American Disability Research Articles

The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans: Results from the Hispanic EPESE

The effect of diabetes combined with stroke on disability, self-rated health, and mortality in older Mexican Americans: Results from the Hispanic EPESE

Observing the onset of disability in older adults

One of the greatest threats to the ability of older adults to live independently is the onset of disability in activities adults perform in their daily lives, such as dressing, eating, toileting, managing one's money, preparing meals and so on. This article examines the onset of disability in older adult Americans using three waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (1993, 1995, 1998; n=4228). We use medical/demographic factors (arthritis, heart disease, diabetes; age, gender, race/ethnicity, wealth), baseline characteristics (affect, cognition, health behaviors, medical insurance), and time-varying covariates (changes in chronic conditions and baseline characteristics) to predict the onset of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) disability, individually and in the aggregate, over time. We find the onset of ADL and IADL disability is a complex process, suggesting important roles for medical, demographic, social, psychological, and behavioral triggers, specifically negative affect, higher body weight, and by the lack of vigorous exercise. We also find that individual ADL and IADL impairments are predicted by a variety of different factors, suggesting that summary measures of disability may be masking a wealth of potentially useful interventions. In general, public health efforts in the area of controlling obesity and treating depressive symptoms should be supported.

Challenging the Authority of the Medical Definition of Disability: An analysis of the resistance to the social constructionist paradigm

This article attempts to explain why the social constructionist paradigm has failed to replace the medical model in American disability theory. The social movement led by American disability activists attempted to reframe the definition of disability using a minority group model based on the social constructionist paradigm. This paper argues that the disability movement was unable to successfully advance the social constructionist paradigm because the activists accepted the Americans With Disabilities Act (1990) despite its ideological basis in the medical model of disability, and the social constructionist theory does not adequately account for the importance of structural constraints to redefinition.

Measuring subclinical disability in older mexican americans.

The purpose of this study was to develop a comprehensive list of adaptive strategies to prevent disability and use this information to devise a preliminary measure of subclinical disability (state of sustained independence in the presence of latent or manifest functional limitations) suitable for older Mexican Americans. Semistructured interviews were conducted with 24 community-dwelling Mexican American elders (> or =65 years old) to elicit information about adaptations in performance of daily living tasks (eg, walking, dressing, and shopping) that may indicate presence of subclinical disability. This information was used to construct a quantitative self-report measure of subclinical disability administered to 207 older Mexican Americans. Item and factor analyses were performed to reduce the number of items and establish their underlying structure. Construct and discriminant validity of the reduced instrument was determined. A framework comprised of nine categories of daily living tasks, three functional levels, and five adaptation types was generated from the qualitative data. The initial 133-item measure (named the ADAPT) was reduced to a 44-item scale with three subscales (physical, household, and social). ADAPT scores correlated significantly in the expected direction with standard functional status measures, but the shared variance was modest, indicating that the ADAPT captured substantial, unique variance. Mean ADAPT scores differed significantly and were monotonically lower across subgroups classified as independent, subclinically disabled, and disabled, respectively. The ADAPT seems to have construct and discriminant validity as a measure of subclinical disability. Additional research is required to determine sensitivity to change and clinically significant cut points for varying risk of frank disability.

