We often rely on our family doctors and specialist clinicians to ensure that we have all the tools needed to have control over our health and be equipped for the challenges of primary and secondary health concerns, co-morbid conditions, general health needs and health needs that require a specialist. We trust our doctors to provide us all with the most up-to-date information on health promotion.
In the 2011 World Report on Disability by World Health Organization (WHO), concerns of inequality in overall access to general health care were addressed in patients with disabilities across the globe, resulting in risk for poorer health outcomes. This is partly because people with disabilities experience barriers to accessing services, including access to important information such as health promotion and assistive technology services that could be provided by all general practitioners.
Since primary care services through family doctors are generally considered the most accessible, affordable, and acceptable, it is important that individuals with disabilities be assessed and treated holistically and receive access to all health promotion tactics that can improve their general health. People with disabilities need to be given the tools and treatment through referrals and guidance from family doctors to increase control over their health and the factors that contribute to it.
The WHO report on disability cited numerous documented cases of people with disabilities excluded from being identified as being at risk of general health problems, but there was also evidence that people with disabilities were also less likely to receive screenings for preventative conditions. People with disabilities were screened for conditions including breast and cervical cancer for women, and prostate cancer for men at a smaller rate; did not receive education in sexual health and reproductive services including information on STDs and birth control options and mental health services.
General health needs include health promotion, preventive care, treatment of acute and chronic illness, and appropriate referral for more specialized needs where required. In the report, we hear Robert’s story of feeling neglected in the care of his physicians.
“Even though during my appointments to the medical centre, doctors haven’t discussed health promotion with me and they don’t even have a scale to measure my body weight, I still try to engage in activities that would enhance my health and wellbeing. It’s not easy as most fitness facilities and equipment are not accessible. I’m yet to find dietary advice for people with spinal cord injury or identify a dentist near my place of residence with accessible facility and equipment.”- Robert
Robert was a prime example of an individual with a physical disability who was withheld information on health promotion interventions by his doctors. Robert experienced barriers which included inadequate equipment, inaccessible environments and lack of availability within his community which put him further at risk of being excluded from quality health services.
For Robert, the stigma of having a spinal cord injury meant that his doctors did not include physical activity as a variant to preventing obesity and further health problems related to obesity. The failure to provide Robert with the proper health promotion did not lie in the lack of knowledge that his doctors had to create a sustainable exercise and diet program, but in the failure to act as the stepping stone to accessing the correct resources that would have provided Robert with those tools.
With a little bit of research, Robert’s doctors would have discovered the numerous health benefits associated with physical activity for individuals with spinal cord injuries and even find free exercise plans specially designed for people with spinal cord injuries. According to SCI Action Canada, individuals with tetraplegia and paraplegia following a spinal cord injury should participate in at least 20 minutes of moderate to vigorous intensity aerobic activity twice weekly alongside strength training exercises, consisting of 3 sets of 8-10 repetitions of each exercise for each major muscle group. Personalized exercise programs for individuals with physical disabilities can be found online from National Center on Health, Physical Activity and Disability and Every Body Fitness or in community-based rehabilitation and exercise centres such as Walk it Off Spinal Cord Injury and Wellness Centre located in Ontario.
In order for an individual with a disability to make meaningful modifications to their daily lives, doctors should be ready to equip their patients with assistive technology resources. This includes mobility aids, prosthetics, hearing aids, environmental control, and switch access tools like tecla-e, that allows patients with paralysis to access their smartphones and the Internet. Clinicians can increase their quality of care by adequately referring their patients with disabilities to local assistive technology resource centres, funding options and organizations who employ assistive technology consultants.
To learn more about WHO’s recommendations that aim to improve healthcare access for individuals with disabilities around the world, read the 2011 World Report on Disability.