Disability as a Public Health Issue: Findings and Reflections from the Massachusetts Survey of Secondary Conditions

Publisher Website
Google Scholar
Abstract
In the last decade, the health status of individuals with disabilities has emerged as an explicit focus of public health attention, with consumers, policymakers, and researchers joining in defining and implementing an agenda in this area. With small federal grants from a few agencies, the field has begun to produce research findings, academic curricula, and model policies and interventions to promote health and prevent adverse outcomes among people with disabilities ( Andresen, Lollar, and Meyers 2000 ; Lollar 1994 ; Pope 1992 ; Seekins, White, Ravesloot, et al. 1999 ; Simeonsson and McDevitt 1999 ; Tanenhaus, Meyers, and Harbison 2000 ). The development of the term secondary conditions and the inclusion of the chapter “Disability and Secondary Conditions” in Healthy People 2010 ( U.S. Dept. of Health and Human Services 2000 ) reflect this progress toward recognizing disability as a national public health issue. Public health researchers and practitioners have begun to recognize the dynamic nature of disability, promote the health of people with disabilities, and develop strategies to prevent secondary conditions among them. To understand the epidemiology of secondary conditions, the authors developed the Massachusetts Survey of Secondary Conditions, a longitudinal study of adults with major disabilities in = 656) based on a conceptual framework linking disability, mediating factors, and health outcomes. This paper reports baseline data on the number of secondary conditions experienced by survey respondents. Respondents experienced a mean of 5.3 of 17 secondary conditions. More numerous secondary conditions were associated with fair or poor general health and number of days unable to do routine activities. Factors amenable to public health interventions included difficulty with weight and exercise maintenance, tobacco and marijuana use, and experiencing assault. Disability should be a focus in all public health research, policy, and programs.