Promoting human wellness: new frontiers for research, practice, and policy

Foreword, by Cornelius L. Hopper and Irene Bronston Acknowledgments Introduction: New Frontiers for Research, Practice, and Policy, by Margaret Schneider Jamner PART ONE. NEW DIRECTIONS IN HUMAN WELLNESS PROMOTION 1. The Social Ecological Paradigm of Wellness Promotion, by Daniel Stokols 2. The Societal Context of Disease Prevention and Wellness Promotion, by Lester Breslow 3. Promoting Wellness: Biomedical versus Outcomes Models, by Robert M. Kaplan 4. Community Participation, Empowerment, and Health: Development of a Wellness Guide for California, by S. Leonard Syme 5. Genetic Determinism as a Failing Paradigm in Biology and Medicine: Implications for Health and Wellness, by Richard C. Strohman PART TWO. WELLNESS PROMOTION RESEARCH: INNOVATIVE STRATEGIES AND PERSPECTIVES 6. Creating Health Promotive Environments: Implications for Theory and Research, by Daniel Stokols 7. Theory-Based Evaluation: Investigating the How and Why of Wellness Promotion Programs, by Johanna Birckmayer and Carol Hirschon Weiss 8. Pregnancy Prevention Opportunities Focusing on the Younger Sisters of Childbearing Teens, by Patricia L. East 9. Immigrants May Hold Clues to Protecting Health during Pregnancy: Exploring a Paradox, by Sylvia Guendelman 10. Race and Health: Implications for Health Care Delivery and Wellness Promotion, by Mack Roach III 11. Health Promotion in Ethnic Minority Families: The Impact of Exposure to Violence, by Kathy Sanders-Phillips 12. Valuing Future Health in Social Policy and Human Health Behavior, by Theodore G. Ganiats and William J. Sieber PART THREE. WELLNESS PROMOTION PRACTICE: TOWARD MORE COMPREHENSIVE APPROACHES 13. Health Promotion at the Dawn of the Twenty-first Century: Challenges and Dilemmas, by Meredith Minkler 14. Bridging the Clinical and Public Health Approaches to Smoking Cessation: California Smokers' Helpline, by Shu-Hong Zhu and Christopher M. Anderson 15. Disease Prevention versus Health Promotion: Pitfalls of Preventive Care in the Geriatric Population, by Andrew Duxbury 16. Preventing Disability in Older Americans: The Challenge of the 21st Century, by John C. Beck 17. An Educational Approach to Engage Health Care Professionals in Wellness Promotion, by Stuart J. Slavin and Michael S. Wilkes 18. University-Community Partnerships to Promote Wellness in Children, Youth, and Families, by Philip R. Nader PART FOUR. WELLNESS PROMOTION POLICY: TOWARD A MORE EXPLICIT CONSIDERATION OF THE POLITICAL CONTEXT 19. Strategies for Reducing Youth Violence: Media, Community, and Policy, by Lawrence Wallack 20. Adolescent Sexuality and Health Care Reform, by Adele Dellenbaugh Hofmann 21. Improving Health and Safety in the Agricultural Workplace, by Marc B. Schenker 22. Enhancing Women's Health: Current Status and Directions in Research and Practice, by Annette L. Stanton, Sharon Danoff-Burg, and Sheryle J. Gallant 23. Cardiovascular Disease in Women: Exploring Myths and Controversies, by Amparo C. Villablanca 24. HIV/AIDS Prevention: Successes and Challenges, Craig R. Waldo and Thomas J. Coates Afterword Sheldon Margen and Joyce C. Lashof Notes on Contributors Index

Using focus groups in rehabilitation nursing.

The purpose of this paper is to describe the research method of focus groups and give an example of how it could be used to advance rehabilitation nursing in the area of poststroke adaptation or recovery. Stroke is a leading cause of death and disability in elderly Americans. Although much is known about the physical effects and treatments of stroke, little has been published on the adaptive behaviors or recovery process of stroke survivors. The focus-group technique can provide an "insider's" view of the adaptive behaviors of stroke survivors and is a cost-effective way to generate rich qualitative data to guide nursing practice.

Lower Body Functioning as a Predictor of Subsequent Disability Among Older Mexican Americans

Disability measures among elderly non-Hispanic White populations have traditionally been associated with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). More recently, performance-based measures have increasingly been used to predict the onset of disability in initially nondisabled elderly populations. We used data from two waves (1993-94 and 1995-96) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (EPESE) to assess the degree with which lower mobility performance measures predict future disability in a representative sample of older Mexican Americans from the Southwestern United States. Performances on an 8-foot walk, repeated chair stands, and standing balance among nondisabled subjects at baseline were significantly associated with the onset of ADL and lower body disability 2 years later, controlling for age, gender, and the presence of medical conditions. The results were significant for each performance measure and for a measure combining all three. This study offers further evidence that performance-based measures of lower body function are able to predict future disability in older Mexican Americans, as has been found with other elderly populations. These measures were able to detect changes over a relatively short period of time (2 years). In addition, the study found that the short (8-foot) walk was the most sensitive measure in predicting future disability.

Functional Disability in Older Mexican Americans

Functional Disability in Older Mexican Americans

AIternative to Estroge Replacement Therapy for Preventing Osteoporosis

Osteoporosis is a leading cause of disability and death in older Americans; women are at higher risk than men. Bone is a living tissue that undergoes continuous remodeling throughout life. Several drugs-including sex hormones, bisphosphonates, calcitonin, and sodium fluoride-can arrest the progression of osteoporosis and prevent fractures. Calcium and vitamin D supplementation may prevent the development of osteoporosis in high-risk individuals and are useful adjuncts when used with other treatments.

