The Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities

Vision for the Future

Principle

Good health is necessary for persons with disabilities to secure the freedom to work, learn and engage in their families and communities.

Goals

GOAL 1: People nationwide understand that persons with disabilities can lead long, healthy, productive lives.

GOAL 2: Health care providers have the knowledge and tools to screen, diagnose and treat the whole person with a disability with dignity.

GOAL 3: Persons with disabilities can promote their own good health by developing and maintaining healthy lifestyles.

GOAL 4: Accessible health care and support services promote independence for persons with disabilities.

The health and wellness of persons with disabilities today is a matter of public health concern. As this Call to Action suggests, what is called for are better approaches to new knowledge, new technologies and new systems of services that emphasize a team approach and partnerships with persons with disabilities themselves. What is needed are health care providers who see and treat the whole person, educators willing to teach about disability, a public that sees beyond the disability to see a whole person, and a community that provides accessible health and wellness services for persons with disabilities.

With the four goals as a guide, this section of the Call to Action identifies specific challenges that must be overcome to realize the principle that with good health, persons with disabilities have the freedom to work, learn and engage actively in their families and their communities. The challenges are present in all aspects of health care and service delivery for persons with disabilities. They include such concerns as an inadequately trained and educated health care and services workforce, and a health care and health promotion service system that is limited in access or availability to persons with disabilities.

This section also suggests strategies for action and research priorities that can lead to improved interaction, communication and cooperation of the health care system and related services with persons with disabilities. Taken together, they represent ways in which the individual objectives and, ultimately, the goal of this Call to Action can be realized for 54 million Americans who, today, are living with a disability.

GOAL 1: People nationwide understand that persons with disabilities can lead long, healthy, productive lives.

Challenges

Misperceptions persist that disability is the equivalent of poor health.
The lack of uniformity in the use of the term “disability” affects public knowledge and understanding about the health and wellness needs of persons with disabilities.
This incomplete public understanding of disability often means that the needs of persons with disabilities are often overlooked when decisions about community adaptations, health and service delivery and public policy are made.

Strategies

Promote the use of language to describe persons with disabilities that emphasizes the individual, not the disability first. This use of “people first” language that refers to persons with disabilities recognizes that individuals with disabilities are—first and foremost—persons with inherent value, individuality, dignity and capabilities and helps raise awareness of and reduce stigma and discrimination against persons with disabilities.
Consider health literacy when making health and wellness information about persons with disabilities available to the public.
Enhance understanding and acceptance of persons with disabilities of all ages nationwide by improving the content and dissemination of educational information in community programs, schools, faith-based programs, workplaces and at home about how persons with disabilities can lead long, healthy lives.
Encourage the entertainment industry to increase its portrayal of realistic characters with disabilities and their challenges and successes in maintaining good health.
Encourage the print and electronic media to increase coverage of disability-related issues and expand current health and wellness reporting to include ramifications for persons with
Continue to include age and specific disability status as demographic indicators in health surveys or surveillance systems.
Encourage persons with disabilities to join as partners in public health initiatives and include them on advisory committees as services are being planned by federal, state, tribal and local governments.

GOAL 2: Health care providers have the knowledge and tools to screen, diagnose and treat the whole person with a disability with dignity.

Challenges

Due to insufficient ongoing education and training for health care professionals and wellness service providers, the needs of persons with disabilities are often overlooked when decisions about community adaptations, health and service delivery and health care policy are made.
Health and other community-based support services are insufficiently integrated to meet the needs of the ‘whole person’ and not just the disabling condition.
Insufficient attention is paid by the health care system on the prevention of secondary conditions in persons with disabilities, specifically the prevention of important conditions such as obesity, type II diabetes, depression and substance abuse.

