The ADA: A Platform for Healthy Living and Inclusion into Mainstream Public Health
The ADA: A Platform for Healthy Living and Inclusion into Mainstream Public Health

Categories: Health

Photograph of Coleen Boyle

By Guest Blogger Dr. Coleen Boyle, PhD, MShyg, Director, CDC’s National Center on Birth Defects and Developmental Disabilities

When the landmark Americans with Disabilities Act of 1990 (ADA) was enacted on July 26th of that year, its stated goals were to promote equal opportunity, full participation, independent living and economic self-sufficiency.  Although employment, transportation and telecommunications receive much of the publicity, the ADA is a platform to good health for every person with a disability who wishes to live, work, play and go to school alongside others in his or her community.

As we celebrate the 23rd year of the ADA, I want to recognize it as a platform for the inclusion of people with disabilities in federal efforts related to health and health care.  In my role as the director for the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC), I see first-hand how inclusion of people with disabilities into mainstream health programs and services can improve the health of Americans living with disabilities.  When children and adults with disabilities receive needed programs, services and health care across their lifespan, they can reach their full potential, experience independence and contribute to their communities.

Disability is part of the normal human experience – anyone can be born with a disability, or develop one at any point in his or her life through congenital conditions, chronic disease, injury or aging – and most likely, we all have a loved one or friend who has a disability.  Having a disability does not – and should not – equal poor health.  Unfortunately, there are major health gaps that make it more challenging for a portion of the estimated 37 million to 56 million people with disabilities in the United States to live the healthiest life possible. 

CDC has embraced the spirit of the ADA.  We operate on the principle that people with disabilities are best served when they are included in mainstream public health activities, and that appropriate accommodations must be provided when there are barriers that limit participation.  In 2010, CDC Director Dr. Tom Frieden established an inclusion initiative to bring disability into CDC’s mainstream public health activities.  In December 2012, he stated, “If we’re not inclusive, we end up with two huge problems: one is that we’re unjust to the disability population and the second is that we’re not being as effective as we could be as an organization; we’re not taking advantage of everyone’s capacity.”

To effectively include people with disabilities in public health programs, we need accurate data on the number of individuals with disabilities and their health status and needs.  Federal data collection efforts have been strengthened, since all health surveys sponsored by the Department of Health and Human Services must now include standardized data on disability status.  In 2011, CDC released the first-ever CDC Health Disparities and Inequalities Report, which includes an assessment of disability-related health disparities.  Currently, we provide a Disability and Health Data System based on a CDC health survey.

We need to increase awareness of the health gaps that exist and the appropriate accommodations that are needed for people with disabilities to access health programs and services.  From our research, we know that people with disabilities are less likely to get the preventive health care services they need, and are more likely to engage in behaviors that are unhealthy (e.g., smoke, physical inactivity).  People with disabilities are also at higher risk for multiple chronic conditions, injuries and increased vulnerability during disasters.  As challenging as that is for individuals with disabilities, their caregivers and their families, it also translates to a financial cost that impacts our health care system.  Health care costs associated with disability were estimated in 2006 at about $400 billion per year, or about one-quarter of all health expenditures.

Children and adults with disabilities need to see health professionals for the same reason that anyone does – to be healthy.  And it’s important for health professionals to treat the person, not the disability. This means making sure that people with disabilities have access to quality health care – including being able to get to and through the front door of a clinic, use an accessible exam table or mammography machine and even get weighed.

In addition to routine care, children with disabilities may also have specialized health needs that must be addressed at critical times in their lives.  These conditions must be identified early and children must be connected to services and resources as soon as possible.  Preparing these children and their families for successful development and transition to adulthood means making sure they have access to services that help a child learn and improve or regain skills and functional abilities that may not be developing typically.

