Accessibility: Closing the Health Equity Gap

For science.
In the United States, 61.4 million adults (26% of the population) live with a disability. Disability is especially common in tribal communities, where 2 in 5 non-Hispanic American Indians/Alaska Natives live with a disability. Because of cost, more than 37% of adults with disabilities have been unable to access primary and regular preventive care. Delayed care puts adults living with disabilities at greater risk to have other health issues like heart disease (11.5% versus 3.8% of adults without disabilities) and diabetes (16.3% versus 7.2%). Access to care is also affected by access to health insurance. In 2020, 28 million people in the U.S. lacked any type of health insurance.

For action.
We can work together to improve the health of people living with disabilities and other marginalized groups by reducing health disparities in health insurance, increasing physical accessibility to care, increasing availability of appropriate care, building more inclusive public health programs and promoting healthy living. Encourage your representatives in Congress to support health equity legislation to reduce the inequities racial and ethnic minorities face. Urge your representatives to strengthen public health infrastructure and support investments in the Build Back Better Act to expand access to comprehensive and affordable health coverage and protect the public from threats associated with climate change.

For health.
Under the Affordable Care Act, uninsured rates have dropped. In 2008, only 83.2% of people younger than 65 reported having medical insurance, but by 2014, the insured rate went up to 86.7%. The Healthy People 2030 initiative has allowed us to monitor public health data and address issues within our most vulnerable populations and put evidence-based policies and programs in place to create a healthier nation. The Boston Center for Independent Living is an example of breaking down barriers to health care access for people with disabilities — how our actions can gain traction for more widespread change. We can see how we have created positive changes in our nation’s health over time.

Where you are.
Efforts to address climate change must focus on the historically redlined, urban neighborhoods where the population is largely Black, Indigenous and other people of color. Such communities have less access to green spaces, cooling centers and clean air and are more likely to suffer from climate gentrification. Expanding public health training to include both cultural competence and disability competence is one way to affect the availability and quality of care people receive. And because our community systems contribute to our health and quality of life just as much as our medical care system, strengthening community organizations that provide preventive physical and mental health care services, catering most specifically to people with disabilities, students and unhoused individuals, is supplemental to improving community health, increasing health education and bringing health care to where people are.

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