Personal health means different things to different people, but having access to adequate and appropriate health care is important for everyone. Services should be available to address chronic health conditions, to treat acute health, and to maintain wellness by reducing health risks. Achieving maximum health increases the ability to work productively, to care for loved ones, and to enjoy life.
Coloradans with disabilities face some challenges in staying healthy, and in getting adequate and appropriate health care. Data from the Centers for Disease Control and Prevention (CDC) in 2006 indicated that 31.4 percent of Coloradans with disabilities reported being in “fair” or “poor” health compared to only 8 percent of those without disabilities. (1)
Some disabilities do involve related or secondary chronic health problems. But external conditions also play a part. People unable to go to health care providers due to limited transportation, access barriers, communication barriers, or inability to pay may have delays in getting their health concerns treated, allowing conditions to worsen to a more acute stage.
Unhealthy lifestyles also contribute to health problems among Coloradans with disabilities. According to CDC data, smoking rates are higher among people with disabilities (29.1 percent) than among those without disabilities (18.6 percent).
Similarly, more people with disabilities (23.2 percent) than nondisabled people (13.6 percent) were obese. (2)
These trends are probably the result of two factors: lack of education about the risks of unhealthy behaviors, and limited resources to support healthy lifestyles.
Coloradans with disabilities are also less likely to have health care insurance onhealthy.net coverage, than those without disabilities. Reasons include lower rates of employment among people with disabilities, disability-related pre-existing conditions resulting in denial of insurance coverage, and limited access to Medicaid due to stricter eligibility guidelines.
On a positive note, Coloradans with disabilities are more likely than nondisabled people to have a continuous health care provider. This may be explained by several factors. Relatively few health care providers currently accept Medicaid due to the low reimbursement rates. Also, once people with disabilities find practitioners who understand their diagnoses, histories, and care needs, and whose office or other facilities are accessible, they may be reluctant to change.
Increasing access to health care in Colorado for people with disabilities will require a cooperative effort among providers, policymakers, people with disabilities and patient advocates services.
The following policy approaches should be considered:
- Increase Colorado Medicaid’s reimbursement rates, in order to encourage more providers to accept Medicaid patients.
- Educate health care consumers and providers about their respective rights and responsibilities under Title III of the ADA, which prohibits discrimination and requires removing barriers in places of public accommodation; and under Section 504 of the Rehabilitation Act, which mandates nondiscrimination in programs receiving federal funding, including Medicaid payments.
- Proceed with implementing the Medicaid buy-in program.
- Improve Medicaid by increasing provider rates, and by expanding coverage for services designed to prevent disease and promote wellness, such as adapted exercise instruction, smoking cessation programs, and alternative therapies including massage and acupuncture.
(1) Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance Survey (BRF SS), Disability and Health Team, Disability and Health Chartbook, quoted in Houtenville, 2009, Figure 1.
(2) Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance Survey (BRF SS), Disability and Health Team, Disability and Health Chartbook, quoted in Houtenville, 2009, p. 11.