Health, Preventive Health Care, and Health Care Access among Women with Disabilities in the 1994–1995 National Health Interview Survey, Supplement on Disability

Baylor College of Medicine, Houston, Texas, United States
Women s Health Issues (Impact Factor: 1.61). 11/2006; 16(6):297-312. DOI: 10.1016/j.whi.2006.10.002
Source: PubMed


This study presents national estimates on the health, preventive health care, and health care access of adult women with disabilities. We compared women with 1 or 2 functional limitations (FLs) and > or =3 FLs with women with no FLs. Topics covered included demographic characteristics, selected reported health measures, selected clinical preventive services, and selected access to care indicators and health care coverage.
Estimates in this report were based on data from the 1994-1995 National Health Interview Survey, Supplement on Disability (NHIS-D). The sample size for women > or =18 years of age used in producing the estimates from the combined 1994 and 1995 NHIS-D was 77,762.
An estimated 16% of women > or =18 years of age had difficulty with at least 1 FL. Women with FLs were less likely to rate their health as excellent or very good and more likely to report their health as fair or poor when compared with women with no FLs. Women with FLs were also more likely to report being a current smoker, having hypertension, being overweight, and experiencing mental health problems. Among women > or =65 years of age, those with FLs were also less likely to have received Pap smear tests within the past year and those with > or =3 FLs were less likely to have received mammograms within the past year than women with no FLs. Women with > or =3 FLs were more likely to report being unable to get general medical care, dental care, prescription medicines, or eyeglasses, regardless of age group, compared with women with no FLs. The main reasons reported for being unable to receive general care were financial problems or limitations in insurance. These findings suggest that increased attention to the health care needs of women with disabilities from researchers, clinicians, and public health professionals is warranted.

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    • "Healthcare worker attitudes and knowledge toward women with a disability have been additional reported barriers. Many healthcare workers ignored the importance of recommending preventive health screening, such as mammograms and Pap tests, to women with a disability, particularly older women (Chevarley et al., 2006; Yankaskas et al., 2010). While Rivera Drew and Short (2010) did not find substantial evidence in their study that women with disability were less likely to receive recommendations for cervical cancer screening, they did report that these women were more likely to underuse the service, with approximately a third citing cost and lack of insurance as major deterrents. "
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    ABSTRACT: This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and papers not meeting the eligibility criteria, 25 papers were systematically and critically reviewed. Socio-demographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, healthcare workers and physical barriers. Socio-demographic, health insurance, health workers and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in healthcare, rather than being marginalized because of their disability.
    Women & Health 09/2015; DOI:10.1080/03630242.2015.1086463 · 1.05 Impact Factor
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    • "Most findings relating to mammography and breast cancer care disparities come from large population-based surveys or cancer registry data, without sufficient detail to identify specific causes(Chan et al., 1999; Chevarley et al., 2006; Iezzoni et al., 2000; Iezzoni et al., 2001; Iezzoni et al., 2008; McCarthy, Ngo, Roetzheim, Chirikos, Li, Drews, & Iezzoni, 2006a; Wei et al., 2006). To explore how physical access affects breast cancer diagnosis and treatment experiences, we conducted in-depth, individual interviews with 20 women with chronic mobility impairments who developed early stage breast cancer. "
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    ABSTRACT: To explore the perceptions of patients with breast cancer with mobility impairments of the physical accessibility of healthcare facilities and equipment. Individual audiotaped interviews lasting one to two hours. Interviews in homes or workplaces or by telephone. 20 women with chronic mobility impairments who developed early-stage breast cancer prior to age 60. Three were recruited from oncologist panels and 17 from informal social networks of disabled women nationwide. Qualitative analyses of interview transcripts to identify common themes. Extent and nature of mobility impairments and concerns raised by patients about barriers to care. The 20 participants identified issues with inaccessible equipment, including mammography machines, examining tables, and weight scales. The patients sometimes needed to insist on being transferred to an examining table when physicians preferred to examine them seated in their wheelchairs. When staff would transfer them, patients feared injury or felt badly when clinical personnel were injured during transfers. Other issues included difficulties with positioning and handling patients' uncontrollable movements. Even when clinical sites had accessible equipment, this equipment was sometimes unavailable for the appointment. Women with major mobility issues who developed breast cancer confronted numerous physical barriers during the course of their breast cancer diagnosis and treatment. With the aging of the baby boomer generation, an increasing number of people with mobility impairments will be seeking healthcare services. Healthcare providers should be proactive in planning to accommodate these patients by considering accessibility whenever they acquire new equipment, renovate older structures, or build new facilities. They also should establish policies and procedures to ensure that equipment is available during appointments of patients with mobility issues and that staff are trained in safe transferring procedures. Ensuring accommodations and accessibility will benefit patients with impaired mobility and clinical staff.
    Oncology Nursing Forum 11/2010; 37(6):711-7. DOI:10.1188/10.ONF.711-717 · 2.79 Impact Factor
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    • "Investigating associations between our measure of activity space and participation in cervical screening Health studies previously identified the link between functional limitation in daily activities and health services consumption in the elderly (Avlund et al., 2001; Chaix et al., 2005b; Fernandez-Mayoralas et al., 2000). With no age restrictions, a number of North American studies have also shown that women with reduced mobility are significantly less likely to avail themselves of cervical and breast cancer screening on a regular basis (Chevarley et al., 2006; Cooper and Yoshida, 2007; Iezzoni et al., 2000; Nosek, 1998). In this research, a similar association in the Paris metropolitan area was observed, too, as women with a severe functional limitation had a greater likelihood of delayed cervical screening (Table 3). "
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    ABSTRACT: Estimates from multilevel regression of 1768 women living in the Paris metropolitan area showed that women who reported concentrating their daily activities in their perceived neighbourhood of residence had a statistically greater likelihood of not having undergone cervical screening during the previous 2 years. Furthermore, the characteristics of the administrative neighbourhood of residence (such as the practitioner density or the proportion of residents with a recent preventive consultation) had a statistically greater impact in terms of delayed cervical screening on women who concentrated the vast majority of their daily activities within their perceived neighbourhood of residence than among those who did not. The residential environment might promote or damage, to a greater extent, the health behaviour of people whose daily activities are concentrated within their perceived neighbourhood, since we can assume that their exposure to their neighbourhood characteristics is stronger. It could thus be useful to study more often the combined effects of activity space and neighbourhood of residence on participation in preventive health-care activities.
    Health & Place 04/2010; 16(5):838-52. DOI:10.1016/j.healthplace.2010.04.009 · 2.81 Impact Factor
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