Disabilities make it harder to do normal daily activities. They may limit what you can do physically or mentally, or they can affect your senses. Disability doesn't mean unable, and it isn't a sickness. Most people with disabilities can - and do - work, play, learn, and enjoy full, healthy lives. Mobility aids and assistive devices can make daily tasks easier.

About one in every five people in the United States has a disability. Some people are born with one. Others have them as a result of an illness or injury. Some people develop them as they age. Almost all of us will have a disability at some point in our lives.

A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).

There are many types of disabilities, such as those that affect a person’s:

• Vision
• Movement
• Thinking
• Remembering
• Learning
• Communicating
• Hearing
• Mental health
• Social relationships

Although “people with disabilities” sometimes refers to a single population, this is actually a diverse group of people with a wide range of needs. Two people with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see.

According to the World Health Organization, disability has three dimensions:

1. Impairment in a person’s body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision or memory loss.
2. Activity limitation, such as difficulty seeing, hearing, walking, or problem solving.
3. Participation restrictions in normal daily activities, such as working, engaging in social and recreational activities, and obtaining health care and preventive services.

Disability can be:

• Related to conditions that are present at birth and may affect functions later in life, including cognition (memory, learning, and understanding), mobility (moving around in the environment), vision, hearing, behavior, and other areas. These conditions may be
  • Disorders in single genes (for example, Duchenne muscular dystrophy);
  • Disorders of chromosomes (for example, Down syndrome); and
  • The result of the mother’s exposure during pregnancy to infections (for example, rubella) or substances, such as alcohol or cigarettes.
• Associated with developmental conditions that become apparent during childhood (for example, autism spectrum disorder and attention-deficit/hyperactivity disorder or ADHD)
• Related to an injury (for example, traumatic brain injury or spinal cord injury).
• Associated with a longstanding condition (for example, diabetes), which can cause a disability such as vision loss, nerve damage, or limb loss.
• Progressive (for example, muscular dystrophy), static (for example, limb loss), or intermittent (for example, some forms of multiple sclerosis).

Impairment is an absence of or significant difference in a person’s body structure or function or mental functioning. For example, problems in the structure of the brain can result in difficulty with mental functions, or problems with the structure of the eyes or ears can result in difficulty with the functions of vision or hearing.

• Structural impairments are significant problems with an internal or external component of the body. Examples of these include a type of nerve damage that can result in multiple sclerosis, or a complete loss of a body component, as when a limb has been amputated.
• Functional impairments include the complete or partial loss of function of a body part. Examples of these include pain that doesn’t go away or joints that no longer move easily.

The World Health Organization (WHO) published the International Classification of Functioning, Disability and Health (ICF) in 2001. The ICF provides a standard language for classifying body function and structure, activity, participation levels, and conditions in the world around us that influence health. This description helps to assess the health, functioning, activities, and factors in the environment that either help or create barriers for people to fully participate in society.

According to the ICF:

• Activity is the execution of a task or action by an individual.
• Participation is a person’s involvement in a life situation.

The ICF acknowledges that the distinction between these two categories is somewhat unclear and combines them, although basically, activities take place at a personal level and participation involves engagement in life roles, such as employment, education, or relationships. Activity limitations and participation restrictions have to do with difficulties an individual experiences in performing tasks and engaging in social roles. Activities and participation can be made easier or more difficult as a result of environmental factors, such as technology, support and relationships, services, policies, or the beliefs of others.

The ICF includes the following in the categories of activities and participation:

• Learning and applying knowledge
• Managing tasks and demands
• Mobility (moving and maintaining body positions, handling and moving objects, moving around in the environment, moving around using transportation)
• Managing self-care tasks
• Managing domestic life
• Establishing and managing interpersonal relationships and interactions
• Engaging in major life areas (education, employment, managing money or finances)
• Engaging in community, social, and civic life

It is very important to improve the conditions in communities by providing accommodations that decrease or eliminate activity limitations and participation restrictions for people with disabilities, so they can participate in the roles and activities of everyday life.

Adults with disabilities are 3 times more likely to have heart disease, stroke, diabetes, or cancer than adults without disabilities.

Nearly half of all adults with disabilities get no aerobic physical activity, an important health behavior to help avoid these chronic diseases.

Adults with disabilities were 82% more likely to be physically active if their doctor recommended it.

More than 21 million US adults 18–64 years of age have a disability. These are adults with serious difficulty walking or climbing stairs; hearing; seeing; or concentrating, remembering, or making decisions. Most adults with disabilities are able to participate in physical activity, yet nearly half of them get no aerobic physical activity. Physical activity benefits all adults, whether or not they have a disability, by reducing their risk of serious chronic diseases, such as heart disease, stroke, diabetes and some cancers. Only 44% of adults with disabilities who visited a doctor in the past year were told by a doctor to get physical activity. Yet adults with disabilities were 82% more likely to be physically active if their doctor recommended it.

Doctors and other health professionals can:

• Ask adults with disabilities how much physical activity they get each week.
• Remind adults with disabilities to get regular physical activity consistent with their abilities. They should try to get at least 2 1/2 hours a week of moderate-intensity physical activity. If this is not possible, some activity is better than none.
• Recommend physical activity options that match the specific abilities of each person and connect them to resources that can help each person be physically active.

Problem

More adults with disabilities need to get physical activity.

Adults with disabilities who get no physical activity are 50% more likely to have certain chronic diseases than those who get the recommended amount of physical activity.

• Aerobic physical activity can help all adults avoid costly and deadly chronic diseases such as heart disease, stroke, diabetes, and some cancers.
• 1 in 2 adults with disabilities get no aerobic physical activity compared with 1 in 4 adults without disabilities.
• Adults with mobility limitations (serious difficulty walking or climbing stairs) are the least likely to get any aerobic physical activity. Nearly 6 in 10 of them do not get any aerobic physical activity.
• Adults with disabilities face physical and emotional barriers to getting aerobic physical activity, including:
  • Knowing about and getting to programs, places, and spaces where they can be physically active;
  • Having social support for physical activity;
  • Finding fitness and health professionals who can provide physical activity options that match their specific abilities.

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  Adults with disabilities are more likely to get physical activity if doctors recommend it.

  • Only 44% of adults with disabilities who visited a doctor in the past year got a physical activity recommendation from their doctor.
  • Adults with disabilities who got a physical activity recommendation from their doctor were 82% more likely to be physically active than those who did not get one.
  • It is critical for doctors to know the Physical Activity Guidelines and help their patients with disabilities overcome barriers to reach their physical activity goals.

Infographic

What Can Be Done

Federal government is

• Funding national and state programs to develop physical activity programs for adults with disabilities.
• Measuring state and national progress towards getting all US adults physically active through the Disability and Health Data System (DHDS) and other systems.
• Providing accessible and high-quality health care to adults with disabilities by improving training and cultural competency for doctors and other health professionals.

Doctors and other health professionals can

• Ask adults with disabilities about how much physical activity they get each week.
• Remind adults with disabilities to get regular physical activity. They should try to get at least 2 hours and 30 minutes a week of moderate-intensity physical activity. If this is not possible, patients with disabilities should avoid inactivity; some activity is better than none.
• Recommend physical activity options that match each person’s specific abilities and connect him or her to resources that can help each person be physically active.
• Use CDC’s website to find resources that can help you talk to patients with disabilities about physical activity.