Strategies

Encourage health care and wellness service providers to relate to persons with disabilities in ways that recognize their value, dignity and capabilities, whether communicating in person, electronically, or in writing.
Educate health care providers of persons with disabilities in an ongoing manner about state-of-the-art health services and supports that should be available to the patients with disabilities.
Ensure that both clinical and health services research include persons with disabilities across the life span, particularly in areas in which health disparities in risk, access and outcome exist
Increase in an ongoing manner health care provider awareness of and compliance with laws designed to protect the rights of individuals with disabilities.
Identify currently available disability-oriented training curricula and programs for health care providers, assess if the training curricula are evidence-based and delineate the next steps necessary to advance the adoption of evidence-based training curricula focused on persons with disabilities in professional and other service provider training and continuing education.
Promote development and use of medical equipment and devices that allow universal access to all recommended screening and diagnostic tests and treatments.
Enhance and broaden the content and expand the use of educational and training materials for health care providers that focus on the health care and wellness needs of persons with disabilities, including secondary conditions
Create a series of provider handbooks that include best practices and current resources to educate health professionals and service providers about the value of wellness promotion for persons with disabilities.
Promote practical experiences with persons with disabilities in health and service provider training and continuing education. Include in this training information regarding civil rights and disability, including the health care ramifications of the Americans with Disabilities Act.
Promote researcher experiences with persons with disabilities in health care research training programs.
Promote the development of research to enhance the evidence base for best practices in clinical service delivery for persons with disabilities.
Promote interdisciplinary collaboration in scientific pursuits and to improve clinical research networks to advance better prevention, early diagnosis and treatment of disabilities and secondary conditions.
Analyze the content and diffusion of information about persons with disabilities that is used in health care settings.

GOAL 3: Persons with disabilities can promote their own good health by developing and maintaining healthy lifestyles.

Challenges

Misperceptions exist regarding the positive role wellness promotion can play for persons with disabilities.
Policy and infrastructure emphasis continues to be placed on both acute illness and on the acute elements of disability rather than on prevention and health maintenance for persons with disabilities.

Strategies

Conduct health research to identify and support effective health promotion programs for persons with disabilities.
Educate persons with disabilities, their families and advocates in an ongoing manner about state-of-the-art wellness and prevention activities.
Consider health literacy when making health and wellness information accessible to persons with disabilities.
Provide increased health promotion and wellness training opportunities specifically for persons with disabilities, their family members, personal attendants and advocates, ensuring that both focus on the whole individual and not just the disability.
Encourage health systems to use all media, computer-based, internet and other adaptive or assistive technologies when planning and developing health information for persons with disabilities. Encourage them to include materials that will be accessible to individuals with limited English proficiency.
Include persons with disabilities in all stages of health care and wellness promotion communication research, including formative research, message development and testing, identification of appropriate communication strategies and channels and evaluations of effectiveness.
Identify evidence-based best practices for health promotion among persons with disabilities by developing, implementing, evaluating and disseminating strategies to translate into practice the results of research.

GOAL 4: Accessible health care and support services promote independence for persons with disabilities.

Challenges

Persons with disabilities may have difficulty getting to health care providers, getting in and getting around the service setting, being able to benefit from health care equipment in the service setting, and communicating with the health care provider and staff about their health needs and concerns.
Insufficient numbers of health care services programs have the tools, skills and capacities to meet the full range of health care and wellness needs of persons with disabilities.

Strategies

Develop and implement surveys to assess the full range of health needs of persons with disabilities, including whether and how those needs are being met by providers and facilities in communities nationwide
Advance accountability by all health service delivery programs, including clinical and community preventive services, to ensure that persons with disabilities have full access to their services.
Bring inventors, clinicians and industry together through more effective incubator and development programs to collaborate efficiently and effectively to enhance research and development of assistive technology for all types of disabilities.
Encourage research efforts that collaborate and partner with integrated community-based provider networks to include individuals with disabilities in those efforts.
Continue to develop community-based, public-private partnerships to facilitate coordinated, integrated care of persons with disabilities. Include collaboration with transportation, education and wellness providers. Include communication between all providers and the disability community about the benefits of wellness resources.
Encourage the development of integrated, multidisciplinary service teams to provide one-stop health care for persons with disabilities.
Encourage or develop partnerships to facilitate coordinated, integrated care for populations identified as traditionally underserved, including persons with disabilities who are members of racial or ethnic groups.
Promote and disseminate the adoption of new treatments, models of care and adaptive or assistive technologies (for example, making available specialized, adaptive cognitive and psychiatric research applications of assistive technology for individuals with communication deficits as well as a mental disorder).
Identify key elements of best practices in health service delivery for persons with disabilities and, among existing health service delivery programs for this population, identify highlighted models that are using the key element and assess why they are successful.
Identify and implement in community-based care evidence-based best practices in health service delivery for persons with disabilities.

Last revised: January 4, 2007