Women with Disability

by CDC

As many as one in five women in the United States are living with disabilities. Disability is a broad term that encompasses a sizable range of conditions and diseases. It refers generally to a limitation in physical or mental function caused by one or more health conditions. Depending on the definition used, 19.9 to 28.6 million U.S. women have disabilities - and the number is growing.

As many as one in five women in the United States are living with disabilities. "Disability" is a broad term that encompasses a sizable range of conditions and diseases. It refers generally to a limitation in physical or mental function caused by one or more health conditions. Depending on the definition used, 19.9 to 28.6 million U.S. women have disabilities - and the number is growing.

Women are more frequently affected by many of the conditions that cause disability, and well over half of all women older than 65 are living with a disability. The most common are associated with chronic conditions such as back disorders, arthritis, heart disease, respiratory problems, and high blood pressure. Disabilities may also result from injuries or birth defects.

Women who experience disability from a large and important group of people who can benefit from public health efforts, according to JoAnn Thierry of the Centers for Disease Control and Prevention's disability and health team. In addition to the same health concerns as nondisabled women, women with disabilities have conditions that make them more vulnerable to a range of secondary conditions such as pain, fatigue, osteoporosis, obesity, and depression. CDC's disability and health team has targeted women with disabilities as a major area of emphasis and works to promote their health and well-being through research, partnerships, and education. CDC funds projects around the United States to improve surveillance and promotes research that focuses on women with disabilities as a special subpopulation.

Breast Cancer Screening

Getting screening exams for early detection of breast and cervical cancer can be a challenge for many women with disabilities.

They are as likely to be at risk for cancer as other women. But CDC studies have shown that women with functional limitations are less likely to have regular mammograms and Pap tests to screen for breast and cervical cancer.

Women with disabilities face many barriers to regular screening. They may have difficulty getting to the doctor's office, undressing for an exam, raising their arms for self-exams, mounting a traditional examination table, standing, or positioning their wheelchairs for mammograms.

The Breast Health Access for Women with Disabilities program highlights some ways to make it easier for women with disabilities to get a mammogram. At Alta Bates Summit Medical Center in Berkeley, California, a nurse specialist provides free clinical breast exams and breast self-exam education. The exam room is accessible, with attendants to help transfer patients to a multi-positioning exam table. Women are referred to mammography services that accommodate women who use wheelchairs or have difficulty standing. Medical staff are trained to be sensitive to disability issues, and staff coordinate transportation for those who need it. The program has also developed techniques to teach women with cognitive disabilities or limited hand functionality to perform breast self-exams

Access to Health Care

Good access to health care is particularly important for women with disabilities because they often have other health concerns in addition to their disabilities. Yet women with disabilities face many barriers to care, often simply because people haven't thought about the problems they may encounter. Women with disabilities may not receive regular medical care because of barriers in the physical environment or the attitudes and perceptions of health-care providers.

The Americans with Disabilities Act requires public buildings to be accessible to people with disabilities, and health-care facilities are held to a high standard under the Act. ADA requires medical offices to have:

• Accessible parking, ramps, and rails for getting in and out of buildings
• Restrooms large enough for wheelchairs

Other universal design features not required by law but more welcoming to women with disabilities include:

• Lower reception counters to greet women in wheelchairs
• Scales that accommodate people who use wheelchairs or have difficulty standing without support
• Motorized, adjustable-height examination tables

Perhaps just as important, medical and office staff need to have training on basic rules of disability etiquette and how to best communicate with and assist women with various disabilities. A few examples:

Offer assistance to a person with a disability if you wish, but wait to see if your offer is accepted and listen to any instructions about the best way to help. Don't touch a person's equipment without asking first.

Speak directly to a person with a disability rather than through someone accompanying her. Identify yourself and others who may be with you when you greet a person with vision impairment. Look directly at a person with hearing loss and speak slowly, clearly, and expressively.

Take time to be sure people with cognitive disabilities understand you. Use simple words and add gestures. You may need to write down information or draw a simple picture.

Think About It

Part of CDC's challenge is to raise awareness about including women with disabilities in research and ensuring they are a target audience for health promotion activities. A study on heart disease, for example, might include women with disabilities and document their incidence of heart conditions so it may be compared with that of women without disabilities. A public service announcement about breast cancer screening might include a woman getting a mammogram in a wheelchair. And a brochure encouraging physical activity could include information on exercise for women with physical limitations.

Thierry stresses the importance of working collaboratively with women with disabilities to ensure they are active participants in all phases of CDC's research projects.

"I don't think people intentionally exclude women with disabilities from their programs," she said. "They just don't think about including them."

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.