Week 9: Disability and Health

What are the Five Major Social Determinants Affected by Disability?

Employment: Some people stop working immediately while others gradually lose their ability to work. Job loss can contribute to financial stress and changes in independence.

Income: reduced employment results in the loss of earnings. Disability also contributes to additional costs, including housing modifications and transportation. However, people with financial stability before disability generally had more resources to manage these changes.

Housing: People often need accessible housing modifications (ramps and doorways) these modifications can be expensive.

Transportation: Some people are unable to drive or required modified transportation. Public transportation is not always accessible or suitable. - this can lead to limited employment, healthcare, shopping, and social interactions.

Social Support and Personal Relationships: Can affect relationships with family, friends, and partners. Sometimes people with disabilities require dependance which can put a strain on relationships. this can lead to social isolation which can play an affect on the other factors.

Barriers vs. Facilitators

What are the environmental and personal barriers vs. facilitators to living with a disability?

Environmental barriers: Discrimination, inaccessible healthcare, limited housing and rehabilitation resources.

Environmental facilitators: Disability funding, accessible services, healthcare professionals, community support.

Personal barriers: Social isolation, lack of acceptance, loss of independence.

Personal facilitators: Family support, friendships, financial stability, resilience.

How do personal qualities influence coping with a disability?

Helpful: Resilience, perseverance, patience, optimism, determination, adaptability and self-awareness.

Unhelpful: Feelings of alienation, low self-esteem, lack of acceptance, hopelessness and negative emotions.

Personal qualities influence coping but cannot eliminate structural barriers such as poverty and discrimination.

How are social determinants of health interconnected following the acquisition of a disability?

Disability → Reduced employment → Lower income and increased expenses → Housing and transportation challenges → Strained relationships and reduced social participation.

A decline in one social determinant can negatively affect several others, creating a cycle of disadvantage.

What broader social issues are associated with disability, and how can they be addressed?

• People with disabilities face higher risks of poverty and social disadvantage.

• Existing socioeconomic disadvantages make managing disability more difficult.

• Solutions: Government support, accessible services, inclusive policies, community support, and rehabilitation addressing both physical and socioeconomic needs.

Goal: Improve health equity, social participation, and quality of life.

how is the relationship between disability and social determinants of health (SDH) two-way?

• Poor SDH → Disability: Poverty, limited healthcare access, and poor living conditions can increase the risk of developing a disability.

• Disability → Poor SDH: Acquiring a disability can cause job loss, reduced income, housing and transportation difficulties, and social isolation.

In Crip Camp, what was Camp Jened, and why was it important?

• Summer camp for teenagers with disabilities (1960s–70s).

• Promoted independence, inclusion, friendships, and belonging.

• Inspired disability rights activism.

• SDoH: Social support and inclusion improve well-being.

In Crip Camp, what is the difference between the medical and social models of disability?

• Medical: Focuses on individual impairments and treatment.

• Social: Focuses on societal barriers, discrimination, and accessibility.

• Example: Stairs without a ramp are an environmental barrier, not an individual's limitation.

How does Crip Camp connect disability to SDoH?

• Education: School exclusion limited educational opportunities. They are excluded from activities or denied appropriate accommodations.

• Employment/Income: Workplace discrimination restricted job opportunities. Cuts to disability benefits and cancellation of the Basic Income Pilot.

• Transportation: Inaccessible public transit reduced independence.

• Social inclusion: Stigma and segregation contributed to isolation. Ableism, discrimination, and exclusion from community movements

• Healthcare: Institutionalization and inadequate services restricted autonomy.

• Housing: Inaccessible buildings limited independent living.

Key takeaway: Disability discrimination creates unequal access to resources, opportunities, and quality of life.

In Crip Camp, what is the difference between institutionalization and independent living?

Institutionalization: Placement in facilities, often limiting freedom, independence, and community participation (e.g., Willowbrook).