States and communities can

• Bring together adults with disabilities, health professionals, and community leaders to address resource needs to increase physical activity.
• Make sure physical activity, recreation, and sport-based program opportunities are accessible to adults with disabilities.
• Incorporate community features such as proper curb cuts on sidewalks, ramps for wheelchair access, and well-maintained trails to improve safe access to public places for physical activity.
• Encourage fitness and recreation facilities to have low-counter front desks for wheelchair users, family changing areas in locker rooms, push-button operated doors, and elevators.

Adults with disabilities can

• Talk to your doctor about how much and what kind of physical activity is right for you.
• Find opportunities to increase physical activity regularly in ways that meet your needs and abilities.
  • Regular aerobic physical activity increases heart and lung function; improves daily living activities and independence; decreases chances of developing chronic diseases; and improves mental health.
• Start slowly based on your abilities and fitness level (e.g. be active for at least 10 minutes at a time, slowly increase activity over several weeks, if necessary).

Studies have shown that individuals with disabilities are more likely than people without disabilities to report:

• Poorer overall health.
• Less access to adequate health care.
• Smoking and physical inactivity.

People with disabilities need health care and health programs for the same reasons anyone else does—to stay well, active, and a part of the community.

Although a smaller percentage than people without disabilities, most people with disabilities report their health to be good, very good, or excellent. Being healthy means the same thing for all of us—getting and staying well so we can lead full, active lives. That means having the tools and information to make healthy choices and knowing how to prevent illness. For people with disabilities, it also means knowing that health problems related to a disability can be treated. These problems (also called secondary conditions) can include pain, depression, and a greater risk for certain illnesses.

Secondary Conditions

People with disabilities often are at greater risk for health problems that can be prevented. As a result of having a specific type of disability, such as a spinal cord injury, spina bifida, or multiple sclerosis, other physical or mental health conditions can occur.

Some of these other health conditions are also called secondary conditions and might include:

• Bowel or bladder problems
• Fatigue
• Injury
• Mental health and depression
• Overweight and obesity
• Pain
• Pressure sores or ulcers

Bowel and Bladder

Some disabilities, such as spinal cord injuries, can affect how well a person’s bladder and bowel works.

Fatigue

Fatigue is a feeling of weariness, tiredness, or lack of energy. Fatigue can affect the way a person thinks and feels. It can also interfere with a person’s activities of daily living.

Injury

Injuries—including unintentional injury, homicide, and suicide—are the leading cause of death for people 1 through 44 years of age. The consequences of injuries can include physical, emotional, and financial consequences that can affect the lives of individuals, their families, and society.

Mental Health and Depression

Mental health is how we think, feel, and act as we cope with life. People with disabilities report higher rates of stress and depression than people without disabilities. There are different ways to treat depression. Exercise can be effective for some people. Counseling or medication also might be needed.

Overweight and Obesity

Children and adults with disabilities are less likely to be of healthy weight and more likely to be obese than children and adults without disabilities. Overweight and obesity can have serious health consequences for all people.

Pain

Pain is commonly reported by people with many types of disabilities. For some, pain can affect functioning and activities of daily living. The length of time a person experiences pain can be classified as either long term (also called chronic) or short term.

Pressure Sores or Ulcers

Pressure ulcers—also known as bed sores, pressure sores, or decubitus ulcers—are wounds caused by constant pressure on the skin. They usually develop on body parts such as the elbow, heel, hip, shoulder, back, and back of the head.

People with disabilities who are bedridden or use a wheelchair are at risk for developing pressure sores.

Other Concerns, Conditions, and Prevention

Many related health conditions and chronic diseases can be prevented. Chronic diseases are among the most common and costly of all health problems, even though many chronic diseases can be prevented. Some chronic diseases can be prevented by living a healthy lifestyle, visiting a health care provider for preventive care and routine screenings, and learning how to manage health issues. For more information and tools on other health conditions that are important to living healthy with a disability, click on the links that follow the text in each of the next sections.

Arthritis

Arthritis—or join inflammation—is the most common cause of disability among adults residing in the United States. It limits everyday activities for 24 million Americans. People with disabilities can be at greater risk of having arthritis.

Asthma

Asthma is a disease that affects the lungs. It is one of the most common long-term diseases among children, but adults can have asthma, too. Asthma is the most common chronic disease of childhood and a leading cause of disability among children.

Cancer

Getting screened for breast, cervical, and colorectal cancers as recommended helps find these diseases at an early, often highly treatable, stage. Research shows that women with disabilities are less likely to be screened for breast and cervical cancer within the recommended guidelines. Some reasons identified by women include encountering inaccessible facilities and equipment, and having to focus on other health issues.

Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) affects more than one million people in the United States. It is four times more common among females than males. People of both sexes and of every race and ethnicity and age (including adolescents) can develop CFS.

Diabetes

Diabetes is a chronic disease for which care and treatment can help people to live normal and productive lives. However, some people might be limited in their everyday activities. People with diabetes, in general, report rates of disability that are significantly higher than those reported by the general U.S. population.

Flu

People with certain types of disability have a higher risk of getting flu-related complications, such as pneumonia. Some physical disabilities can affect how well their body fights off infection. They should discuss their risk of illness with their health care provider.

Heart Disease

Heart disease, also called cardiovascular disease, is the leading cause of death in the United States. Around 630,000 Americans die of heart disease each year. It is also a leading cause of disability.

Learning Disabilities

Learning disabilities are disorders that may affect a person’s ability to understand or use spoken or written language, do mathematical calculations, coordinate movements, or direct attention. Learning disabilities can be lifelong conditions and some people can have several overlapping learning disabilities. Other people can have a single, isolated learning problem that has little effect on their lives.

Limb Loss

Limb loss can occur due to trauma, infection, diabetes, vascular disease, cancer, or other diseases. Some children are born with limb loss or differences. Limb loss more often is the result—rather than the cause—of other health problems. However, loss of a limb can result in decreased physical activity, skin problems associated with using a prosthesis, and phantom pain for the residual limb.

MRSA

Methicillin-resistant Staphylococcus aureus, or MRSA, is a type of bacteria that is resistant to certain antibiotics. MRSA, most often occurs among people in hospitals and health care facilities such as (nursing homes and dialysis centers) who have weakened immune systems. A person can get MRSA through direct contact with an infected person or by sharing personal items, such as towels or razors that have touched infected skin.

Musculoskeletal Disorders

Musculoskeletal disorders include problems such as back pain, joint injuries, tendinitis, and repetitive strain. Musculoskeletal injuries can cause temporary or even permanent disability, leaving some individuals unable to move around easily. Work-related musculoskeletal disorders are the leading cause of disability for people during their working years.

Nutrition (Healthy Eating)

Healthy eating is associated with reduced risk for many diseases, including the three leading causes of death in the U.S.: heart disease, cancer, and stroke.

Oral Health

Good oral health is important and can affect the health and well-being of a person’s life. Oral health is more than just having healthy teeth; for example, lifestyle behaviors, such as tobacco use, can affect general and oral health. Oral diseases and conditions are associated with other health problems as well. However, safe and effective measures exist to prevent the most common dental diseases.

