Equity, Diversity & Inclusion: Accessibility & Disability

What is disability?

Currently, the AODA defines disability broadly. It states that disability can happen at birth, or through illness or injury. Furthermore, the act also outlines several types of disability. These types are examples, rather than a complete list of all disabilities.

The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I offer an overview of recent disability theory, outline a set of responsibilities clinicians have to disability communities, and provide recommendations for clinicians who hope to justly treat patients with disabilities and improve their care and health outcomes.

An Infographic from Statistics Canada.

A study to understand physicians’ perspectives on communication experiences with people with disability.

The increasing diversity of the nation brings opportunities and challenges for health care providers, health care systems, and policy makers to create and deliver culturally competent services. Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. A culturally competent health care system can help improve health outcomes and quality of care, and can contribute to the elimination of racial and ethnic health disparities.

One important element of effective communication is having a shared language or at least a shared understanding of the meaning of the central words used in a conversation. One term that is often used in discussions between patients and medical providers, in the academic literature, and in policy discussions, is “chronic disease.”

In the US, medical training is inadequate regarding the symptomatology, prognosis, and treatment for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). As a result, many physicians lack the appropriate level of knowledge about effective methods for ME and CFS symptom reduction and often suggest inappropriate treatments, such as increased exercise or psychiatric services. The authors’ purpose in this study was to analyze negative patient experiences with health care professionals.

Start by avoiding ableism and toxic positivity.

Suicide is a major public health concern that has wide-reaching implications on individuals, families, and society. Efforts to respond to a public health concern as a portal-of-entry provider can reduce morbidity and mortality of patients. The objective of this commentary is a call to action to initiate dialogue regarding suicide prevention and the role the chiropractic profession may play.

Facts and Statistics about mental illness and substance use disorders

Factsheets providing a snapshot of the current state of mental health of minority populations and some factors that may contribute to mental health disparities among these groups.

Our culture, beliefs, sexual identity, values, race and language all affect how we perceive and experience mental health conditions. In fact, cultural differences can influence what treatments, coping mechanisms and supports work for us. It is therefore essential for culture and identity to be a part of the conversation as we discuss both mental health and mental health care.

This page offers background information and tips for providers to keep in mind while using person-first language, as well as terms to avoid to reduce stigma and negative bias when discussing addiction.

Guidance from the CDC.

What is trauma-informed care and why does it work so well?

People with disabilities often face major barriers getting the health care services they need. Improving physical access to health care services is essential to achieving health equity. Designed for health care providers, staff, and administrators in outpatient settings, this resource highlights some of the physical barriers people may face, discusses actions you can take to assess the accessibility of your facility, and describes ways to design and carry out programs and policies that deliver high-quality, patient-centered care.

An infographic from Statistics Canada.

Part of the DD CARES Best Practices series on improving primary care, emergency care and community follow-up, this video demonstrates common practice errors as well as strategies that can help a patient with a developmental disability tolerate a difficult procedure.

Part of the DD CARES Best Practices series on improving primary care, emergency care and community follow-up, this video demonstrates common practice errors as well as strategies that can help a patient with a developmental disability tolerate a difficult procedure.

As more children with autism become adults, understanding this condition across the life span grows paramount. While many studies have focused on understanding how diagnosis and treatment can help young children, few have focused on adults with autism and how primary care teams can better assist these individuals. This is changing, however, with studies of the benefits of employment programs and pharmacologic treatment and of the reproductive health needs of adults with ASD. Here we provide an updated review of ASD in adult patients.

Effective communication skills are essential for all healthcare professionals. Specialist teaching on communicating with people with intellectual disabilities is often lacking, resulting in poorer healthcare and worse outcomes than in the general population. Working with professionally trained actors with intellectual disabilities, we developed an interprofessional workshop that sought to provide authentic communication skills training to enable healthcare students from various disciplines to communicate effectively with patients of all abilities.

Results from the 2017 Canadian Survey of Disability (CSD) have shown that over half of Canadians with a mobility disability need at least one workplace accommodation. Among population groups designated as visible minorities who have a disability, one-quarter considered themselves to be disadvantaged in employment because of their condition.

This webinar featured an overview of key patient-clinician communication challenges and disability law and policies applicable for accessible and effective communication during the COVID-19 pandemic, identified techniques to facilitate health care communication with people with disabilities, and provided tools and resources to consider for better communication in the COVID world.

