HEALTH
PROMOTION—General Information
Interventions
Return to Health Promotion
Highlights
Women with disabilities face numerous barriers to getting good preventive health care services.
For
more general information on the ability of women with disabilities to obtain
health care, please click here.
For more information on breast and
cervical cancer screening, please click here.
Wellness programs for non-disabled women often have equipment or architectural barriers
that prevent women with disabilities from participating.
It
is increasingly recognized that women with disabilities are an underserved
population in health promotion efforts despite their great need for these services.
For years, people with disabilities or chronic health conditions were not
considered suitable candidates for health promotion efforts because the
emphasis in public health was to prevent disability, disease, or infirmity.
Today, the focus of public health is shifting from disability prevention to
promotion of health.
Unfortunately,
wellness programs for women in the general population are often not designed
with consideration to women with physical disabilities. Women with disabilities
frequently have combined barriers to participation by virtue of being female
and being disabled. For example, women with disabilities, like other women, are
often caregivers for children or older adults, and they may have difficulties
in participating in wellness programs due to difficulty in finding or affording
daycare services.
Women with disabilities may also
have structural, interpersonal, or policy barriers related to their disability.
Health promotion activities that are held in inaccessible clinics, fitness
centers, or other settings may present significant barriers to the
participation of these women. Programs that use health educators or fitness
professionals who have received little training in exercise prescriptions for
women with disabilities may be of little benefit to them, and women with
disabilities may be reluctant to use their services. Furthermore, the cost of fitness centers,
psychological counseling, weight management services, and other health promotion
resources is often prohibitive for women with disabilities, who may be on fixed
incomes.
Programs aimed at increasing
screening rates and preventive services may also overlook women with
disabilities. Community health promotion recruitment methods oriented towards
the general population may not reach women with disabilities, and physicians
may not provide these services. Additionally, mammography equipment and exam
tables are frequently inaccessible to women who are unable to stand or
walk.
It is not surprising, then, that
some researchers have found that women with mobility impairments report lower
cervical and breast cancer screening rates and physician smoking inquiries than
other women. Women with multiple sclerosis report low rates of pelvic
examinations, Pap smears, mammograms and bone density screening.
Health promotion researchers and
researchers who are designing interventions should consider whether women with
disabilities are being excluded from their programs. Women with disabilities
can be excluded from health promotion and wellness programs in ways that
researchers and health educators may not easily recognize. Therefore, holding
focus groups with women with various types of disabilities and discussing these
issues with key members of the disability community is necessary to help health
promotion professionals better identify ways to improve the design of the
intervention or the setting in order to be more inclusive of this population.
Members of the disability community and disability advocates will welcome the
opportunity to assist health promotion professionals in this endeavor.
Several new wellness programs have been developed to help
women with disabilities develop health promoting behaviors.
Health promotion intervention programs
may help prevent or ameliorate secondary health conditions among women with
physical disabilities. To date, a handful of wellness programs have been
developed and tested for women with physical disabilities.
Researchers have tested wellness
interventions for women with multiple sclerosis, polio, sickle cell anemia,
mobility impairments, and a variety of physical disabilities. These studies
have demonstrated generally quite positive results. Participants have increased
healthy behaviors after completion of these studies, such as improved level of
physical activity, healthy nutrition behaviors, and relaxation or
stress-reduction behaviors. Some studies have also found that women were able
to decrease their stress and depression, increase their self-efficacy or
confidence for health behaviors, increase social activities, and demonstrate
improvements on indicators of physical and general health. However, researchers
have documented continued barriers to participation in health promotion
activities for these women.