Respiratory Virus

Respiratory syncytial virus—or RSV—is a virus common in childhood and important among older adults. RSV infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in 1 to 2 weeks. However, infection can be severe among some people.

Substance Abuse

Alcohol, tobacco, illicit drugs, and prescription medications all can be substances of abuse. People with disabilities might have multiple risk factors that can increase their chances for substance abuse.

Violence

Violence is a serious public health problem in the United States. People with disabilities are 4 to 10 times more likely to become victims of violence, abuse, or neglect than people without disabilities. Children with disabilities are more than twice as likely to be physically or sexually abused as children without disabilities.

Finding Breast Cancer Early Can Save Lives

Breast cancer is the most common type of cancer among women in the United States, and the second leading cause of cancer-related deaths. Thinking “breast cancer won’t happen to me” is a risk no woman should take. Having a screening mammogram regularly is an important way to maintain good health. A mammogram, which is an X-ray picture of the breast, is the best way to find breast cancer early, when it is easiest to treat and before it is big enough to feel or cause symptoms.

• If breast cancer is found early, treatment can have a greater chance for success.
• Many women who are diagnosed with and treated for breast cancer live long and healthy lives.

Women with Disabilities Are Less Likely to Have Received a Mammogram During the Past Two Years

Breast Cancer Screening Recommendations

If you are between the ages of 50-74 years, be sure to have a screening mammogram every two years. If you are between the ages of 40-49 years, talk to your doctor about when and how often you should have a screening mammogram.

Percentage of U.S. Adult Women 50-74 Years of Age Who Received a Mammogram During the Past 2 Years, By Disability Status – 2010 National Household Interview Survey(NHIS)

Getting Screened: Tips for Women with Disabilities

If you are a woman living with a disability, you may face challenges that make it hard to get a mammogram. Here are some questions to ask when scheduling your mammogram that can help you prepare for your appointment:

• How should I dress?
• How do I prepare if I use a wheelchair or a scooter?
• Can the machine be adjusted so I can remain seated?
• How long is the appointment and can I have more time if I need it?

Let the scheduling staff, radiology technicians, or radiologist know if you can/cannot:

• Sit upright with or without assistance.
• Lift and move your arms.
• Transfer from your chair/scooter.
• Undress/dress without assistance.

When preparing for your mammogram, remember:

• Wear a blouse that opens in the front.
• Wear a bra that you can remove easily.
• Do not wear deodorant or body powder.
• If you have any disability-related concerns, discuss them with your primary care physician, women’s health specialist, radiologist, physician’s assistant, or other healthcare professional.

COVID-19 is a new disease and we are still learning about it and who is more likely to become severely ill.

Most people with disabilities are not more likely to become infected with or have severe illness from COVID-19. However, some people with disabilities might be more likely to get infected or have severe illness because of underlying medical conditions, congregate living settings, or systemic health and social inequities. All people with serious underlying chronic medical conditions like chronic lung disease, a serious heart condition, or a weakened immune system seem to be more likely to get severely ill from COVID-19. Adults with disabilities are three times more likely than adults without disabilities to have heart disease, diabetes, cancer, or a stroke.

Disability groups and risk

If you have one of the disability types listed below, you might be at increased risk of becoming infected or having unrecognized illness. You should discuss your risk of illness with your healthcare provider.

• People who have limited mobility or who cannot avoid coming into close contact with others who may be infected, such as direct support providers and family members
• People who have trouble understanding information or practicing preventive measures, such as hand washing and social distancing
• People who may not be able to communicate symptoms of illness

Protect yourself

If you or someone you care for are at higher risk of getting very sick from COVID-19, take steps to prevent getting sick. In addition to practicing everyday preventive actions, people with disabilities who have direct support providers can help protect themselves from respiratory illness in the following ways:

• Ask your direct support provider if they are experiencing any symptoms of COVID-19 or if they have been in contact with someone who has COVID-19
• Tell your direct service provider to
  • Wash their hands when they enter your home and before and after touching you (e.g., dressing, bathing/showering, transferring, toileting, feeding), handling tissues, or when changing linens or doing laundry.
  • Clean high-touch surfaces and objects (e.g., counters, tabletops, keyboards, wheelchairs, scooters, oxygen tanks, doorknobs) regularly (for example, daily or after each use).
  • Wear a well-fitting mask or respirator over the nose and mouth.

Prepare

There are some additional things people with disabilities can do to prepare during the COVID-19 outbreak:

• Plan what you will do if you or your direct support provider gets sick. Create a contact list of family, friends, neighbors and local service agencies that can provide support in case you or your direct support provider becomes ill or unavailable.
• Plan at least two ways of communicating from home and work that can be used rapidly in an emergency (e.g., landline phone, cell phone, text-messaging, email). Write down this information and keep it with you.
• Have enough household items and groceries so that you will be comfortable staying home for a few weeks, at least a 30-day supply of over the counter and prescription medicines and any medical equipment or supplies that you might need. Some health plans allow for a 90-day refill on prescription medications. Consider discussing this option with your healthcare provider. Make a photocopy of prescriptions, as this may help in obtaining medications in an emergency situation.

About COVID-19

• Coronavirus disease is a respiratory illness that can spread from person to person. The virus is thought to spread mainly between people who are in close contact with one another (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes. It is also possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes.
• Risk of infection with COVID-19 is higher for people who are in close contact with someone known to have COVID-19, such as healthcare workers, direct support providers, and household members. Other people at higher risk for infection are those who live or have recently been in an area with ongoing spread of COVID-19.

Prevention

The best way to prevent infection is to take everyday preventive actions, including:

• Wear a mask.
• Stay at least 6 feet from people who don’t live with you.
• Avoid crowds and poorly ventilated spaces.
• Wash your hands often, or use hand sanitizer made with at least 60% alcohol.​

Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. Behavior, environment, and genetic factors can affect whether a person is overweight or obese.

Adults

For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because, for most people, it correlates with their amount of body fat.

• An adult who has a BMI between 25 and 29.9 is considered overweight.
• An adult who has a BMI of 30 or higher is considered obese.

Children

Among children of the same age and sex, overweight is defined on CDC growth charts as a BMI at or above the 85th percentile and lower than the 95th percentile. Obesity is defined as having a BMI at or above the 95th percentile.

Did You Know?

Researchers have shown that BMI may not be the best measurement for some people with disabilities.

For example, BMI can underestimate the amount of fat in people with spinal cord injuries who have less lean muscle mass.

Some researchers prefer measuring a person’s waist or neck where extra fat might be on the body, and using other methods to determine if a person is overweight or obese.

The Obesity Epidemic

Obesity affects different people in different ways and may increase the risk for other health conditions among people with and without disabilities.

People with Disabilities

• Children and adults with mobility limitations and intellectual or learning disabilities are at greatest risk for obesity.
• 20% of children 10 through 17 years of age who have special health care needs are obese compared with 15% of children of the same ages without special health care needs.
• Annual health care costs of obesity that are related to disability are estimated at approximately $44 billion.