The skill of active listening, also known as attentive listening, involves various techniques intended to help facilitate, direct, and structure the clinician’s interaction with the patient.

The clinician's use of understandable language relates to how information is communicated to the patient—regardless of the patient's level of health literacy—including using clear, recognizable words and short sentences; communicating only essential information; and avoiding the use of medical jargon, abbreviations, or any complex words or phrases that might obstruct the information the clinician is trying to convey.

It is key for the clinician to establish a clinician–patient relationship that promotes partnership and builds trust, empowering the patient.

The clinician's use of non-stigmatizing language reflects the patient's full identity, and acknowledges the patient's capacity to change and grow, by avoiding words or phrases that could be perceived by the patient as dehumanizing, that perpetuate stigma, and that marginalize rather than support.

Clinicians should use always use "people-first" language in the patient interview, and this is especially true when speaking with patients with physical and/or sensory disabilities. Establishing rapport with these patients during the interview involves eliciting their preferences for how best to communicate, how they wish to navigate the physical exam room, and whether they require assistance, or some combination of these approaches. Always speak directly to the patient, even when they are accompanied.

Advance directives allow the patient to guide critical care decisions that might need to be made if they become seriously ill. Every patient should have an advance directive, but clinicians should especially encourage their older adult and chronically ill patients to consider these important decisions and make their preferences known.

Discussing sensitive topics is a difficult yet integral part of the clinician's role. Several basic principles can guide the approach to these discussions, the most important of which is to be nonjudgmental and practice acceptance. Using these techniques, the clinician will become more comfortable discussing sensitive topics and help patients achieve better health.

Clinicians often need to discuss behavior change with patients to optimize health or treat illness. Using three key aspects of the motivational interviewing technique--ask, listen, and inform--clinicians help patients discover their own reasons for wanting to make behavior changes and improve their health.

Members of the Deaf community in America use a different language—literally. Not only does their language—American Sign Language (ASL)—connect them to others who are Deaf, it also serves as a membership card into a linguistic subculture of our society that not everyone is privileged to enjoy.

Being part of the Deaf community is not the same as having hearing impairment.

What you need to know.

Communication barriers are the number one reason Deaf people have had poorer health compared to hearing people.

Physicians reading this will have a broad range of in-depth knowledge about their own subspecialty. However, in daily medical practice there are topics of which all physicians should have some knowledge. Those who deal with young people should have some knowledge of the needs of the hearing-impaired population within this group of patients. This article is intended to provide an overview of young people with hearing impairment (HIYP), the challenges they face and what we can do to help them.

Key facts from the World Health Organization.

Guidelines for assisting people who are visually impaired

Guidelines and resources for interacting with a person who is vision blind.

This guide provides best practices for transportation service providers subject to the requirements in the Accessible Transportation for Persons with Disabilities Regulations (ATPDR). These best practices are designed to assist transportation service provider personnel in their interactions with persons with disabilities and to support compliance with the ATPDR requirements relating to personnel training, communicating with persons with disabilities, and the provision of services to them.

Mount Sinai's Tips for Treating Patients with Physical and Sensory Disabilities.

People are always first, disabilities are second.

Suggestions for the portrayal of people with disabilities from the Government of Canada.

Persons with disabilities have to face a number of clichés, stereotypes and myths associated with disability. These are the misconceptions that are deeply rooted in the mental framework of the society.

This following is guidance on disability language and etiquette. The language and actions that this guidance sheet suggest are based on what may make some individuals with and without disabilities feel more comfortable and respected, but each individual’s preference is unique.

The Disability History Museum hosts a Library of virtual artifacts, Education curricula, and Museum exhibits. These programs are designed to foster research and study about the historical experiences of people with disabilities and their communities.

WeCapable is a disability portal for information on all types of disabilities. This collection of tools includes a braille translator, text to sign language and more.

You Can't Ask That is a documentary series that confronts prejudices and breaks down taboos in our society in an authentic and relatable way.

A collection of resources on wellness from an Indigenous perspective in addiction treatment.

These options can be used by anyone who would like to communicate better when wearing a mask, but are especially helpful for people with hearing loss. Having patience when using these strategies and tools will help you successfully communicate.

The doors to a healthcare facility open and a man walks in, using a white cane. You’re working the information desk. Do you know what to do?