This brief dives into the impact of the COVID-19 pandemic on the ability of people with disabilities to access vital health care services during the public health emergency.
Better Defining Disability Will Make Data More Inclusive and Usable ASTHO, association of state and territorial health officials, access to health care, centers for disease control, syndromic surveillance systems, health outcomes, person with a disability, disaster medical assistance team dmat, mental health conditions, people with disabilities, health disparities, mental health, health equity, public health emergencies, syndromic surveillance, disaster medical assistance teams, disability data, people living with disabilities, disability inclusion Margaret Nilz ASTHO | Syndromic surveillance data on disability prevalence will help people with disabilities in emergencies. Over the past two decades, the frequency and intensity of natural disasters have increased — and will continue to do so. While disasters impact whole communities, past incidents highlight specific effects on people with disabilities, as it is more challenging for them to prepare for and recover from an incident. Understanding the prevalence of disability in a jurisdiction helps fully address the population’s needs. There is not a universally accepted way to collect data on people with disabilities. However, the need for disaggregated data by disability status is critical to helping measure health disparities and underlying factors contributing to inequities. Such data will support the development and continuous evaluation and improvement of public health programs and policies. Key Considerations for Collecting Data on People with Disabilities Disability data is essential for inclusive public health practice. Several factors are important to keep in mind when gathering data on people with disabilities. Participation is critical as exclusion from research can further marginalize already vulnerable groups and limit access to advancements. Accounting for historical trauma/negative impacts helps people with disabilities who are at increased risk of coercion, inclusion without consent, and other exploitation. Unwarranted disability assessments, particularly those implemented with limited evidence of effectiveness, have been shown to have negative mental health impacts on participants with disabilities. Different models of disability provide a reference as programs, services, laws, and regulations are developed. Primary models of disability include the Medical Model, Functional Model, Social Model, and Medical/Rehabilitative Model. Current Measures and Definitions of Disability - Brief - Better Defining Disability Disability Inclusion in National Syndromic Surveillance Program (NSSP) NSSP includes electronic health record (EHR) data from 73% of the nation’s emergency departments (EDs). However, it contains no systemic way to identify people with disabilities. Including disability data within a system as valuable as NSSP can help close gaps in monitoring the impacts of emergencies on people with disabilities. Syndromic surveillance data can guide decision-making during emergencies and policy formation at the local, state, and national levels. There are limitations of using syndromic surveillance data. First, diagnostic codes may not map directly onto functional limitations. Second, codes do not provide information about residual functioning, loss of functioning, or disability severity. Additionally, reporting in EHRs may not be accurate due to input or data errors. Codes can be related to a visit or encounter, even if it does not end up being true for a patient. Furthermore, diagnostic codes reflecting disability may not be used in every encounter and people with disabilities may be missed through using ED data as it only represents a snapshot in time. Benefits of Expanding Disability Data Access and Use Expanding the collection, access, and use of disability data for public health program development and emergency preparedness promotes health equity for people with disabilities. More specifically, this data can inform fiscal, programmatic, service policy, and public health planning decisions. When Disaster Medical Assistance Teams (DMATs) deployed to shelters in North Carolina, CDC’s NSSP team asked health officials if they wanted to integrate these data. Within 24 hours, data from DMATs were available in NSSP, providing a snapshot of health in those shelters. Data were monitored along with ED visits to give a complete picture of the storm’s health impacts. In 2017, Hurricane Harvey made landfall in Texas, resulting in 88 deaths and $125 billion in infrastructure damage. Public health officials used syndromic surveillance to understand increases in ED visits by those who evacuated to the Dallas–Fort Worth (DFW) area. Area hospitals saw roughly 4,400 more ED visits than normal; at least 600 were evacuees. Syndromic surveillance data demonstrated extensive health care services use outside the affected areas by highlighting the importance of surge capacity planning one to four hours outside the disaster area. Ongoing Efforts Through a cooperative agreement with CDC, ASTHO is working with subject matter experts to create a definition of disability for syndromic surveillance. ASTHO conducted key informant interviews with disability professionals to inform the development of this new diagnostic code-based definition, along with four scientific panels to assess the drafting and review of national and state-level pilot testing. An expansion of this kind benefits jurisdictions through increased data capacity for fiscal, programmatic, and service policy decision-making and supporting longitudinal tracking of prevalence and risk. Conclusion Efforts to expand data about people with disabilities can help build public health capacity to monitor the health and well-being of people with disabilities before, during, and after public health emergencies. However, efforts in data collection on disabilities require interoperability and standardization across all systems to be successful. Efforts to contextualize public health emergency data and gather supporting data on impacted populations allow health officials to better turn data into action in pursuit of health equity across public health emergencies. NU38OT000290 website yes
The Louisiana Department of Health has developed Power Outage Partners, a first-of-its-kind program to recruit owners of stand-by residential generators to recharge the batteries of neighbors’ life support equipment during power outages.
