This paper presents a model of disability disparities. Though the concept of health disparities is discussed in the health care literature, there is no such model that explicitly addresses disparities in the disability literature. Therefore, this model begins to fill a void in the disability literature. Part of the value of such a model is that it represents an attempt to address the question of why cultural competency is important in the disability arena at this point in the 21st century. The urgency in addressing cultural competency at this time in history is supported by understanding the multiple accountability demands on rehabilitation and disability providers these days, e.g., increasing diversification of the United States population, that render providing effective services to everyone a clear mandate. The author provides a working definition of disability disparity. The disability disparity model is described in terms of its five-domain continuum as well as its macro- and micro-level aspects that are designed to both promote clarity of the concept for researchers and offer practitioners ideas on how to explore the existence of disability disparities in working with specific service recipients. Limitations and strengths of the model are discussed along with suggested next steps in model validation.
"It is evident that rehabilitation professionals need to place more rigorous attention on the specific needs of minorities during treatment planning and service delivery to optimize short and long-term employment outcomes. Lewis  "
[Show abstract][Hide abstract] ABSTRACT: Employment outcomes of racial and ethnic minority groups with traumatic brain injury (TBI) have not been thoroughly examined in the research literature beyond five years. The objective of this study was to examine differences in employment outcomes 10 years after TBI among racial and ethnic minorities. Using a multi-center, nationwide database, 382 participants (194 minorities and 188 whites) with primarily moderate to severe TBI from 16 TBI Model System Centers were examined. A logistic regression model indicated that the odds of being competitively employed versus not competitively employed at 10 years follow-up were 2.370 times greater for whites as compared to minorities after adjusting for age at injury, pre-injury employment status, cause of injury, and total length of stay (LOS). In addition, the odds of being competitively employed at 10 years follow-up versus not being competitively employed ranged from being 1.485 to 2.553 greater for those who were younger, employed at injury, had shorter total LOS, and non-violent injuries, respectively. This study supports previous research illustrating that compared to whites, employment is less promising for minorities after TBI both short and long term. Recommendations are suggested to help rehabilitation professionals target the specific needs of minorities with TBI in order to address employment disparities through culturally-based interventions and service delivery.
Journal of Vocational Rehabilitation 01/2010; 33(1). DOI:10.3233/JVR-2010-0516
[Show abstract][Hide abstract] ABSTRACT: (1) To compare the odds of competitive employment versus not competitive employment among a group of white, African American, and Hispanic persons with spinal cord injury (SCI) at 1, 5, and 10 years after injury; (2) to examine the changes in the odds of competitive employment versus not competitive employment over time within each racial/ethnic group, and (3) to compare the changes in the odds of competitive employment versus not competitive employment over time between the racial/ethnic groups.
Model SCI systems.
A total of 11,090 persons with SCI (7735 whites, 2381 African Americans, and 974 Hispanics), between ages 18 and 55 years, enrolled in the National Spinal Cord Injury Statistical Center database.
Employment status dichotomized as competitively employed versus not competitively employed.
The odds of being competitively employed at 1, 5, and 10 years after injury were 1.58, 2.55, and 3.02, times greater for whites than African Americans and 1.71, 1.86, and 1.71, respectively, times greater for whites than Hispanics. At 10 years after injury, the odds of being competitively employed were 1.77 times greater for Hispanics than for African Americans. Persons of all races/ethnicities and with SCI showed significantly greater increases in the odds of being competitively employed versus not competitively employed over time (1-5 years, 1-10 years, 5-10 years after injury); however, whites and Hispanics had greater increases in the odds of competitive employment over time compared with African Americans.
Regardless of race, short- and long-term employment outcomes were not favorable for persons with SCI; however, African Americans and Hispanics fared worse in employment outcomes compared with whites. Rehabilitation professionals should work to improve employment outcomes for all individuals with SCI, with special emphasis on addressing specific needs of African Americans and Hispanics.
[Show abstract][Hide abstract] ABSTRACT: This study examines the relationship between race and mobility over 5 years in initially well-functioning older adults and evaluates how a broad set of socioeconomic status indicators affect this relationship.
Data were from 2,969 black and white participants aged 70-79 from the Health, Aging, and Body Composition study. Mobility parameters included self-reported capacity to walk a quarter mile and climb 10 steps and usual gait speed. Incident mobility limitation was defined as reported difficulty walking a quarter mile or climbing 10 steps at two consecutive semiannual assessments. Gait speed decline was defined as a 4% reduction in speed per year.
At baseline, even though all participants were free of mobility limitation, blacks had slower walking speed than their white counterparts, which was not explained by poverty, education, reading level, or income adequacy. After 5 years, accounting for age, site, and baseline mobility, blacks were more likely to develop mobility limitation than whites. Adjusting for prevalent conditions at baseline eliminated this difference in women; controlling for education eliminated this difference in men. No differences in gait speed decline were identified.
Higher rates of mobility loss observed in older blacks relative to older whites appear to be a function of both poorer initial mobility status and existing health conditions particularly for women. Education may also play a role especially for men.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2011; 66(10):1114-23. DOI:10.1093/gerona/glr102 · 5.42 Impact Factor
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