In the United States

• More than one-third of adults – more than 72 million people – are obese.
• Obesity rates are significantly higher among some racial and ethnic groups. Non-Hispanic Blacks or African Americans have a 51% higher obesity prevalence and Hispanics have a 21% higher obesity prevalence than Non-Hispanic Whites.
• A CDC Vital Signs report, titled “State-Specific Obesity Prevalence Among Adults – United States, 2009,” points out that people who are obese incurred $1,429 per person extra in medical costs compared to people of normal weight.
• Annual health care costs of obesity for all adults in the United States were estimated to be as high as $147 billion dollars for 2008.

Challenges Facing People with Disabilities

People with disabilities can find it more difficult to eat healthy, control their weight, and be physically active. This might be due to:

• A lack of healthy food choices.
• Difficulty with chewing or swallowing food, or its taste or texture.
• Medications that can contribute to weight gain, weight loss, and changes in appetite.
• Physical limitations that can reduce a person’s ability to exercise.
• Pain.
• A lack of energy.
• A lack of accessible environments (for example, sidewalks, parks, and exercise equipment) that can enable exercise.
• A lack of resources (for example, money, transportation, and social support from family, friends, neighbors, and community members).

What can be done?

Obesity is a complex problem that requires a strong call for action, at many levels, for both adults as well as children. More efforts are needed, and new federal initiatives are helping to change our communities into places that strongly support healthy eating and active living.

All people can:

• Eat more fruits and vegetables and fewer foods high in fat and sugar.
• Drink more water instead of sugary drinks.
• Watch less television.
• Support breastfeeding.
• Promote policies and programs at school, at work, and in the community that make the healthy choice the easy choice.
• Be more physically active.

Physical Activity for People with Disabilities

Evidence shows that regular physical activity provides important health benefits for people with disabilities. Benefits include improved cardiovascular and muscle fitness, mental health, balance, and a better ability to do tasks of daily life.

Health Consequences of Overweight and Obesity

Overweight and obesity increases the risk of a number of other conditions, including:

• Coronary heart disease
• Type 2 diabetes
• Cancers (endometrial, breast, and colon)
• High blood pressure
• Lipid disorders (for example, high total cholesterol or high levels of triglycerides)
• Stroke
• Liver and Gallbladder disease
• Sleep apnea and respiratory problems
• Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
• Gynecological problems (abnormal periods, infertility)

Most women with disabilities can have healthy pregnancies and deliver healthy babies, especially if they have a health care team that is knowledgeable about their disability. However, in a national study, many women reported difficulty finding health care providers and hospitals that had experience managing pregnancies with their disability.

Women with disabilities face many of the same health problems, including weight gain and fatigue, as other pregnant women. However, these problems can be more serious or lead to other complications in women with disabilities. Other challenges faced by women with disabilities may include:

• More problems with bladder function, such as infections and leakage. An increase in infections could lead to pregnancy loss, preterm labor, and a low-birth-weight infant.
• Breathing difficulties and pneumonia, particularly for women who have breathing problems before pregnancy.
• Worsening of the symptoms of multiple sclerosis (MS) following delivery. One study shows that this occurs within 1 month of delivery in as many as 30% of pregnant women with MS.
• Increased seizures in women who experience seizures already as a result of a traumatic brain injury.
• Autonomic dysreflexia (a severe, sudden rise in blood pressure). The risk of autonomic dysreflexia is increased for pregnant women with spinal cord injuries.

Pre-Pregnancy care and prenatal care from health care providers experienced in managing pregnancies with women with disabilities can improve the health of the mother and the infant.

Cigarette smoking kills almost one in five adults each year.

Tobacco use is the leading preventable cause of death in the United States.

Current cigarette smoking is significantly higher among adults with a disability (27.8%) compared to adults without a disability (13.4%). The percentage of adults with disabilities using E-cigarettes is also higher (8%) compared to adults without disabilities (3.9%).

Public Health Programs and Campaigns

Access to proven smoking cessation treatments and services and public information campaigns may significantly reduce health care costs and save the lives of people, including those with disabilities. Evidence shows that access to comprehensive tobacco control programs can reduce smoking rates, tobacco-related deaths, and diseases caused by smoking.

To reduce and prevent smoking among people with disabilities, public health programs can:

• Include disability in public health surveys and research activities
• Update existing health promotion campaigns or programs with targeted smoking cessation messages for people with disabilities
• Include people with disabilities in health promotion activities

What is CDC Doing to Reduce Smoking among People with Disabilities?

CDC provides funding to 19 State Disability and Health Programs that work to improve the health and wellness of people with disabilities by including them in health promotion activities to reduce smoking. For example,

The Ohio Disability and Health Program collaborated with the Ohio Department of Health’s Tobacco Use Prevention and Cessation Program (TUPCP) to encourage people with disabilities to use the Ohio Tobacco Quit Line.

• The highlights of the program include:
  • Collaborating with TUPCP to add a disability screener question to the Quitline intake form to track people with disabilities who use the service. The addition of this identifier allows the program to track change in use of the Quitline by people with disabilities over time.
  • Collaborating with TUPCP to create a mass media campaign to raise awareness of the Quitline among people with disabilities. Focus groups were held to gather feedback from the disability community in the development of effective marketing materials. During the 3-month campaign, the proportion of callers with a disability who called the Quitline, relative to all callers, increased by 25%.
• Engaging in a Tobacco Cessation Community of Practice that included TUPCP and National Jewish Health (provider of Ohio Tobacco Quitline). This work resulted in National Jewish Health requiring disability sensitivity training for Tobacco Quitline counselors.

Members of the Disability and Health and Tobacco units at the Michigan Department of Health and Human Services (MDHHS) are working together to promote the Michigan Tobacco Quitline among people with disabilities.

• The highlights of the program include:
  • Training vocational service specialists—those who work directly with employees—at Peckham Industries. Peckham is the largest vocational rehabilitation agency in Lansing (Michigan’s capitol), and the agency employs quite a few people with disabilities. Among other employee services, Peckham assists employees who wish to quit tobacco. Since the training, Peckham has changed its policies so that all employees who wish to quit tobacco are automatically referred to the Michigan Tobacco Quitline.
  • Partnering with a creative advertising class at Michigan State University, students were asked to design posters and other print materials that creatively illustrate the differences in smoking rates for various groups of people and the importance of accessible smoking cessation resources. This raised awareness about access and inclusion among the students and provided strong visual messages that MDHHS is using to promote the Michigan Tobacco Quitline among people with disabilities.

The New Hampshire Disability and Public Health Program developed materials that can be used by healthcare providers to support people with disabilities who want to quit smoking.

• The highlights of the program include:
  • Developing a smoking cessation brochure [631 KB/2 pages] that offers tips to help people with disabilities quit smoking.
  • Exploring the possibility of including disability identifiers on the state’s Quitline intake form.
  • Providing technical assistance and offering training to the New Hampshire Tobacco Prevention and Cessation Program (TPCP) to improve inclusion and accessibility of the program.

Nickole Cheron’s Story

In 2008, a rare winter storm buried Portland, Oregon under more than a foot of snow. The city was gridlocked. Nickole Cheron was stuck in her home for eight days. Many people would consider that an inconvenience. For Nickole, whose muscles are too weak to support her body, those eight days were potentially life-threatening.