I’m pleased to report that CDC is doing its part as the nation’s health protection agency to help children and adults with disabilities live healthy lives.  In addition to our national data and awareness activities, we are focused on assuring that people with disabilities are included in emergency preparedness and response efforts – there are too many tragic stories of people with disabilities being left out and left behind.  We work with states to ensure that individuals with disabilities are included in ongoing state disease prevention, health promotion and emergency response activities.  We partner with national organizations to improve the lives of individuals living with disabilities by delivering health information, education and consultation to the public.

People with disabilities need public health programs and health care services for the same reasons anyone does — to be well, active and a part of the community. The work of CDC honors the intent of the ADA as a critical piece of civil rights legislation for people with disabilities.  If you are someone with a disability, I encourage you to live a healthy life.  If you don’t have a disability, I encourage you to help increase access to important health programs for people with disabilities by using our resources and tools.  In closing, I leave you with some personal stories of people with disabilities.

Coleen Boyle serves as Director of the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at CDC. Dr. Boyle joined NCBDDD’s Division of Birth Defects and Developmental Disabilities in 1988, first as Section Chief and later as Branch Chief and Division Director. In 2001, Dr. Boyle was named the Associate Director for Science and Public Health for CDC’s newly created National Center on Birth Defects and Developmental Disabilities (NCBDDD). In October 2004, she was appointed the Director of the Division of Birth Defects and Developmental Disabilities.

Dr. Boyle received her MSHyg in biostatistics and PhD in epidemiology from the University of Pittsburgh, School of Public Health, and she completed postdoctoral training in epidemiologic methods at Yale University.

18 Responses to The ADA: A Platform for Healthy Living and Inclusion into Mainstream Public Health

  1. Pat, College Student says:

    I needed this, because I was trying to find blogs that can help me with my healthy living.

  2. Sara H. says:

    I do see a correlation between not being able to work and a decline in physical and mental health. I also see that our Government programs penalize people who try to work while receiving disability checks. Most are not able to work full time and therefore could not sustain themselves on that income alone. It is a vicious cycle. I work with adults with Intellectual Disabilities and have fought this fight for years.
    Another health issue I see is dental care. To not have proper dental care causes other health problems. Do you know of any programs that can help to pay for this?

  3. Robert B. says:

    Looking for transportation resources, like a car. Just to make a long story short, received polio at the age of two years old. I just turned fifty-eight. polio Mainly effected my left leg with total muscle atrophy. For the last five years my only source of transportation has been a bike and the use of public transportation. Consider this, there is a combination of severe back pain and weakness in my strong leg or right leg. I try to stay in physical shape and watch my weight, but do not know how long I can continue with the physical exertion on the old body. Also over the years I have acquired a college education, the latest is in medical billing, which was completed as an AS at Monterey Peninsual College in 2012. My only income is SSDI. Would like to give back, just do not know how. It would help the quality of life if there was car to drive again. Can you help with this and how?

    Sincerely R.O.B.

  4. robert b. says:

    Looking for transportation rescources, like a car? Just to make a long story short, received polio at the age of two years old, now I just turned fifty-eight, polio mainly effected my left leg with total muscle atrophy, for the last five years my only source of transportation has been a bike and the use of public transportation. Consider this, their is a combination of severe back pain and weakness in my strong leg or left leg, I try to stay in physical shape and watch my weight, but, Do not know how long I can continue with the physical exertion on the old body, Also over the years I have acquired college education, the latest is in medical billing which was completed as a AS at Monterey Peninsual College, my only income is SSDI, Would like to give back, just do not know how, it would help the quality of life, if their was car to drive again, can you help with this and how?
    Sincerely R.O.B.

  5. Eddie M. says:

    HI…I NEED TO ALSO say that the attacks and retaliations of the govt. employees who just keep denying me access, well these have really taken a toll of my mind, a heavy price….when I ask for mental health services, I am told only 70 IQ or less is considered developmentally disabled. I am autistic and I matter! It does not work when I try to access any of the systems. I am told no, you can’t be developmentally disabled. I have bene the same for 50 years, I was quite functional before I left the protections of the USA and moved to Montana. To add to the craziness, the top officer during this, last 3 years here, he is now the governor, still won’t answer my calls.

