UM doctor talks equity for disability health care
Medical School Prof. Michelle Meade addressed common health and health-care disparities and how to promote positive changes to the current health-care system for people with disabilities Wednesday night in Mason Hall. The event, sponsored by the Interprofessional Health Student Organization, drew a crowd of about 20 students.
Meade directs programs for the University of Michigan’s Rehabilitation Engineering Program, developing health-management technologies for individuals with disabilities.
Meade began her presentation by pointing out problems with defining the term “disability,” which differs depending on which area of academia or society people are processing the definition from.
“The actual definition of disability or having a disability depends on where you look,” she said. “In surveys and research, it generally is defined by limitations; in some policy, it’s defined by a lack of ability to work and then in clinical practice, it’s diagnosis.”
As opposed to health disparities, which revolve around medical treatment and the burden of the illness, health-care disparities deal with how the disease is managed and what is done to assist those living with disability. Meade said those who are disabled have an equal amount of need for health care as non-disabled individuals, yet they do not get the treatment or health care they need.
“Despite having no differences in regards to aspects of health insurance or mutual care … you have increased need and decreased access (for the disabled),” she said.
In her paper “The intersection of disability and health care disparities: a conceptual framework,” Meade, along with University researchers Elham Mahmoudi and Shoou-Yih Daniel Lee, created a narrative flowchart to describe the factors contributing to the poor health care experienced by the disabled. Meade said certain elements contribute to health-care disparities; more so for the disabled.
“It’s not ‘one-size-fits-all,’ ” she said. “I think the easiest way to understand it, or for me to explain it, is that you can have the most wonderful doctor providing fantastic information … but if he’s speaking in English and the individual only speaks Spanish, there’s a mismatch in terms of needs, and that’s automatically going to reduce or impact the quality of care.”
Meade provided examples of problems and possible solutions, such as the issues of low literacy with the implementation of video health instructions, executive dysfunction with concrete and practical support and children with disabilities with appointments and clinics. These are, Meade said, only a few of the changes we can make to reduce health-care disparities for those with disabilities.
The Patient Protection and Affordable Care Act, most commonly known as the Affordable Care Act or Obamacare, was passed by Congress in 2010. The act tried to reduce health disparities for Americans with disabilities by gathering more data on the issue and increasing health-care-provider training. However, the current House and Senate have already voted to approve new budget resolutions that will make it easier for the Trump administration to repeal the ACA in the future.
Meade said she is shocked many health-care providers still do not work toward improving general comfort for their patients with disabilities.
“One of the things that continues to shock me is (the lack of) access to a wheelchair-accessible scale,” she said. “These are some of the basic factors that we need to think … how we make this as easy as possible.”
In addition to scales, Meade said people must actively improve current environments to assist individuals with disabilities in any way they can.
“We can consciously create environments,” she said. “Just as we create environments that are inviting based on age or gender, we can do the same (here). We can think about not only the accessibility of doors, the height of the table, the way we interact. We can think about the signage, the themes of use. We can think about the pictures that are up there.”
In her research, Meade said she doesn’t want to merely conduct research, write a paper and be done with the topic. She aims to use her data to improve knowledge and measurable action to lessen health-care disparities for people with disabilities.
“Thinking about creating or adapting clinical services based on research evidence, making sure if you’re collecting data, it’s for a reason and how is this going to change our practice,” she said.
Meade concluded by emphasizing knowing how to care for and support individuals with disabiltiies is something everyone should undertake.
“Most people are touched some way by disabilities,” she said. “They have siblings, they have parents … so being aware of what’s involved, being knowledgeable about the factors … and just addressing them and being respectful. Not assuming that we know everything makes a difference.”
Public Health student Suzie Genyk, president of IHSO, said the group invited Meade to IHSO to speak because of her inclusion of many medical disciplines in her research.
“The group of members we have with IHSO, it’s students from all the different health schools,” she said. “We try to have different events to bring in different perspectives that they wouldn’t necessarily get in the classroom, and also to have conversations with students outside of their normal cohort.”
Pharmacy student Chris German said Meade’s statements shed a light on health-care controversies and ways we can improve life for people with disabilities.
“She … pointed out things that the health-care system could do better in order to make sure we recognize people with disabilities as individuals and to make sure that they get the kind of care people without disabilities even get,” he said.