People who use electricity-dependent durable medical equipment (DME) at home—such as ventilators and oxygen concentrators—can face life-threatening consequences during a power outage. HHS reports that 2.7 million Medicare beneficiaries rely on electricity-dependent DME to live independently. This ASTHOBrief details the significant challenges that individuals who rely on electricity-dependent DME face during power outages and discuss recent efforts to increase support for this population.
ASTHO, in collaboration with CDC, provided full-time disability and preparedness specialists to 17 jurisdictions to better meet the needs of people with disabilities. In this brief, specialists share their thoughts on why people living with disabilities may be hesitant to get the COVID-19 vaccine and some approaches public health officials can take to address vaccine hesitancy in people living with disabilities.
According to the federal government, a homebased individual is someone who requires the help of another person or supportive device to leave the home, someone who is advised against leaving the home by a physician, and/or someone for whom it is extremely taxing to leave the home. Compared to non-homebased adults, homebased people are more likely to be older, have lower income, and belong to racial minority groups—as well as live with disabilities, chronic health conditions, and comorbidities. Individuals who are homebased therefore tend to be at increased risk for COVID-19 morbidity and mortality.
For many individuals living with disabilities, inaccessible vaccination websites have been a significant barrier to receiving the COVID-19 vaccine. Recent studies have found that many vaccination websites do not reliably meet accessibility standards. This brief discusses how several disability rights laws apply to COVID-19 vaccine registration websites and offers considerations for state and territorial health agencies as they work to improve website accessibility for people living with disabilities.
To promote health equity for people with disabilities, public health planning efforts should be intentional and inclusive. ASTHO has identified health equity as a strategic priority and supports its members in their quest to increase disability inclusion through capacity building, partnerships, workforce development, and data collection.
Web Accessibility Content Review Guides Guides to Review for Digital Accessibility Emily Lapayowker These actionable guides help you prepare accessible web and digital content. Digital accessibility is an important process that makes websites, files like Word documents or PDFs, and other digital products accessible to people with disabilities, as well as making these products more user-friendly overall. There are many criteria to meet when making your digital content accessible. The guides on this page serve as checklists for ensuring that web content and digital products are accessible, as laid out in the 2024 ADA Title II Web Rule, and meet the current standard of WCAG 2.1. Neither will address the web development needs laid out in WCAG, but they are useful for most digital content creation. The two checklists represent two different approaches to meeting accessibility standards: standards-driven and content-driven. It is important to remember that many of the techniques contained in each are not exclusive to websites, emails, or Microsoft Office products; they can be used for all forms of digital content. Guide for Meeting WCAG Web Accessibility Standards The structure of this checklist template roughly corresponds with the Preliminary Easy Checks Checklist by W3C. Each section contains a list of relevant WCAG links that detail the criteria and conformance levels covered in that section. It also indicates which checks are manual and which can be done by an automated checker, like the applet ANDI. Get the Checklist for Meeting WCAG Accessibility Standards (automatic Word download) Special Thanks - Resource - Guide for Meeting WCAG Web Accessibility Standards Padding Block - Large Padding Block - Small Guide to Reviewing Digital Content for Accessibility This checklist has a content-first focus and is less technical than the Guide for Meeting WCAG Web Accessibility Standards. Sections are organized to keep like-topics together. Overarching sections include document content, document structure, and multimedia. Get the Guide to Reviewing Digital Content for Accessibility (automatic Word download) Padding Block - Medium OE22-2203 PHIG article yes