  6. Eddie M. says:

    Hi, I made the mistake of moving to Montana without knowing that Montana is exempt from the ADA – this is not at all legal, but I can prove that it is real. It begins with a common attitude among MT. residents that the federal laws are a bother. The federal government has a responsibility to ensure the protection of disabled folks, but in MT., these end at the front door of the legal services agencies. They do not as policy, sue anyone for the disabled, they only educate. Heck, the law itself educates. I can prove 15 thousand cases of discrimination, but my ONLY way out is to self-educate on civil procedure and attempt to sue on my own. AND I AM A VULNERABLE ADULT. HOW IS THIS HAPPENING?

  7. Chareene H. says:

    I became totally disabled at the age of 42 from a stroke that left my left side paralyzed. I became a stay-at-home Mom after working 17 years at my last job before my 2 children were born. I went back to work in 1989 and had my stroke 1993. I was denied disability because I didn’t work enough quarters before my disability. I was at work when I had that stroke and was asked to resign my position! I feel this is an act of discrimination against stay-at-home mothers. This law needs to be changed!! How many Moms know they and their children under 18 will be denied benefits because they were fortunate enough to stay home and raise their children safely instead of being raised in day care programs? If they are struck down with an unexpected illness, they will be denied disability benefits. Why should Moms be punished for wanting to stay home and raise their children? We need help!!!

    • Disability.Blog Team says:

      Hi Chareene,

      There are two types of disability benefits that are paid by the Social Security Administration – Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI pays benefits based on how long a person has worked and paid Social Security taxes. SSI pays benefits based on financial need, without regard to how long a person has worked.

      Based on your comment, it sounds like you were denied SSDI because you did not have enough “work credits.” The number of work credits you need to qualify for disability benefits depends on the age you were when you become disabled. Generally, a person needs 40 credits (20 of which must have been earned in the 10 years before the person became disabled). For more information, visit http://www.socialsecurity.gov/dibplan/dqualify2.htm.

      Depending on your income, you may still qualify for SSI, even if you have been denied for SSDI. Visit http://www.socialsecurity.gov/pgm/ssi.htm to learn more about SSI.

      Best,

      The Disability.gov Team

    • Pamela F. says:

      I agree about being a stay at home Mom. I have had 5 children, I paid for them, not the state. Did not have enough skills to work or money to afford daycare. Worked at night when husband came home so we could make ends meet. Did not get public assistance. So if you are not married for 10 years you cannot get your husband’s work credits. My second husband (child number 3), I helped him start a business, took care of the children, worked with him, worked at night for him to make ends meet. So when I needed my SSDI, I had enough work credits excluding my husband’s. The Judge looked at me and thought I was OK, it took 3 years and appeals and I was still turned down. Never returned to work, had 3 doctors, including State Doctor, saying I could not go back to hard labor, my bones are so bad. It’s like a slap in the face. I have worked since age 12, I am a US citizen. Now I get SSI, not my SSDI, which I should have gotten. People come into the US, never have worked, and get SSI. I will take this to my grave. It’s discrimination. Wish they would go back and look at my case. Women who stay at home when their children are babies because it would cost more for daycare deserve work credits.

  8. David S. says:

    I’M LOOKING TO START MY OWN BUSINESS BUT DON’T HAVE THE MONEY TO DO IT. HOW DO I GET FUNDING OR HELP? I HAVE TBI AND BEEN STRUGGLING WITH MONEY FOR YEARS. NOW IM READY TO START MY OWN BUSINESS.

  9. Forest says:

    I observe the concentration in this article is focused upon health care. I and many other disabled individuals consider obtaining employment a focus for mental health.

