets, and Strong 1999; Havercamp, Scandlin, and Roth 2004; Turk et al. 2001; USDHHS 2001). People with disabilities also report having more unmet health care needs (NOD/Harris 2004) and receiving fewer preventive services (Chevarley et al. 2006) than people without disabilities. There are recognized disparities in health behavior practice by adults with disabilities, including higher rates of cigarette smoking (Armour et al. 2007; Brawarsky et al. 2002; Drum et al. 2005), and lower participation in physical activity and exercise (NOD/Harris 2004) than the general adult population. But why consider health promotion for people with disabilities specifically? It is tempting, knowing that a public health need exists, to simply move ahead with model health promotion programs developed for the general population and immediately apply them to populations with disabilities. While there are many similarities in the health needs of people with disabilities compared to the needs of the general population, additional considerations are necessary. Throughout this chapter, we will consider health promotion as a combination of health education and environmental change activities that reflect these similar and different health needs. For example, although all women need to understand optimal breast health, women with intellectual, learning, or sensory disabilities may not be able to use health education materials developed for the general population because they may require adaptations in language, reading level, or format. More uniquely among people with disabilities, interactions with the environment differ among people with various disabilities. For example, individuals with mobility limitations may face environmental barriers such as examination tables that do not lower. Therefore, to combat disparities, specific attention to health promotion for people with disabilities is imperative.