Disability in America Toward a National Agenda for Prevention (1991) / Chapter Skim
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9 Recommendations
9 Recommendations
Pages 267-287
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From page 267... ...
That same impetus, amplified by the desire for accessible, affordable quality health care for all, led to the committee's finding that there is an urgent need for a well-organized, coordinated national disability prevention program. An agenda for such a program is presented on the next page.
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From page 268... ...
Educate health professionals, people with disability, family members, and personal attendants in disability prevention and preventing the development of secondary conditions.
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From page 269... ...
Leadership of the National Disability Prevention Program The congressionally mandated role of the National Council on Disability (NCD) is to provide advice and make recommendations to the President and to Congress with respect to disability policy.
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From page 270... ...
. In assuming the lead responsibility for implementing the national agenda for the prevention of disability over the life course, the NDPP should coordinate activities with other relevant agencies, emphasizing comprehensive surveillance, applied research, professional and public education, and preventive intervention with balanced attention to developmental disabilities, injuries, chronic diseases, and secondary conditions.
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From page 271... ...
Thus a national disability prevention program will be centrally dependent on public attitudes toward people with disabilities and on the way community activities are organized, which includes access to housing, public transportation, and the workplace. Equally important is the reduction of prejudice and discrimination toward people with disabilities.
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From page 272... ...
The interagency council should have a permanent staff and issue public reports to the Secretary of Health and Human Services, Congress, and the National Council on Disability. The members of the interagency council should be high-level administrators drawn from the major agencies involved in the various aspects of disability, which include the following: Centers for Disease Control; Health Care Financing Administration; Alcohol, Drug Abuse, and Mental Health Administration; National Institute on Disability and Rehabilitation Research; Health Resources and Services Administration (HRSA)
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From page 273... ...
RECOMMENDATION 6: Develop a conceptual framework and standard measures of disability The CDC, which is responsible for surveillance of the nation's health, should design and implement a process for the development and review of conceptual frameworks, classifications, and measures of disability with respect to their utility for surveillance. This effort should involve components of the private sector that collect disability data, as well as federal agencies including the National Institutes of Health; Alcohol, Drug Abuse, and Mental Health Administration; National Council on Disability; Office of Human Development Services (a component of the Department of Health and Human Services)
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From page 274... ...
A National Disability Surveillance System Despite its significance as a public health and social issue, disability has received little attention from epidemiologists and statisticians; consequently, surveillance of disabling conditions is inadequate in many ways. When disability is a focus of attention, surveillance is more often concerned with counting the number of people affected than with investigating its causes and secondary conditions.
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From page 275... ...
The system should also monitor causal phenomena, risk factors, functional status, and quality of life, and provide state-specific data for program planning and evaluation of interventions. This system should be developed in cooperation with a broad range of federal agencies and private organizations and be implemented as part of the National Disability Prevention Program.
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From page 276... ...
As discussed in Chapter 3, an objective analysis is needed that will lead to the development of alternative indexes of disability risk and public health impact. These indexes could be developed and used by the National Disability Prevention Program to help set priorities for prevention efforts among all conditions.
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From page 277... ...
Much more needs to be known, however, and such knowledge can be acquired only through a broad range of research activities. Coordinated Research Program RECOMMENDATION 11: Develop a comprehensive research program A coordinated, balanced program of research on the prevention of disability associated with developmental disabilities, injury, chronic disease, and secondary conditions should be an essential component of the National Disability Prevention Program.
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From page 278... ...
In addition, because rapid changes are occurring for people with disabling conditions in telllls of health services, public attitudes, and opportunities for social participation, cohort studies are needed to assess the effects of these changes over the life course. Relationship of Socioeconomic Status Deeper understanding of the biological underpinnings of pathologies, impairments, and functional limitations is an obvious need, and this knowledge is being pursued in a variety of biomedical research programs, such as those sponsored by the National Institutes of Health and the Alcohol, Drug Abuse, and Mental Health Administration.
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From page 279... ...
The National Institute on Disability and Rehabilitation Research, the Department of Veterans Affairs, the National Institutes of Health, the Alcohol, Drug Abuse, and Mental Health Administration, and the Agency for Health Care Policy and Research should join with CDC to develop cooperative and collaborative research programs in the biological, behavioral, and social sciences as they relate to disability prevention. These programs should also emphasize the translation of new findings into national prevention efforts that inform and educate people with disabilities, their families, personal attendants, and advocates, as well as clinical practitioners.
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From page 280... ...
These factors demonstrably contribute to the incidence, prevalence, and severity of primary and secondary disabling conditions and, tragically, avoidable disability. Recently, the U.S.
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From page 281... ...
In certain circumstances for example, providing prenatal care for the prevention of low birthweight the economic consequences have been shown to be favorable, but they need to be explored further in other areas of health care delivery. Research on prenatal care has demonstrated that comprehensive obstetric care for pregnant women, beginning in the first trimester, reduces the risk of infant mortality and morbidity, including congenital and developmental disability.
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From page 282... ...
absence of local coordinating mechanisms. RECOMMENDATION 18: Develop new health service delivery strategies for people with disabilities New health service delivery strategies should be developed that will facilitate access to services and meet the primary health care, health education, and health promotion needs of people with disabling conditions.
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From page 283... ...
the cost-effectiveness of assistive technologies that will enable people with disabling conditions to pursue health promotion strategies that would not otherwise be accessible to them. Building Capacity A network of services that include information and instruction regarding personal care and assistance in finding a job is an important aspect of a National Disability Prevention Program.
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From page 284... ...
should emphasize surveillance, interventions and assessment of their effectiveness, and the special needs of low socioeconomic status populations (e.g., prenatal care, access to and financing of preventive services, and health promotion and disability prevention education)
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From page 285... ...
In addition, such curricula should address physiatric principles and practices appropriate to the identification of potentially disabling conditions of acute illness and injury. Appropriate interventions, including consultation and collaboration with mental health and allied
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From page 286... ...
Such grants should include components that support education, training, and social reintegration of people with disabilities as well as basic clinical training in the prevention of disability and secondary conditions. Education of the General Public Because disability is a function of social context, many potentially disabling conditions can be prevented with the help of an appropriately informed public.
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From page 287... ...
Independent living centers are also effective advocates for attitudinal and architectural changes in society that would improve accessibility, stimulate social interaction and productivity, and facilitate an active, quality lifestyle. RECOMMENDATION 27: Provide more training opportunities for family members and personal attendants of people with disabling conditions Persons with disabilities, their families, personal attendants, and advocates should have access to information and training relative to disability prevention with particular emphasis on the prevention of secondary conditions.
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