Disability disparities: a beginning model.
ABSTRACT 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.
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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. · 4.31 Impact Factor
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ABSTRACT: To examine the adequacy of existing service systems in addressing the needs of refugees with disabilities resettled in the U.S.A. A cross-disability group of eight Cambodian and seven Somali refugees were purposively selected to participate in a 2-year qualitative study in the Midwestern U.S.A. Ten disability/refugee service providers and key experts on refugee resettlement were also recruited to participate. Data sources included in-depth interviews, focus groups, participant observations and social network surveys with disabled refugees. Participant observations and semi-structured interviews were also conducted with service providers and key experts. Data were analyzed using coding procedures based on a grounded theory approach. Disabled refugee participants experienced several unmet disability-related needs and limited access to resettlement resources on account of their disability. These findings were associated with refugee service providers having limited awareness of disability rights and resources and a narrow biomedical perspective of disability. Additionally there was a disconnection between refugee and disability service systems resulting from resource limitations within agencies, mistrust between the different service entities, and a lack of cross-cultural nuance among disability service organizations. These findings contribute important insights to the literature on disability disparities. Disabled refugees resettled in the U.S.A. have many unmet needs associated with gaps in-service delivery stemming from disconnections between refugee and disability service systems.Disability and Rehabilitation 01/2012; 34(7):542-52. · 1.54 Impact Factor