FAQ for Preparing for CBRNE Emergencies at Mass Gatherings FAQ for Preparing for CBRNE Emergencies at Mass Gatherings Kelsey Tillema, Adrianna Evans Learn how to prepare for Chemical, Biological, Radiological, Nuclear, and Explosive events with this handy FAQ. As the United States prepares to host multiple high-profile or international mass gathering events in the coming years, preparedness professionals should revisit and strengthen plans to address complex and high-impact threats. Among the most critical are Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) hazards — a grouping of high-consequence threats with potential to significantly impact public safety and health: Chemical agents (toxic chemicals, nerve agents). Biological agents (harmful bacteria, viruses). Radiological materials (accidental or intentional dispersion of radioactive material, including from nuclear power plants). Nuclear incidents (nuclear detonations). Explosives (intentional or accidental blasts). Human health could be greatly impacted, with the potential for the following consequences: Acute injuries (burns, trauma, poisoning, radiation sickness) and mortality, along with other long-term conditions (cancer, organ damage, etc.). Psychological impacts such as PTSD, anxiety, and depression, among other long term mental health impacts. Strain on health care and public health systems, including disruptions to hospital services and the supply chain. As jurisdictions prepare for the 2026 FIFA World Cup and future mass gathering events, this resource serves as a broad overview of the roles and responsibilities of public health in relation to a CBRNE incident. This information is not comprehensive but is intended to provide consideration and further resources for planning efforts. article yes
Learn about engaging partners in a virtual space, with actionable steps, examples, and resources.
Learn how health agencies are prioritizing children’s health as they develop public health emergency preparedness planning in this blog.
Discover how improving public health data infrastructure can create more robust care for people with disabilities in this blog post.
The COVID-19 pandemic has highlighted the intersections of social determinants of health, such as transportation, education, and housing, and their impact on the health of individuals and communities. As the moratorium on evictions ends in many parts of the United States, housing in particular looms as a potential public health crisis. Braiding and layering funding is when government agencies and non-traditional partners collaborate and coordinate to combine different streams of funding to address social determinants of health. This post lists three examples where funding has been successfully braided or layered to support housing needs.
Following disruptions to daily life caused by the COVID-19 pandemic, emergency departments saw an increase of mental health-related visits. A June 2021 study showed a significant increase of mental health-related visits among 12–17-year-olds compared to the previous year. States and territories that implement a comprehensive public health approach to suicide prevention across all domains of life—an approach known as the socio-ecological model—can reduce contributing risk factors.
Every year in mid-July is National Youth Sports Week—in 2021 it falls on July 19-23. It’s an important health observance because youth sports create strong connections with peers and caring adults, as well as promote socio-emotional skills and positive well-being. The Office of Disease Prevention and Health Promotion’s National Youth Sports Strategy outlines policies and strategies that support access to youth sports. NYSS Champions, including ASTHO, work to promote participation and recognize the positive health outcomes sports can have on youth, such as limiting the impacts of adverse childhood experiences and building resiliency.
As the Delta variant spreads across the country and increases the number of COVID-19 cases, the strain it is placing on the nation’s health system continues to grow. The surge of COVID-19 patients is contributing to a shortage of the medications and equipment used to treat the disease. As these limitations grow, decisions will need to be made as to which patients receive resources and care and which patients don’t. To guide these decisions, policies called crisis standards of care are often established to maximize resource benefit and ensure they are distributed equitably.
On Dec. 3, the International Day of People with Disabilities commemorates disability rights and brings awareness to essential issues for those with disabilities by promoting the “well-being of persons with disabilities in all spheres of society.” While the ADA laid a critical foundation for disability rights, the work to ensure equitable access to services and needs continues, including access to state and local emergency preparedness and response activities like crisis communication, access to resources, allocation of vaccine and other medical countermeasures, and transportation.
Health agencies play a key role in preparing for and responding to hurricanes and other severe weather events.
It has never been more important for public health to better understand the disability community and quickly build skills and resources to better serve them, which makes it critical to include more people living with disabilities in the public health workforce.