Disability Garrison – Episode 11: Health Equity and Disparity with Andy Imparato

April 26, 2022

• Disabilities
• Podcast
• Self-direction

The Problem

Health equity is when everyone can achieve their full health potential. And there are no barriers for them to do so. But we have not achieved health equity. Communities of color, people with disabilities, individuals who identify as LGBTQ+, and others are exposed more often to environments that negatively affect their health outcomes. This is known as health disparity.

Ventilators and ICU beds were rationed during the COVID-19 pandemic. This put people with disabilities, and the elderly, at the back of the line for critical care. But this is only one of many examples of health disparity. This problem is everywhere. And many times, it isn’t happening on purpose. It is just built into our society. We need to work together toward a world with health equity.

Join Michael and Holly as they talk with Andy Imparato, Executive Director of Disability Rights California. Andy discusses pandemic-era healthcare resource rationing. They also go over ideas on how to address disparities in their communities.

What We Can Do About It

It’s easy to get paralyzed by the feeling that we can’t make a difference. But helping out can be a lot simpler than we think.

Step 1: Become Informed About Health Disparity

Learning about health equity means looking disparity straight in the face. How do disparities show up in your area? Does your hospital have an ethics committee with community representation? Is your church accessible to people with disabilities? There are many ways we can make a difference locally.

Step 2: Keep An Eye On Legislation

Section 1557 of the Affordable Care Act prohibits discrimination based on race, color, national origin, sex, age, or disability. It is expected that the Biden administration will look to strengthen these provisions. Their updates would advance equity even further. We don’t know for sure if this will happen and what it may look like. But, the federal government focusing on health equity is a positive sign.

Step 3: Support Disability Rights California

Disability Rights California was founded in 1978. DRC defends, advances, and strengthens the rights of people with disabilities. They work for a world where all disabled people have power in their own lives. And, they are treated with dignity and respect. They strive to create an inclusive culture for all people.

Boom. You’ve made a difference.

Get More Information on Health Equity

What are Health Equity and Health Disparity?

• Very Well Health – What are health disparities and why do they matter?
• Public Health Report – “[Health disparity] was intended to denote a specific kind of difference, namely, worse health among socially disadvantaged people.”
• American Journal of Public Health – This article discusses matching cultural characteristics with public health programs designed for that group of people.
• American Progress – This article discusses racial disparity in the HIV/AIDS crisis.
• National Council on Disability – A 2019 report on medical futility and disability bias.
• Off Kilter Show – A podcast episode about refusing to apologize for your needs.
• Health Affairs – A 2021 study revealed 82.4% of physicians surveyed believed that people with significant disability have worse quality of life than nondisabled people.

Health Disparity During COVID-19

• Washington Post – Washington’s protocol said doctors should consider a patient’s “baseline functional status” when rationing ventilators.
• The Center of Public Integrity – This October 2021 article discusses rationing that occurred early in the pandemic. It also acknowledges that it was still a potential problem that hadn’t been resolved.
• NPR – A December 2020 investigation found Oregon “doctors and hospitals denying equipment [and] insisting that an elderly or disabled person sign a DNR.”
• The Guardian – The British Medical Association recommended stable patients be taken off ventilators in favor of those more likely to survive.
• Disability Rights Washington – A copy of the official complaint of disability discrimination from rationing protocol in March 2020.
• Alabama Disabilities Advocacy Program – The March 2020 disability discimination complaint stemming from rationing protocol in Alabama.
• NPR – “Most saw what she couldn’t do. But a smaller number of people, but the ones who knew her best, saw something different. They saw what was possible for McSweeney. They saw the choices she made and the things she did.“
• Gothamist – A 2015 pandemic guidance document for New York became relevant during COVID-19. It stated any patient who came to the hospital with their own ventilator could have it given to someone else.
• NPR – Oregon hospitals didn’t have shortages. So why were disabled people denied care?
• The ARC – The state of Alabama withdrew their ventilator rationing policy after a federal complaint was filed.
• BBC News – Charity Wellchild’s ventilator filter should have been changed every day. Because of supply shortages, she ended up using one for six months.
• The Atlantic – “Politicians’ refusal to admit when hospitals are overwhelmed puts a terrible burden on health-care providers.”

Identifying and Eliminating Health Disparity

• North Carolina Health News – “‘People with disabilities don’t believe they’ll be treated as fully human when they’re seeking health care,’ said Corye Dunn. ‘They’ve experienced discrimination and expect to experience it again.’
• Time Magazine – Biden’s Health Equity Task Force highlights progress in addressing COVID-19 disparities.
• The White House – The Biden Administration‘s November 2021 response to the Health Equity Task Force report.
• U.S. Department of Health and Human Services (HHS) – In April 2022, $90 million was approved to support health center efforts to reduce health disparities.
• Health Affairs – An article on how misperceptions of people with disabilities leads to low-quality care. This article includes suggestions on how policy makers can counter this.

Learn More About Disability Garrison Podcast