key: cord-0029290-lekdl02e
authors: Swenor, Bonnielin K
title: Including disability in all health equity efforts: an urgent call to action
date: 2021-05-26
journal: Lancet Public Health
DOI: 10.1016/s2468-2667(21)00115-8
sha: f24e286d93c6e2546685dde94c78c8fbd0f5a4ba
doc_id: 29290
cord_uid: lekdl02e

nan

Including disability in all health equity efforts: an urgent call to action Globally, over 1 billion, or one in seven people, have a disability. 1 This estimate highlights that the disability community is one of the largest minority groups in the world, and people with disabilities are part of all of our communities.

Although disability is common, health disparities remain largely unaddressed for this population. People with dis abilities are more likely to be denied health care than people without disabilities, and face unique barriers and stigma when accessing health care. [1] [2] [3] In part, these persistent inequities are fuelled by an antiquated view of disability as the antithesis of health. As a result, most public health and medical research efforts are focused on prevention and treatment of disabilities. While efforts to prevent and treat diseases and conditions will always be important and necessary, this myopic focus perpetuates stigma, ableism, and inequities for the disability community. Research aimed at maximising the health and inclusion of people with disabilities is crucial.

The COVID-19 pandemic has magnified the urgent need for disability to be viewed through a lens of health equity. Historical data gaps, such as the paucity of data on disability collected within public health systems and health-care settings, have prevented accurate tracking of the effect of COVID-19 among the disability community. 4 The absence of health equity data among the disabled community is often viewed as an absence of inequities, which has led to oversights in the pandemic response for this group. Instead, these data gaps represent the exclusion of people with disabilities from data collection efforts and reflect a deep social injustice that perpetuates health inequities. Without disability data, it is impossible to create inclusive evidence-based policies and strategies.

The future of health equity research and policy must be holistic and intersectional, and must include disability. Barriers from many root causes can derail the path to achieving equity. People with disabilities can face similar types of systemic barriers to health as women, racial and ethnic minorities, and individuals from the lesbian, gay, bisexual, transgender, and queer com munity, including stigma and discriminatory policies. 5 But additional challenges exist in access and accessibility that are unique to the disability community, such as physical barriers and gaps in accessibility of communication and information. Until people with disabilities are included in all efforts to advance health equity, we will fall short in reaching this goal.

The inclusion of researchers with disabilities must also be part of the solution. Including researchers from diverse backgrounds enriches our pub lic health efforts and expands our research focus; 6 researchers with disabilities are no diff er ent and must also be included as core members of all diversity, equity, and inclusion initiatives. This inclu sion ranges from includ ing students and trainees with disabilities in div ersity pro grammes, addressing barriers to career advance ment for faculty and researchers with dis abilities, and ensuring institutional policies support disability inclusion. [7] [8] [9] As the pandemic seems to begin to wane in some areas around the world, a focus on health equity is paving the path to recovery. Now is the time to expand the scope of health equity to include everyone in our communities, including people with disabilities. This urgent call to action will require many to re-examine their views of disability and acknowledge that ableism is a formidable threat to health equity. Including people with disabilities in all health equity efforts is the first step, and this work must begin with public health.

Geneva: World Health Organization

Prevalence of disabilities and health care access by disability status and type among adults -United States

Physicians' perceptions of people with disability and their health care

Disability and COVID-19: who counts depends on who is counted

Health inequities, social determinants, and intersectionality. NAM Perspectives

The Editors of the Lancet Group. The Lancet Group's commitments to gender equity and diversity

Disability inclusion -moving beyond mission statements

Global commitments to disability inclusion in health professions

The unexamined diversity: disability policies and practices in US graduate medical education programs