Health and Disability Flashcards
The Burden of Disability
Disability is part of the human condition. Almost everyone will be temporarily or permanently impaired at some point in their life, and those who survive to old age will experience increasing difficulties in functioning.
Disability is not a health condition or an impairment itself, but rather the result of the interaction between an individual with an impairment and his or her environment.
Classification of Disability
Disability refers to problems with any one or more of these three categories:
1. Impairment - problems in body function or alterations in body structure
2. Activity limitation - difficulty in executing activities
3. Participation restrictions - problems with involvement in any area of life
Health conditions that lead to disability include any number of physical, mental or sensory impairments. They can be congenital or acquired, and when acquired can result from illness or injury. They can be transient, persistent or pregressive. Disability depends on the experience of the individual - the course of their condition and the context of his or her life.
Paradigm Shift in Disability
In recent decades there has been a move away from a medical understanding towards a social understanding. Disability arises from the interaction between people with a health condition and their environment.
The Convention on Rights of Persons with Disabilities reflects this emphasis on removing environmental barriers which prevent inclusion.
Disability on a Scale
Disability can exist as neither a purely medical or purely social problem. Persons with disabilities can often experience problems arising from their health condition, as well as problems arising from society.
A balanced approach is needed, giving appropriate weight to the different aspects of disability.
Disability Prevalence
Is high and growing.
There are over 1 billion people with disabilities in the world, of whom 110-190 million experience very significant difficulties. This corresponds to about 15% of the world’s population.
Disability is Disproportionate
Disability is disproportionate on who it affects. It more commonly occurs in women, older people, and households that are poor.
Lower income countries have a higher prevalence of disability than higher income countries.
Disability is Diverse
Disability experience varies greatly. Not all people with disabilities are equally disadvantaged.
Mental health or intellectual impairments are oftne the worst.
Disabilities and Healthcare Access
People with disabilities face widespread barriers in accessing services such as health, education, employment, transportation, as well as information.
These can include inadequate policies and standards, negative attitudes, lack of service provision, inadequate funding, lack of accessibility, inadequate information and communication and lack of particupation in decisions that directly affect their lives.
Even after physical barriers have been removed, negative attitudes can produce barriers in all domains. To overcome the ignorance and prejudice surrounding disability, education and awareness-raising are required.
Capacity vs Performance
Capacity indicates what a person can do in a standardized environment, often a clinical setting, without the barriers or facilitators of the person’s usual environment.
Performance indicates what a person does in the current or usual environment, with all barriers and facilities in place.
Disabilities and Outcomes
People with disabilities have worse health and socioeconomic outcomes. Across the world, people with disabilities consistently display poorer health, lower educational achievement, less economic particupation and higher rates of poverty than people without disabilities.
People with disabilities have ordinary needs - for health and well-being, for economic and social security, to learn and develop skills, and to live in their communities.
Ableism
Basically to discriminate in favour of able-bodied people. It is the social prejudice that views “normal” as right and “non-normative” as abnormal, abhorrent or wrong.
The result is the favouritism of certain abilities and pressure on those who don’t measure up to either adapt (strive to be normal) or exist in a sub-standard, less than fully human state.
Future Shock and Enhancement Medicine
The aim of a physician is to sometimes heal, often relieve, and always console the patient.
Consolation is done particularly with an eye to the “burden” that the disabled individual placed on family or caregivers. Consolation can take the form of prenatal screening and abortion.
Relieving may be done with psychiatry and cultural changes to accessibility.
Heal is done by using programs such as cardiac rehab programs, or cochlear implants.
Accident Prevalence
Leading cause of death in people ages 1-35
Still significant in the 35-54 age group
Haddon’s Matrix
Used for injury or disease prevention…
Pre-event: Try to prevent the marshalling of energy, reduce the amount of energy, prevent the release of energy, and seperate the host from the agent.
Event: Modify the rate and distribution of release, insulate the host from the agent, modify the interaction between host and agent, and strengthen the resilience of the host.
Post-event: Hasten the response, and repair and rehabilitate the host.