Born with spinal muscular atrophy, a genetic disease that progressively weakens the body’s muscles, Nickole is fully reliant on a wheelchair and full-time caregivers for most routine tasks. Being alone for eight days was not an option. So Nickole signed up for “Ready Now! [PDF – 4.8MB] ,” an emergency preparedness training program developed through the Oregon Office of Disability and Health.

“The most important thing I learned from ‘Ready Now!’ was to have a back-up plan in case of an emergency situation,” she said. “When I heard the snow storm was coming, I emailed all my caregivers to find out who lived close by and would be available. I made sure I had a generator, batteries for my wheelchair, and at least a week’s supply of food, water and prescription medication.”

Nickole said the training was empowering, and reinforced her ability to live independently with a disability. She felt better informed about the potential risks people with disabilities could encounter during a disaster. For example, clinics might close, streets and sidewalks might be impassable, or caregivers might be unable to travel.

Among the tips Nickole learned from Oregon’s “Ready Now!” training are:

• Develop a back-up plan. Inform caregivers, friends, family, neighbors or others who might be able to help during an emergency.
• Stock up on food, water, and any necessary prescription medications, medical supplies or equipment. Have enough to last at least a week.
• Make a list of emergency contact information and keep it handy.
• Keep a charged car battery at home. It can power electric wheelchairs and other motorized medical equipment if there is an electricity outage.
• Learn about alternate transportation and routes.
• Understand the responsibilities and limitations of a “first responder” (for example, members of your local fire department of law enforcement office) during a disaster.

“This training shows people with disabilities that they can do more to triage their situation in a crisis than anyone else can,” she said. “‘Ready Now!’ encourages people with disabilities to take ownership of their own care.”

CDC would like to thank Nikole and the Oregon Office of Disability and Health for sharing this personal story.

Jerry’s Story

Jerry is a 53 year old father of four children. He’s independent, has a house, raised a family and his adult kids still look to him for support. Jerry recently retired as a computer programmer in 2009, and competes and coaches in several sports. This “healthy, everyday Joe, living a normal life” has even participated in the Boston Marathon.
Jerry also has had a disability for over 35 y ears. In 1976 on December 3 (the same day that International Persons with Disabilities Day is recognized) Jerry was hit by a drunk driver. The accident left him as a partial paraplegic.

Jerry’s life is not defined by his disability. He lives life just like anyone else without a disability would live their life. “There’s lots I can do, and there are some things that I can’t do,” said Jerry. “I drive, I invest money. I’m not rich, but I’m not poor. I enjoy being healthy, and being independent.”

As a person with a disability, however, Jerry has experienced many barriers. Recovering from recent rotator cuff surgery, his rehabilitation specialists “couldn’t see past his disability”, administering tests and delivering additional rehabilitation visits that a person without a disability wouldn’t receive. He once was being prepared for surgery when a nurse proclaimed “he doesn’t need an epidural, he’s a paraplegic.” Jerry had to inform the nurse that he was only a partial paraplegic and that he would indeed need an epidural.

Jerry was in line at an Alabama court house to renew his parking permit and also renew his son’s registration. He watched a worker walk down the line and ask people “what do you need?” When she got to Jerry and saw his wheelchair, he was asked “who are you here with?” And Jerry finds it difficult to go to concerts and baseball games with a large family or friends gathering, because rarely are handicap-accessible tickets available for more than two people.

Jerry has seen a lot in over 35 years as someone living with a disability. He’s seen many of the barriers and attitudes towards people with disabilities persist. But he’s also seen many positive changes to get people with disabilities physically active through recreational opportunities such as golf, fishing and even snow-skiing. There are now organizations such as Lakeshore Foundation – where Jerry works part-time coaching youth basketball and track – that provide recreational opportunities.

Jerry states: “I don’t expect the world to revolve around us. I will adapt – just make it so I can adapt.”

Justin’s Story

Justin was first diagnosed with a disability in the form of ADD (attention deficit disorder, now known as ADHD, or attention-deficit/hyperactivity disorder) at the age of 5 years. The diagnosis resulted in his removal from a regular classroom environment to special education courses. Justin’s parents were informed by Justin’s educators that he probably wouldn’t graduate high school, much less college.

Years later, as a young adult, Justin developed Meniere disease (an inner ear disorder), which affected his hearing and balance. The onset of the disorder left Justin with the scary reality that he could permanently lose his hearing at any time. Justin recalled a former supervisor taking advantage of this knowledge with an inappropriate prank: While speaking in a one-on-one meeting, the sound from the supervisor’s mouth abruptly halted, while his lips continued to move. Justin thought he had gone deaf – until the supervisor started laughing – which Justin could hear. Behaviors like the above took its toll on Justin’s confidence – yet, he knew he could contribute in society.

Spurred in part by adversity, Justin went back to school, earned a business degree, and shortly after, entered the commercial marketing industry. However, despite his education and experience, Justin was still regularly subject to the same stigma. Many of Justin’s work experiences over the course of his career left him feeling ashamed, guilty, offended, and sometimes, even intimidated. Rather than instilling confidence, it left him demoralized – simply because he was differently abled.

In July of 2013, everything changed for Justin. He joined the Centers for Disease Control and Prevention working as a contractor in the Division of Human Development and Disability at the National Center on Birth Defects and Developmental Disabilities. Justin’s colleagues put an emphasis on making him feel comfortable and respected as a member of a diverse and productive workforce. They welcomed Justin’s diversity, positively contributing to his overall health.

The mission of the Division of Human Development and Disability is to lead public health in preventing disease and promoting equity in health and development of children and adults with or at risk for disabilities. One in two adults with disabilities does not get enough aerobic physical activity, and for Justin, regular physical activity is important to help him combat potentially lethal blood clots due to a genetic blood clotting disorder that he has. Every working hour, Justin walks for a few minutes, stretches, or uses his desk cycle. Justin also participates in walking meetings, which he believes leads to more creative and productive meetings.

Stories such as Justin’s are reminders that employment and health are connected. CDC is proud to support National Disability Employment Awareness Month every October. The awareness month aims to educate about disability employment issues and celebrate the many and varied contributions of America’s workers with disabilities.

Suhana’s Story

Suhana has a sister, Shahrine, who is older by 18 months. While Shahrine’s mother was pregnant with Suhana, their uncle came to town for a visit. During the visit, their uncle was quick to notice that Shahrine did not seem to be talking at an age appropriate level or respond when called upon. Shahrine would also turn up the volume on the television and radio when others could hear it without difficulty. Shahrine’s parents thought that her speech development and behavior were normal for a toddler, but thanks to the uncle expressing his concerns, the family soon took action. A hearing test found that Shahrine was hard of hearing.

Due to Shahrine’s diagnosis, Suhana received a hearing screening at birth and was found to be hard of hearing, as well. Had it not been for the concerns raised by the children’s uncle, not only would Shahrine’s hearing loss have possibly gone on longer without being detected, but Suhana would most likely not have had a hearing screening at birth.

As a result of their early diagnoses, Suhana and Shahrine’s parents were able to gain the knowledge they needed to make sure both of their children could reach their full potential in life. They had access to early services from a team of physicians, speech therapists, counselors, and teachers.

