While all of the programs within the Genetic Services
Section work to ensure that services are truly population based, we
spend considerable time trying to reduce/eliminate health disparities
for people with disabilities. Clearly not every one with a genetic
disorder has a disability, nor does everyone with a disability have a
genetic disorder. However, there is significant overlap, and if
you can "fix" the environment to reduce disparities for one group, then
you have fixed it for all.
Specifically, we work to prevent secondary conditions
(e.g., obesity, hypertension, depression, bed sores, etc.) in people
with disabilities. Our philosophy is that by working to promote
increased participation in all aspects of community life for a person
with a disability, the likelihood of secondary conditions will diminish.
This means that to actually measure aspects of community
life and develop appropriate interventions, one must work within the
community (as opposed to a state level policy approach).
We have been working in two counties for the past four
years -- Spokane and Jefferson. In 2002 Grays Harbor County was
added and in 2003 Kitsap County was added as well. In each
community, a local Disability, Awareness, Surveillance & Health
Promotion (DASH) advisory committee is formed and is responsible for
identifying surveillance and intervention needs and figuring out how to
implement these strategies. Each community is very different
geographically, economically, and with respect to available resources.
It's important that these decisions are made locally.
The boards have
chosen activities and intervention that fall into two broad categories:
-
Public awareness
of disability and education of policy makers, city council, businesses,
and the general public.
-
Promoting
community environmental changes to enhance access for people with
disabilities
- reducing/eliminating effects of disability by making changes to
the environment, rather than providing training
or assistive devices to persons with disability.
To date there
have been many successes, here are a few examples:
Spokane -- completed a "You in Transition"
survey and discovered that while youth reported relatively few health
problems, they were more socially isolated and more concerned about the
future than their peers without disabilities. Interventions
underway or planned include:
-
Jobs
mentoring/coaching program for youth.
-
Discussions with
the transit office to allow handicap vans to run past 10 p.m. on
weekends.
-
Collaborative
effort among Spokane-area hospitals and the Health Improvement
Partnership.
-
Use of existing
network to assist rural Eastern Washington communities to develop
community interventions to help individuals with disabilities better
access to services.
Jefferson -- the DASH board identified lack of
access to restaurants, hotels and other public buildings as a
significant barrier to participation. DASH members volunteered to
visit various establishments and assess their accessibility. In
turn, owners or building managers were informed of DASH findings and
recommendations. As a result, businesses are making changes:
-
the local
hospital made entrances more accessible,
-
the city hall
decided to build a new building which will be disability friendly,
-
and a disability
friendly restaurants brochure was developed
- available at the Chamber of Commerce and the ferry leading to
Jefferson County
-
disability-friendly map of Port Townsend, a Jefferson County tourist
attraction linked to the ferry system.
Grays Harbor -- A coastal community struggling
economically due to a logging based economy. Obesity is prevalent
in Grays Harbor County, so much emphasis has been placed on encouraging
businesses to be disability-friendly and accommodating to people of
size. The board has evaluated medical buildings and restaurants in
Grays Harbor, developing disability-friendly brochures. The board
(still in its infancy) has begun several public awareness efforts,
including trainings on the ADA and service animals. In addition,
Grays Harbor is hosting their first Disability for a Day event, inviting
city council members, media, and other influential Grays Harbor
residents.
Kitsap -- is in the early stages of this
project and is just forming a community board and identifying the needs
of the county.
