Neuro-Rehabilitative Medicine

There are 61 million adults in the United States living with a disability. The Centers for Disease Control and Prevention (CDC) describes that one in four Blacks, one in six Hispanics, and three in ten American Indians have a disability, making this population the most prevalent yet unrecognized population. This chapter introduces a framework to mitigate the health disparities of people with disabilities in the context of rehabilitation medicine. Health disparities are defined as systemic health differences that can adversely affect people with disabilities and are plausibly avoidable. Health equity is further defined as the commitment to attaining the highest level of health for all people. By understanding the complex interaction of functional impairments and their impact on healthcare disparities for people with disabilities, clinicians can begin to address disparities from a systemic perspective. Advocacy efforts can be focused on designating people with disabilities as a Special Medically Underserved Population to help incentivize research funding. Requiring comprehensive disability clinical-care curriculum for healthcare providers and improving physical access to medical care are additional avenues to implement systemic changes to combat healthcare inequities. The Model of Healthcare Disparities and Disability (MHDD) is an integrated conceptual model that acknowledges that healthcare disparities among individuals with disabilities result from the dynamic interaction of personal and environmental factors. Clinicians in neurologic and rehabilitation medicine are specifically poised to address the interactions between a primary diagnosis and how it affects a person’s disability, health, and level of functioning.