Suhana credits her parents for her own successes, saying that she couldn’t have made it as far as she has without their support and patience. Today, Suhana is employed at the Centers for Disease Control and Prevention (CDC) as an epidemiologist with the agency’s Early Hearing Detection and Intervention (EHDI) program. All children who are deaf or hard of hearing receive critical services they need as a result of the EHDI program, which funds the development of data systems and provides technical assistance to help improve screening, diagnosis and early intervention for these infants. When children who are deaf or hard of hearing receive services early, they are more likely to reach their full potential and live a healthy, productive adult life.

People with disabilities need health care and health programs for the same reasons anyone else does—to stay well, active, and a part of the community.

Having a disability does not mean a person is not healthy or that he or she cannot be healthy. Being healthy means the same thing for all of us—getting and staying well so we can lead full, active lives. That means having the tools and information to make healthy choices and knowing how to prevent illness.

For people with disabilities, it also means knowing that health problems related to a disability can be treated. These problems, also called secondary conditions, can include pain, depression, and a greater risk for certain illnesses.

To be healthy, people with disabilities require health care that meets their needs as a whole person, not just as a person with a disability. Most people with or without disabilities can stay healthy by learning about and living healthy lifestyles.

Leading a Long and Healthy Life

Although people with disabilities sometimes have a harder time getting and staying healthy than people without disabilities, there are things we can all do to get and stay healthy.

Tips for leading a long and healthy life:

• Be physically active every day.
• Eat healthy foods in healthy portions.
• Don’t get too much sun.
• Get regular checkups.
• Don’t smoke.
• Use medicines wisely.
• If you drink alcoholic beverages, drink in moderation.
• Get help for substance abuse.
• Stay in touch with family and friends.
• If you need help, talk with your health care professional.

Getting the Best Possible Health Care

People with disabilities must get the care and services they need to help them be healthy.

If you have a disability, there are many things you can do to make sure you are getting the best possible health care:

• Know your body, how you feel when you are well and when you’re not.
• Talk openly with your health care professional about your concerns.
• Find health care professionals that you are comfortable with in your area.
• Check to be sure you can physically get into your health care professional’s office, such as having access to ramps or elevators if you use an assistive device like a wheelchair or scooter.
• Check to see if your health care professional’s office has the equipment you need, such as an accessible scale or examining table.
• Ask for help from your health care professional’s office staff if you need it.
• Think about your questions and health concerns before you visit your health care professional so that you’re prepared.
• Bring your health records with you.
• Take a friend with you if you are concerned you might not remember all your questions or what is said by the health care professional.
• Get it in writing. Write down, or have someone write down for you, what is said by the health care professional.

Physical Activity

Adults of all shapes, sizes, and abilities can benefit from being physically active, including those with disabilities. For important health benefits, all adults should do both aerobic and muscle-strengthening physical activities. Regular aerobic physical activity increases heart and lung functions; improves daily living activities and independence; decreases chances of developing chronic diseases; and improves mental health.

Adults with disabilities should try to get at least 2 hours and 30 minutes (150 minutes) a week of moderate-intensity aerobic physical activity (i.e., brisk walking; wheeling oneself in a wheelchair) or at least 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity (i.e., jogging, wheelchair basketball) or a mix of both moderate- and vigorous-intensity aerobic physical activities each week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity. They should avoid inactivity as some physical activity is better than none.

Muscle-strengthening activities should include moderate and high intensity, and involve all major muscle groups on two or more days a week (i.e., working with resistance-band, adapted yoga) as these activities provide additional health benefits. All children and adolescents should do 1 hour (60 minutes) or more of physical activity each day.

If a person with a disability is not able to meet the physical activity guidelines, they should engage in regular physical activity based on their abilities and should avoid inactivity. Adults with disabilities should talk to their healthcare provider about the amounts and types of physical activity that are appropriate for their abilities.

Tips for getting fit:

• Talk to your doctor about how much and what kind of physical activity is right for you.
• Find opportunities to increase physical activity regularly in ways that meet your needs and abilities.
• Start slowly, based on your abilities and fitness level (e.g. be active for at least 10 minutes at a time, slowly increase activity over several weeks, if necessary).
• Avoid inactivity. Some activity is better than none!

Abuse and Violence of People with Disabilities

People with disabilities are at greater risk for abuse, violence, and harm than people without disabilities. This is called victimization. Victimization is harm caused on purpose. It is not an “accident” and can happen anywhere. The two most common places where victimization occurs are in hospitals and homes.

Victimization includes:

• Physical violence with or without a weapon.
• Sexual violence of any kind, including rape.
• Emotional abuse, including verbal attacks or being humiliated.
• Neglect of personal needs for daily life, including medical care or equipment.

In the United States, people with disabilities are 4 to 10 times more likely to be victimized than people without disabilities. Children with disabilities are more than twice as likely to be victimized as children without disabilities. Researchers found that 11.5% of adults with a disability were victims of sexual assault vs. 3.9% of adults without disabilities. In addition, 13.0% of people with disabilities were victims of attempted sexual assault compared to 5.7% without disabilities.

Victims usually know the person who harms them. They can be health care workers, intimate partners, or family members. More men than women cause harm to people with disabilities. If you or someone you love is being victimized, there is help available.

• Dial 911 if you need immediate assistance.
• Call the National Domestic Violence hotline at:
  • 1-800-799-SAFE or TTY 1-800-787-3224

Sexual Health and Sexuality

Health care professionals and people with disabilities should feel comfortable talking to each other about sexual health and sexuality. People with disabilities can ask their doctor questions about sexuality, sexual functioning, contraceptives, and reproductive concerns.

Mental Health and Well-Being

For everyone, overall mental health and well-being is very important. Mental health is how we think, feel and act as we cope with life. People need to feel good about their life and value themselves.

All people, including those with disabilities might feel isolated from others, or have low self-esteem. They may be depressed. There are different ways to treat depression. Exercise may be effective for some people. Counseling, medication, or both might also be needed.

Everyone feels worried, anxious, sad or stressed sometimes. If these feelings do not go away and they interfere with your daily life, you should talk with other people about your feelings, such as a family member or health care professional.

Everybody needs physical activity for good health. However, less than half of U.S adults with serious difficulty walking or climbing stairs (mobility disability) report engaging in aerobic physical activity. For those who are active, walking is the most common physical activity. Yet, adults with disabilities report more environmental barriers for walking than those without disabilities. Here are some ways that people with disabilities can stay active and healthy.

Physical activity plays an important role in maintaining health, well-being, and quality of life. According to the Physical Activity Guidelines for Americans, 2nd edition, physical activity can help control weight, improve mental health, and lower the risk for early death, heart disease, type 2 diabetes, and some cancers. Physical activity can also improve mental health by reducing depression and anxiety. For people with disabilities, physical activity can help support daily living activities and independence.

Any amount of physical activity that gets your heart beating faster can improve your health. Some activity is better than none. For even greater health benefits, the Guidelines recommend that all adults, with or without disabilities, get at least 150 minutes (2.5 hours) of aerobic physical activity per week. Activities can be broken down into smaller amounts, such as about 25 minutes a day every day. Muscle-strengthening activities, such as adapted yoga or working with resistance bands, provide additional health benefits.

