According to Lisa Iezzoni, MD, Professor of Medicine and Director of the Institute for Health Policy at Harvard Medical School, discrimination against people with disabilities stretches back thousands of years in human history.
They "have been discriminated against, stigmatized, institutionalized, and hidden behind closed doors," she
The disability rights movement, which began in the 1970s with deinstitutionalization, made progress through the passing of the Americans with Disabilities Act in 1990.
Now, says Iezzoni
, new health reform measures will offer people with disabilities important additional protections.
Data on the healthcare experiences of people with disabilities are limited, says Iezzoni
"Part of this is attitudinal," said Iezzoni
, noting that doctors often behave as if sex and reproduction are just not part of the lives of people with disabilities.
Physical barriers also hinder access to care, and even medical equipment itself is often not adaptable for people with disabilities.
For example, medical examination tables are very high, and women with disabilities may have difficulties getting onto one or maintaining the typical position for a pelvic exam.
The same might also be true for mammography equipment.
"Women with disabilities are far less likely to get standard of care procedures for breast cancer and their outcomes are worse," Iezzoni
explains, referring to her
Among the disparities that health reform is intended to address are higher rates of mastectomy (complete breast removal), rather than lumpectomy (limited to removal of the tumor) for women with disabilities, lower rates of radiation therapy needed to produce disease-free survival, and higher death rates from breast cancer.
Providing people with disabilities a chance to be more independent is also a pivotal issue for healthcare reform.
Trying to build in measures to improve access for people with disabilities is uncharted terrain, however, according to Iezzoni
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, long term care, mental health, patient centered medical homes, physical disabilities