Bonnie O'Day

Use of Screening and Preventive Services Among Women With Disabilities

Roughly 54 million Americans have some disability; at older ages, women are more likely to be disabled than men. Many people with disabilities today live virtually normal life spans, and therefore routine screening and preventive services are essential to their overall quality of care. We used the 1994-1995 National Health Interview Survey (NHIS), with Disability, Family Resources, and Healthy People 2000 supplements, to examine screening and preventive service use for adult women with disabilities living in the community-about 18.4% of women (estimated 18.28 million). Disability was associated with higher age-adjusted rates of: poverty; living alone; low education; inability to work; obesity; and being frequently depressed or anxious. Disabled women generally reported screening and preventive services at rates comparable to all women. Women with major lower extremity mobility difficulties had much lower adjusted odds of Papanicolaou smears (odds ratio, 0.6; 95% confidence interval, 0.4-0.9), mammograms (odds ratio, 0.7; 95% confidence interval, 0.5-0.9), and smoking queries (odds ratio, 0.6; 95% confidence interval, 0.5-0.8). Various approaches exist to improve access for disabled women to health care services.

Research on the Lives of Persons with Disabilities: The Emerging Importance of Qualitative Research Methodologies

This article describes the significance of qualitative methodologies in capturing the complexities of the disability experience. The authors discuss some of the principles of qualitative research and show how those principles lend themselves to the new disability paradigm that has emerged in the last 20 years. They give examples of three disability studies in which qualitative methods were used to shed light on the complex interrelationships among physical impairment, societal barriers, and public programs. They also explore the underlying assumptions of both qualitative and quantitative approaches, emphasizing their ultimate compatibility and showing how each approach can complement the other to provide a more holistic view of the disability experience.

Challenging expectations: how individuals with psychiatric disabilities find and keep work.

The results of this qualitative study involving in-depth interviews of 32 individuals with psychiatric disabilities document the importance of beliefs and expectations with regard to employment. Each of the participants were either currently receiving Social Security benefits or had received them in the past due to his or her psychiatric disability. The authors briefly describe the systemic and programmatic barriers to employment that study participants encountered. They discuss how negative beliefs and expectations concerning employment are imbedded within the policies and programs that impacted these participants. They also describe the representative experiences of three study participants who were successful at overcoming these barriers and maintaining employment. Finally, they identify and discuss some of the common factors that may have contributed to successful employment.

Advocacy Issues and Strategies for the 21st Century Key Informant Interviews

The authors conducted key informant interviews with 16 disability advocacy and research leaders; half of the interviews were with leaders in shaping national disability policy during and after passage of the Americans with Disabilities Act of 1990, and half were with state and local leaders representing constituencies who had not had a visible presence at the national level. During audiotaped telephone interviews, we asked the informants to identify the top 5 advocacy priorities for the next 10 years, as well as what strategies they thought could advance the disability advocacy agenda. Two overarching themes emerged: the impact of poverty among people with disabilities and the connections among various advocacy issues. The authors discuss the 5 issues most often cited by the participants, as well as issues particular to various constituencies, and draw conclusions about what strategies would advance the disability agenda.

Preventing unemployment and disability benefit receipt among people with mental illness: Evidence review and policy significance.

Objective: We identify effective services to assist 3 groups of people with mental illnesses become or remain employed and prevent dependence on disability cash benefits: (a) individuals, including youth, who are experiencing an initial episode of psychosis; (b) employed individuals at risk of losing jobs due to mental illness; and (c) individuals who are or may become long-term clients of mental health services and are likely to apply for disability benefits. Method: We searched for articles published between 1992 and 2015 using key word terminology related to employment support services and each subgroup, and prioritized articles by study design. Results: The individual placement and support model of supported employment is more effective than traditional vocational programs in helping people with serious mental illnesses who are engaged in treatment or receiving disability benefits obtain competitive employment. Some early intervention programs effectively serve people who experience a first episode of mental illness, but more research is needed to demonstrate long-term outcomes. Less is known about the effectiveness of employment interventions in preventing unemployment and use of disability benefits among individuals at risk for job loss or long-term mental illness. Conclusions and Implications for Practice: States can fund employment supports to help prevent the need for disability benefit receipt by creatively combining federal sources, but the funding picture is imperfect. Medicaid expansion and other provisions of the Affordable Care Act may fund employment supports and assist in reducing dependence on disability benefits.

Effects of Welfare Reform on Statistics for Young Women With Disabilities

This article uses the Current Population Survey (CPS) data to show that changes in family policy implemented in the 1990s led to a substantial increase in the number of young women reporting work limitations. These changes also affected measures of socioeconomic outcomes for young women reporting limitations. Hence, the demographic changes mask the effects of changes in family policy and changes in other environmental factors on those outcomes. The findings emphasize the importance disability has in family policy issues and suggest that past underreporting of disability by young mothers might well have disguised its importance. The findings also suggest that the impact of family policy on mothers with disabilities has been quite different than the impact on other mothers. An important effect of family policy changes may have been to financially segregate mothers with low income who have disabilities from other mothers with low income, continuing to relegate them, and possibly their children, to lives of poverty and dependency.

Centers for independent living: Advocates for disability rights

This article describes Centers for Independent Living (CILs) and how they advocate for changes that build community capacity to include all citizens, including those with disabilities. In spring 2001, we mailed a survey to executive directors of all 238 centers that received funding under Title VII, chapter I, Part C of the Rehabilitation Act. Based upon executive directors’ responses, CILs promote integration of individuals with disabilities into the community, personal empowerment, and community accessibility. They engage in a wide variety of activities to promote community and systems change to achieve their goals, including advocating for accessible transportation, assisting people to move out of institutions and into the community, and advocating for enforcement of civil rights and access laws. CILs can be an important resource for community development agencies because they provide a high level of expertise on disability issues, including access to physical facilities and program design.