People with Disabilities

One in four U.S. adults is living with a disability, defined as

• Serious difficulty walking or climbing stairs;
• Deafness or serious difficulty hearing;
• Blindness or serious difficulty seeing;
• Serious difficulty concentrating, remembering, or making decisions;
• Difficulty doing errands alone; or
• Difficulty dressing or bathing.

Adults with disabilities are more likely to have obesity, heart disease, stroke, diabetes, or cancer than adults without disabilities. Physical activity can reduce the risk and help manage these chronic conditions.

Be Active to Stay Healthy

Many adults with disabilities and chronic health conditions can participate in regular physical activity; however, it’s important to consult with a healthcare professional or physical activity specialist (for example, physical therapist or personal trainer) to understand how your disability or health condition affects your ability to safely do physical activity.

If you have a disability and want to make physical activity part of your daily routine, here are some options.

Being Active In Your Neighborhood

Engaging in physical activity outdoors can help improve your physical health, as well as your mental health and well-being. Most people can engage in an active lifestyle through walking—including people with disabilities who are able to walk or move with the use of assistive devices, such as wheelchairs or walkers. In fact, walking is the most common form of physical activity reported among active adults with mobility disability.

Unfortunately, adults with disabilities report fewer neighborhood environmental supports (such as sidewalks, public transit, and walkable shops) and more barriers (such as traffic, crime, and animals) for walking than those without disabilities. To improve this, resources were created to help promote the development of supportive environments for walking for individuals with disabilities.

Being Active In Your Home

Being active in your home can also be a good option. Here are some resources that can help you stay physically active while at home.

Decide how much physical activity is right for you and your fitness level, pick an activity you enjoy—for example, gardening, doing chores around the house, wheeling yourself around in your wheelchair, walking briskly, or dancing—and find ways to include your favorite physical activity into your everyday life.

Since the Americans with Disabilities Act was enacted in 1990, many social barriers have been removed or reduced for people with disabilities. But there is more work that needs to be done for people with disabilities to become more independent and involved in their world. Good health is important to be able to work, learn, and be engaged within a community.

Healthy Living

People with disabilities need health care and health programs for the same reasons anyone else does—to stay well, active, and a part of the community.

Having a disability does not mean a person is not healthy or that he or she cannot be healthy. Being healthy means the same thing for all of us—getting and staying well so we can lead full, active lives. That means having the tools and information to make healthy choices and knowing how to prevent illness.

Safety

People with disabilities can be at higher risk for injuries and abuse. It is important for parents and other family members to teach their loved one how to stay safe and what to do if they feel threatened or have been hurt in any way.

Assistive Technology

Assistive technologies (AT) are devices or equipment that can be used to help a person with a disability fully engage in life activities. AT’s can help enhance functional independence and make daily living tasks easier through the use of aids that help a person travel, communicate with others, learn, work, and participate in social and recreational activities. An example of an assistive technology can be anything from a low-tech device, such as a magnifying glass, to a high tech device, such as a special computer that talks and helps someone communicate. Other examples are wheelchairs, walkers, and scooters, which are mobility aids that can be used by persons with physical disabilities.

School

In order to help a child fully participate in school, plans can be developed around the child’s specific needs. These plans, known as 504 plans, are used by general education students not eligible for special education services. By law, children may be eligible to have a 504 plan which lists accommodations related to a child’s disability. The 504 plan accommodations may be needed to give the child an opportunity to perform at the same level as their peers. For example, a 504 plan may include your child’s assistive technology needs, such as a tape recorder or keyboard for taking notes and a wheelchair accessible environment.

A different plan is needed for children taking special education classes. An Individual Education Plan (IEP) is a legal document that tells the school its duties to your child.

Transitions

For some people with disabilities and their parents, change can be difficult. Planning ahead of time may make transitions easier for everyone.

Independent Living

Independent living means that a person lives in his or her own apartment or house and needs limited or no help from outside agencies. The person may not need any assistance or might need help with only complex issues such as managing money, rather than day-to-day living skills. Whether an adult with disabilities continues to live at home or moves out into the community depends in large part on his or her ability to manage everyday tasks with little or no help. For example, can the person clean the house, cook, shop, and pay bills? Is he or she able to use public transportation? Many families prefer to start with some supported living arrangements and move towards increased independence.

Finding Support

For many people with disabilities and those who care for them, daily life may not be easy. Disabilities affect the entire family. Meeting the complex needs of a person with a disability can put families under a great deal of stress — emotional, financial, and sometimes even physical.

However, finding resources, knowing what to expect, and planning for the future can greatly improve overall quality of life. If you have a disability or care for someone who does, it might be helpful to talk with other people who can relate to your experience.

Find a Support Network

By finding support within your community, you can learn more about resources available to meet the needs of families and people with disabilities. This can help increase confidence, enhance quality of life, and assist in meeting the needs of family members.

A national organization that focuses on the disability, such as Spina Bifida Association, that has a state or local branch, such as Spina Bifida Association in your state, might exist. State or local area Centers for Independent Living could also be helpful. United Way offices may be able to point out resources. Look in the phone book or on the web for phone numbers and addresses.

Other ways to connect with other people include camps, organized activities, and sports for people with disabilities. In addition, there are online support groups and networks for people with many different types of disabilities.

Talk with a Mental Health Professional

Psychologists, social workers, and counselors can help you deal with the challenges of living with or caring for someone with a disability. Talk to your primary care physician for a referral.

About 36 million women in the U.S. have disabilities – and the number is growing. About 44% of those aged 65 years or older are living with a disability. The most common cause of disability for women is arthritis or rheumatism.

Women with disabilities may need specialty care to address their individual needs. In addition, they need the same general health care as women without disabilities, and they may also need additional care to address their specific needs. However, research has shown that many women with disabilities may not receive regular health screenings within recommended guidelines.

This section of our website has tools and health information for women with disabilities.

Breast Cancer Screening: The Right To Know

Breast cancer is a major public health concern for all women, including women with disabilities. Women who have disabilities are just as likely as women without disabilities to have ever received a mammogram. However, they are significantly less likely to have been screened within the recommended guidelines. CDC has developed a family of health promotion materials (e.g., posters, MP3 files, low-tech fliers, print advertisements, and tip sheets) to increase awareness of breast cancer among women with physical disabilities and encourage these women to get screened. Materials share the tagline “Breast Cancer Screening: The Right To Know” and feature four women with physical disabilities who have survived breast cancer.

Cervical Cancer Screening

Cervical cancer is the easiest female cancer to prevent, with regular screening tests and follow-up. It also is highly curable when found and treated early. All women are at risk for cervical cancer, including women with disabilities. It occurs most often in women over age 30. It is important to get tested for cervical cancer because 6 out of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years. Learn more about cervical cancer screening.

Healthy Living

People with disabilities need health care and health programs for the same reasons anyone else does—to stay well, active, and a part of the community.

Having a disability does not mean a person can’t be healthy. Being healthy means the same thing for all of us—getting and staying in good physical, mental, and emotional health so we can lead full, active lives. That means having the tools and information to make healthy choices and knowing how to prevent illness.

