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(IOM’s) 1991 report Disability in America (Pope and Tarlov, 1991) and its 1997 report Enabling America (Brandt and Pope, 1997). Both reports defined secondary conditions specifically in terms of physical or mental health problems.

The new concept was embraced, especially by the federal funding agencies, such as the National Center for Medical Rehabilitation Research (NCMRR), the National Institute for Disability Related Research (NIDRR), and the Centers for Disease Control and Prevention (CDC). These agencies initially funded research to identify and define secondary conditions and then supported further studies to evaluate interventions that can be used to prevent or modify such conditions. The concept also became a part of the strategic planning cores within the agencies.

Recognizing the potential to improve the prevention of secondary conditions, CDC organized national conferences highlighting their epidemiology as well as preventive and modifying strategies. The conferences promoted discussions that enriched the understanding of secondary conditions. Individuals with disabilities were active participants in the discussions, including discussions of areas for research. The CDC Disability and Health Team initiated a funding stream for research into the secondary conditions of individuals with disabilities, and it also supported statewide disability and health programs and projects. As a result of these CDC-supported initiatives and the strategic plans of NCMRR, NIDRR, and other funding sources, a science base for secondary conditions is developing.

On another front, the American Association of Health and Disability was established. The mission of this professional and advocacy organization is the prevention of additional health complications and secondary conditions in people with disabilities and the encouragement of health promotion and wellness programs that will assist people with disabilities to attain and maintain a positive health status. This national organization promotes interactions and information sharing among consumers, professionals, and agencies regarding secondary conditions and wellness for individuals with disabilities.


No single seminal article has defined and enumerated secondary conditions. Various definitions and lists of conditions have appeared in articles and book chapters, on websites, and in promotional material (Pope and Tarlov, 1991; Lollar, 1994; Brandt and Pope, 1997; Coyle et al., 2000; U.S. Department of Health and Human Services, 2000; Simeonsson et al., 2002; Traci et al., 2002; Turk and Weber, 2005). Notwithstanding certain differences, these discussions generally specify some common key dimensions, in particular, that a secondary condition

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