Almost 20 percent of Americans -- and 42 percent of those over age 65 -- live with a disability, and the numbers are growing as baby boomers age. A new book says that despite a multitude of barriers that prevent people with disabilities from obtaining optimal and efficient health care, many can be overcome.

"More Than Ramps: A Guide to Improving Health Care Quality and Access for People with Disabilities" (Oxford University Press, 2006), by Lisa I. Iezzoni, M.D., professor of medicine at Harvard Medical School, and Bonnie L. O'Day, research associate at Cornell University's Institute for Policy Research in Washington, D.C., focuses on adults who are blind, deaf, hard of hearing or have difficulties using their legs, arms or hands.

Starting with a look at the history of health-care access for persons with sensory and physical disabilities in the United States, the authors then discuss the current situation, social and health insurance policies affecting people with disabilities and the special challenges for those with disabilities.

The second part discusses current barriers to effective health care, from examining tables that are too high to restrictive health insurance policies to faulty communication between patients and health-care professionals. This includes misconceptions among clinicians about the daily lives, preferences, values and abilities of patients with disabilities. The authors weave in anecdotes by people with physical and sensory disabilities and review national surveys, governmental policies and current practices.

The final section suggests a multitude of strategies to circumvent the barriers, some as simple as simply asking people with disabilities about workable solutions and applying universal design principles more widely.

"Ensuring that people with disabilities have easy access to high-quality health care will involve more than simply building ramps," said O'Day, who herself has low vision and performs her job with computer software that translates printed text into synthesized speech. With a Ph.D. from the Heller School for Social Welfare Policy at Brandeis University, she served for eight years on the National Council on Disability, appointed by President Clinton and approved by the Senate to advise Congress and the president on disability policy. "The results will benefit virtually everyone at some point in their lives."

"This book both opens eyes and offers practical suggestions that could improve quality of life for millions of Americans," wrote C. Everett Koop, M.D., the former U.S. Surgeon General, in a review. "All health-care professionals should read this book."

Cornell's Institute for Policy Research, which was established in 2000, is a collaborative effort of Cornell's vice provost for sponsored research, the College of Human Ecology and the School of Industrial and Labor Relations and collaborates on disability research with faculty in the Department of Policy Analysis and Management and researchers in the Employment and Disability Institute.

Joe Schwartz
bjs54cornell.edu
Cornell University News Service
newsrnell.edu