Intimate Partner Violence

About 1 in 4 women have experienced contact sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime. Research has shown that women with a disability are more likely to experience intimate partner violence (IPV) than those without a disability. In fact, researchers found that, compared to women without a disability, women with a disability were significantly more likely to report experiencing each form of IPV measured, which includes rape, sexual violence other than rape, physical violence, stalking, psychological aggression, and control of reproductive or sexual health.

If you are a family member who cares for someone with a disability, whether a child or an adult, combining personal, caregiving, and everyday needs can be challenging. This site has information for family caregivers such as yourself to help you and those you care for stay safe and healthy.

Caregiving Tips for Families of People With Disabilities

These general caregiving tips provide families with information on how to stay healthy and positive. Keep in mind that these tips can be used to address many family issues. Information, support, advocacy, empowerment, care, and balance can be the foundation for a healthy family and are appropriate no matter what the challenge.

Be Informed

• Gather information about your family member’s condition, and discuss issues with others involved in the care of your family member. Being informed will help you make more knowledgeable health decisions and improve your understanding about any challenges your family might face.
• Notice how others care for the person with special needs. Be aware of signs of mental or physical abuse.

Get Support

• Family members and friends can provide support in a variety of ways and oftentimes want to help. Determine if there are big or small things they can do to assist you and your family.
• Join a local or online support group. A support group can give you the chance to share information and connect with people who are going through similar experiences. A support group may help combat the isolation and fear you may experience as a caregiver.
• Don’t limit your involvement to support groups and associations that focus on a particular need or disability. There are also local and national groups that provide services, recreation, and information for people with disabilities.
• Friends, family, health care providers, support groups, community services, and counselors are just a few of the people available to help you and your family.

Be an Advocate

• Be an advocate for your family member with a disability. Caregivers who are effective advocates may be more successful at getting better service.
• Ask questions. For example, if your family member with a disability uses a wheelchair and you want to plan a beach vacation, find out if the beaches are accessible via a car, ramp, portable walkway mat, or other equipment.
• Inform other caregivers of any special conditions or circumstances. For example, if your family member with a disability has a latex allergy, remind dental or medical staff each time you visit them.
• Document the medical history of your family member with a disability, and keep this information current.
• Make sure your employer understands your circumstances and limitations. Discuss your ability to travel or to work weekends or evenings. Arrange for flexible scheduling when needed.
• Become familiar with the Americans with Disabilities Act, the Family Medical Leave Act, and other state and national provisions. Know how and when to apply them to your situation.

Be Empowering

• Focus on what you and your family member with a disability can do.
• Find appropriate milestones and celebrate them.
• If someone asks you questions about the family member with a disability, let him or her answer when possible. Doing so may help empower the individual to engage with others.
• When appropriate, teach your family member with a disability to be as independent and self-assured as possible. Always keep health and safety issues in mind.

Take Care of Yourself

• Take care of yourself. Caring for a family member with a disability can wear out even the strongest caregiver. Stay healthy for yourself and those you care for.
• Work hard to maintain your personal interests, hobbies, and friendships. Don’t let caregiving consume your entire life. This is not healthy for you or those you care for. Balance is key.
• Allow yourself not to be the perfect caregiver. Set reasonable expectations to lower stress and make you a more effective caregiver.
• Delegate some caregiving tasks to other reliable people.
• Take a break. Short breaks, like an evening walk or relaxing bath, are essential. Long breaks are nurturing. Arrange a retreat with friends or get away with a significant other when appropriate.
• Don’t ignore signs of illness: if you get sick, see a health care provider. Pay attention to your mental and emotional health as well. Remember, taking good care of yourself can help the person you care for as well. Exercising and eating healthy also are important.

Keep Balance in the Family

• Family members with a disability may require extra care and attention. Take time for all family members, taking into account the needs of each individual. For example, it’s important for parents of a child with a disability to also spend time with each other and with any other children they might have.
• Consider respite care. “Respite” refers to short-term, temporary care provided to people with disabilities so that their families can take a break from the daily routine of caregiving.

Disabilities: Healthy Living

People with or without disabilities can stay healthy by learning about and living healthy lifestyles.

Emergency and Disaster Preparedness

It is important that people with disabilities and their caregivers make plans to protect themselves in the event of an emergency or disaster. Emergencies and disasters can strike quickly and without warning and can force people to leave their home or be confined in their home. For the millions of Americans who have disabilities, emergencies such as acts of terrorism and disasters such as fires and floods present a real challenge.

People with disabilities face many barriers to good health. Studies show that individuals with disabilities are more likely than people without disabilities to report:

• Having poorer overall health.
• Having less access to adequate health care.
• Engaging in risky health behaviors, including smoking and physical inactivity.

People with disabilities often are more susceptible to preventable health problems that decrease their overall health and quality of life. Secondary conditions such as pain, fatigue, obesity, and depression can occur as a result of having a disabling condition.

Health disparities and secondary conditions can be the result of inaccessible health care facilities and equipment, lack of knowledge among health professionals about specific differences among people with disabilities, transportation difficulties, and higher poverty rates among people with disabilities.

Accessibility applies to both communication and physical access. For instance, health professionals need to be aware of how to effectively communicate with patients who have a range of disabilities, including people who are deaf or hard of hearing, or who have a speech, vision, or intellectual disability. Providers should ensure that accessible medical equipment is available for people with disabilities (such as scales, examination tables, or chairs). In addition, providers should plan for additional time during examinations, if needed. Some examinations may take longer than others, for all sorts of reasons, in the normal course of a medical practice.

What Health Care Providers Can Do

The Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities asks that all health care providers:

• Give each patient—including people with disabilities—the information needed to live a long and healthy life.
• Listen and respond to the patient’s health concerns. Give each patient the information needed to prevent or treat a health concern—even if the patient does not ask for it. As a health expert, you should offer the information.
• Communicate clearly and directly with the patient. If your patient does not understand your questions or instructions, repeat what you have said, use other words, or find another way to provide the information.
• Take the time needed to meet the patient’s health care needs.

Regular physical activity is good for everyone's health, including people with disabilities. Getting active can help you:

• Strengthen your heart
• Build strong muscles
• Lower stress
• Boost your mood
• Improve symptoms of anxiety or depression

Before you start:

• Talk to your doctor about the types and amounts of physical activity that are right for you. If you're taking medicine, be sure to find out if it can affect how your body responds to physical activity.
• It’s also a good idea to talk to a trained exercise professional. Find a gym or fitness center near you that's comfortable and accessible. Ask if they have experience working with people with similar disabilities. Talk to your doctor if you need help finding a trained exercise professional.

Aim for 150 minutes a week of moderate-intensity aerobic activity.

• Choose activities that make your heart beat faster — like walking fast, wheelchair walking, swimming, or raking leaves
• Start slowly and do what you can — even 5 minutes of physical activity has real health benefits, and you can build up to more over time

Do muscle-strengthening activities at least 2 days a week.

• These include activities like push-ups or lifting weights. Pick activities that work for you.
• You may need someone to help you do certain muscle-strengthening activities — talk with your doctor or a trained exercise professional if you think you need help
• If you can, try working on the muscles that you use less often

Find support and stick with it.

• Bring a friend along, especially if you're trying out a new activity
• If you don’t meet your physical activity goal, don’t give up — you can try again tomorrow
• Be active according to your abilities — remember, any amount of physical activity is better than none!