Preemployment Physical Evaluation

There is a growing trend toward using preemployment tests to select employees for physically demanding jobs. Women are, in increasing numbers, entering physically demanding occupations that were traditionally dominated by men. Under current Federal employment law, it is illegal to disqualify an employee for a job because of race, color, religion, sex, national origin, and with the recent passage of the American Disabilities Act (ADA), handicap. Because of gender differences in strength, body composition, and VO2max, preemployment tests for physically demanding jobs tend to screen out more females than males. Employers are using preemployment tests not only to enhance worker productivity, but also to minimize the threat of litigation for discriminatory hiring practices and to reduce the risk of musculoskeletal injuries. The primary ergonomic methods used in industry to reduce the risk of back injuries are preemployment testing and job redesign. When a test results in adverse impact, the validity of the test must be established. Validity in this context means that the test represents or predicts the applicant's capacity to perform the job. Criterion-related, content, and construct validation studies are the means used to establish validity. The validity of preemployment hiring practices for physically demanding jobs has been decided in the courts. The most common reason for ruling an employment practice invalid is the failure to show that the test measured important job behaviors. Much of this litigation has involved height and weight requirements for public safety jobs. The courts have generally ruled that using height and weight standards as a criteria for employment is illegal because they were not job related. If fitness tests comprise part or all of the preemployment test, it is essential to demonstrate that the fitness component is related to job performance. Although there are many factors to consider when establishing a cut score, there is a growing trend toward establishing the cut score on the basis of the job's physical demands, defined by VO2max and strength. This literature is limited because most validation studies are not published. They more typically take the form of a technical report to the governmental agency or company that funded the project. There are published preemployment validation studies for outdoor telephone craft jobs involving pole-climbing tasks; firefighters; highway patrol officers; steel workers; underground coal miners; chemical plant workers; electrical transmission lineworkers; and various military jobs.

Physical disability in older Americans.

Physical disability in older Americans.

The American Disabilities Act

The American Disabilities Act

Public Library Buildings and the American Disabilities Act:

The American with Disabilities Act (ADA) became law in January, 1992. Six publications are reviewed here. The review deals principally with building accessibility issues contained in each publication.

The Americans with Disabilities Act and the Current State of U.S. Disability Policy

The passage of the Americans with Disabilities Act (ADA) reflects a new stage in American disability policy. However, important policy issues that pre-date the passage of ADA remain unresolved. The most important concern policy assumptions that have guided various disability income and medical assistance programs since their inception in the 1950s and 1960s. The most detrimental assumption is that, to be eligible for income or medical assistance, the impairment must be so hopeless that future prospects for work are impossible. This assumption is self-fulfilling and out of step with the policy assumptions that motivated the passage of the ADA. The article recommends six policy changes that will allow other portions of the nation's disability policy to function in harmony with the policy goals of the ADA.

Domestic Politics and International Expertise in the History of American Disability Policy

Architects of American disability policy partly emulated British and German social insurance programs through the New Deal's early years. Thereafter, social planners failed to tailor European manpower and income-maintenance programs to gain American lawmakers' approval. Distrust between the planners and legislators, intrafederal bureaucratic competition, congressional responsiveness to particular interests, and revitalized federalism all politically hindered Social Security from becoming a full-fledged social insurance program. Public/private-sector linkages, court actions, and voluntaryism constitute other salient American means of aiding persons with disabilities.

Disability evaluation: a fledgling science?

Although medicine and law often operate from incompatible bases, physicians must occasionally work with lawyers and in the process reconcile medicine to the legal world. Nowhere is this more evident than in disability evaluation. Indeed, explains Talmage G. Hiebert, PhD, MD, medical director of the American Disability Evaluation Research Institute (ADERI) and the National Association of Disability Evaluating Physicians (NADEP), Ann Arbor, Mich, while disability is a legal term, each year American physicians receive hundreds of thousands of requests to determine it. In fact, almost every physician at some point in his career will be called on to do so. But physician misunderstanding of disability evaluation is rampant, say Hiebert and others, and this in turn invites accusations of bias, lackeyism, and malpractice. Such misunderstanding has been plaguing groups like the American Academy of Compensation Medicine (AACM), the American Academy of Occupational Medicine, and the American Occupational Medicine Association for

Public Provision for the Mentally Ill in Colonial America

Previous articleNext article No AccessPublic Provision for the Mentally Ill in Colonial AmericaAlbert DeutschAlbert Deutsch Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Social Service Review Volume 10, Number 4Dec., 1936 Article DOIhttps://doi.org/10.1086/631925 Views: 7Total views on this site Citations: 1Citations are reported from Crossref Copyright 1936 The University of ChicagoPDF download Crossref reports the following articles citing this article:Laurel Daen Beyond impairment: Recent histories of early American disability, History Compass 17, no.44 (Apr 2019): e12528.https://doi.org/10.1111/hic3.12528