As it currently stands, people with a disability must navigate each interaction within the medical system because it is built with individuals with disabilities as an afterthought. Additionally, the attitude of individuals with disabilities towards the health-care system is rocky at best and is only further soured by harassment and stigmatization.

Disability Health Inequity

Mental health is one of the most neglected parts of public health across the world. Mental health issues can stem from stressors in other parts of people’s lives; including, but not limited to, ethnicity, violence, gender identity, sexual orientation, and disability. Mental health programs that are community based and focused on assimilation are needed so as not to further isolate a stigmatized group. 

Mental Health Inequity

Similarly to disability and mental health, gender identity and sexual orientation health inequities tend to happen as a result of stigma. This is also aided by the criminalization of homosexuality and the refusal of some societies to accept these identities as part of the norm. These identities correlate highly with low mental health status. More research must be done with SO and GI as parameters in order to better improve access to and quality of healthcare.  

Sexual Orientation and Gender Identity Inequity

 Simply closing health gaps will not be enough to improve people with the aforementioned identities’ lives. Society needs to create a medical and cultural structure that highlights differences. These differences create collective identities in these groups as well as highlights their needs to be able to function independently in today’s society. 

Final Health Inequity and Accessibility Discussion

Disability, sexual orientation, gender identity, and mental health have a large impact on people's experience in the medical field within the context of health equity. Lived experience and differences should be placed at the forefront of this discussion. These four identities affect health equity through comorbidity and the experience of stigma (directly or indirectly). 

University of Virginia, Charlottesville

Ensuring that all people have the ability to utilize a product, facility, or service, regardless of any disability they may have. Accessibility may include the modification of existing infrastructure, products, or services or designing them with disabled users in mind.

Accessibility

Nakkeeran, N., & Nakkeeran, B. (2018, October 9). Disability, mental health, sexual orientation and gender identity: Understanding health inequity through experience and difference - health research policy and systems. SpringerLink. Retrieved July 15, 2022, from https://link.springer.com/article/10.1186/s12961-018-0366-1 

Reference for Health Equity and Accessibility

- Visual Accessibility
- Auditory Accessibility
- Mobility
- Seizures
- Learning and Cognitive Accessibility
- Color Theory for Accessibility


Types of Accessibility

Devices that help maintain or improve the functional capabilities and/or independence of individuals with disabilities.

Assistive Technology (ATs)

Accommodations refer to adaptations that are tailored to a specific individual's unique needs. Whereas, accessibility refers to design choices that are not created with a specific individual in mind but still attempt to make a product, service, or environment accessible to as many people as possible regardless of disability.
Accessibility is a more general approach while accommodations are a more individualized approach.

Difference between Accessibility and Accommodation

Accessibility is often difficult to measure or define, due to the many types of accessibility that exist. A structure may be accessible to someone with one type of disability, but not to someone with another. Additionally, there are many different criteria that can be used to determine or measure accessibility.

Challenges in Determining Accessibility

Captioning is the process of displaying text while a video is being played. Typically, the text will be a transcription of the video's audio, noting who is speaking along with sound effects and important musical cues. This helps to make films, television shows, and other video recordings accessible to those who are hard of hearing or deaf.

Captioning

Section 504 of the Rehabilitation Act (29 U.S.C. § 794) requires that the housing owner/landlord is required to pay for any accommodations as well as fix them. The exception is that if the person demonstrates that providing payment for this would be a burden. Section 504 and the ADA requires that governmental bodies will be financially responsible for accommodations for public housing and other federally assisted provided housing, 24 C.F.R. part 8, 24 C.F.R. part 9. 

Payment for Reasonable Accommodation

Created in 1973, the U.S. Access Board is a federal agency that serves to ensure accessibility in federally funded properties/buildings. The agency is responsible for determining accessibility standards when it comes to built environments, vehicles used for transportation, equipment in the medical field, tools for communicating, as well as IT. 

United States Access Board 

Audio Description is the process of narrating certain actions or details that are normally seen visually, such as what a character is wearing. This process is often provided with films, television shows, stage plays, museums to accommodate people with visual impairments. It is often provided via an alternate audio track on a DVD or a handheld audio player.

Audio Description

Health Inequity of Disability, Mental Health, Sexual Orientation, and Gender Identity

The COVID 19 pandemic impacted all people in profound ways, however, people with disabilities have been impacted more harshly and at a much higher level than people without disabilities. People of different disabilities were also impacted in varying ways. It is important to keep in mind that while these challenges are COVID specific, many of the remedies can be incorporated into daily life to make day to day living easier. 

Pandemic and Disability: Challenges Faced and Role of Technology

Children with disabilities are much more likely to need mental health support than their non-disabled peers. Despite this, children with disabilities are very rarely diagnosed with and receive treatment for mental health issues. 

Mental Health Services Use Among School-Aged Children with Disabilities

Around the world, one billion people live with disabilities. This report argues that these individuals are being left behind regarding health. Lack of access not only goes against the rights of people with disabilities under international law but also poses a challenge to achieving better health services for one billion people with disabilities, which is essential for achieving Universal Health Coverage (UHC) and Sustainable Development Goal 3. Most of these individuals are in low and middle-income countries and the poorest sections of society. People with disabilities encounter more obstacles in obtaining healthcare services and have less health coverage, leading to poorer health outcomes due to their higher healthcare needs.

Access to Healthcare

The Americans with Disabilities Act (ADA) of 1990 is a key piece of U.S. legislation that prohibits discrimination against individuals based on their disability. The law is founded on the principle that people with disabilities are capable of making valuable contributions to organizations. A central requirement of the ADA is that employers must provide reasonable accommodations to help employees with disabilities perform their jobs, so long as these accommodations do not cause undue hardship to the employer.

Americans with Disabilities Act (ADA) of 1990

This article examines how people with disabilities experience the design of public urban spaces in a social housing area in Aarhus, Denmark. Drawing on 14 universal design walks conducted with 17 participants, the study shows how ableist design practices create physical, mental, and social constraints in everyday life.

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