    This is my personal story that I realize many disabled individuals have experienced. Almost a decade and a half ago ago, I was involved in an automobile accident. I lived a life able to sufficiently support myself. I lost a leg in the accident. After I recovered from a coma several months later, and the total result of the accident years later, the challenge of obtaining employment began.

    I received invitations ranging from vocational rehab to help from the Veterans Administration. At the locations, the pay offered for employment was $2.25 and $3.25 an hour for 20 hours a week. The programs combined all disabled individuals. There is a difference between people who experience physical disability and mental disability, but we are offered the same employment opportunities.

    At this moment, I have agreed to invest over $50,000 in education expenses in an attempt to become eligible for a decent paying job. On Social Security Disability, I receive 66% of my former pay. If I accept employment earning approximately $12,000 annually, I will be considered unable to receive disability support.

    I have searched extensively for apprentice programs to obtain employment paying $15.00 or better, which would match the pay I received almost 15 years ago, with no great fortune.

    The employment opportunities offered involve physical activities. The only option offered is to become an administrative assistant. As a male, the task offered is as difficult as offering a female employment dominated by males.

    I experienced employment in excess of over a quarter century and suddenly I am involved in a life changing accident. I am offered an opportunity to restart employment earning the funds I earned at the age of 18. The decision would cause me to experience bankruptcy. The choice is considered unacceptable.

    The choices offered are a contributing factor as to why many people receiving Social Security Disability reluctantly chose to retain Disability payments though their desire is to return to employment. I wish there were a concentration on separation of people with physical and mental disabilities regarding employment opportunity availability.

  10. Forest says:

    I observe the concentration in this article is focused upon health care. I and many other disabled individuals consider obtaining employment a focus on mental health.
    This is my personal story that I realize many disabled individuals have experienced. Almost a decade and a half I was involved in an automobile accident. I lived a life able to sufficiently support myself. I lost a leg in the accident. After I recovered from a coma several months later and the total result of the accident years later the challenge of obtaining employment began.
    I received an invitation ranging from vocational rehab to the Veterans administration. At the locations the pay offered for employment was $2.25 and $3.25 cents an hour for 20 hours a week. The programs combined all disabled individuals. There is a difference between people who experience physically disability and mental disability but we are offered the same employment opportunities.
    At this moment I have agreed to invest over $50,000 in education expense in an attempt to become eligible for a decent paying job.On Social Security Disability I receive 66% of my former pay. If I accept employment earning approximately $12,000 annually I will be considered unable to receive disable support.
    I have searched extensively for apprentice programs to obtain employment paying $15.00 of better which would match the pay I received almost 15 years ago with no great fortune.
    The employment opportunities offered involves physical activities. The only option offered is to become an administrative assistant. As a male the task offered is as difficult as offering a female employment dominated by males.
    I experienced employment in excess of over a quarter century and suddenly I am involved in a life changing accident. I am offered an opportunity to restart employment earning the funds I earned at the age of 18. The decision would cause me to experience bankruptcy. The choice is considered unacceptable.
    The choices offered are a contributing factor as to why many people receiving Social Security Disability reluctantly chose to retain Disability payments though their desire is to return to employment. I wish there were a concentration on separation of people with physical and mental disabilities employment opportunity availability.

  11. AnnaMaria G. B. says:

    I have a son born with a Craniosynostosis Syndrome (redirected from Cranial Stenosis). He had Neuro-Surgery at three months of age, born 08-04-1961. Cared for him at home til 1981. Been in institutions the rest of his life. Diagnosed wrongly many times, abused, criminalized in the community due to his brain damage, cannot become competent and is at the State Hospital for life. His behavior is good and he is minimum medication. I am his LPS and Murphy Conservator, been in the mental health system for 59 years, his father family was afflicted by a number of disabilities.

  12. Born Again Child Of The Most High says:

    Who took my health care records? Idenity theft in mental health.

  13. Patty says:

    This is good info, but I need info for getting help with getting back in school. I can’t afford it on my disability. Where can I get help?