Independent living: Having autonomy, choices, and access to necessary support.

Center for Independent Living (CIL): Provided housing, transportation, personal care, and accessibility support.

In Crip Camp, what was Section 504 of the Rehabilitation Act (1973)?

• Prohibited disability discrimination in federally funded programs and organizations.

• Goal: Ensure equal access to education, healthcare, and other services.

In Crip Camp, what was the significance of the Section 504 Sit-in (1977)?

• Disability rights activists protested in San Francisco to demand enforcement of Section 504.

• Outcome: Helped secure the signing of regulations protecting disability rights.

In Crip Camp, what was the Americans with Disabilities Act (ADA) of 1990?

• Expanded protections against disability discrimination in employment, transportation, public services, and public accommodations.

• Key distinction: ADA provided broader protections than Section 504, which applied mainly to federally funded programs.

How do Crip Camp and Sarah Jama's video demonstrate intersectionality and disability justice?

• Intersectionality: People may experience overlapping discrimination based on disability, race, gender, class, and other identities.

• Disability justice: Recognizes these inequalities and prioritizes people facing multiple systemic barriers.

• Collective action: Marginalized communities unite to advocate for equal rights and inclusion.

• SDoH connection: Overlapping discrimination increases social exclusion and limits access to education, employment, healthcare, and opportunities.

What does it mean by disability is a social justice and human rights issue, not a medical one?

Disability is a social justice and human rights issue because people with disabilities face discrimination and systemic barriers in education, employment, healthcare, and accessibility.

Rather than focusing only on medical treatment, society must remove these barriers to ensure equal rights, independence, inclusion, and opportunities, regardless of a person's ability to work.

What is the Disability Justice Network of Ontario (DJNO), and what is its purpose?

• Empowers young people with disabilities to advocate for their rights.

• Challenges inaccessible institutions and promotes systemic change through grassroots activism.

• Key takeaway: People with disabilities should help shape the systems and policies that affect their lives.

What is the difference between accessibility and disability justice in relation to SDoH?

Accessibility: Removes barriers within existing systems (e.g., ramps, accessible transportation, accommodations).

Disability justice: Challenges systemic inequalities in SDoH, including poverty, education, employment, housing, and healthcare.

Key difference: Accessibility improves access, while disability justice aims to change discriminatory systems.

What is the difference between independence and interdependence in disability justice?

Independence: Having control over your life and making your own decisions.

Interdependence: Recognizing that everyone relies on others, services, and communities.

Key takeaway: Needing assistance does not reduce a person's value; society should provide support that enables equal participation.

What is ableism, and how does systemic discrimination affect people with disabilities?

Ableism: Prejudice, discrimination, or systems that disadvantage people with disabilities.

Examples: School exclusion, inadequate accommodations, underfunded services, and policies prioritizing economic productivity.

SDoH connection: Systemic ableism limits access to education, healthcare, employment, and social participation.

What is the Accessibility for Ontarians with Disabilities Act (AODA), and what are its limitations?

• Introduced: 2005, with the goal of making Ontario accessible by 2025.

• Limitations identified by Jama: Weak enforcement, inadequate funding, and too much focus on employment and consumer participation.

• Key takeaway: Accessibility laws require funding, enforcement, and systemic change to achieve disability justice.

How do government policies and income support programs affect disability and SDoH?

• Ontario Disability Support Program ODSP: Financial assistance for eligible people with disabilities.

• Ontario Works (OW): Financial and employment-related support.

• Basic Income Pilot: Its cancellation negatively affected people with disabilities in Hamilton.

• Assistive Devices Program ADP: Helps fund assistive devices but faces coverage gaps, costs, and long wait times.

• Key takeaway: Inadequate financial and disability support increases poverty, reduces independence, and worsens health inequalities.

How do barriers to assistive devices affect healthcare access and SDoH?

• Barriers: High costs, long wait times, limited funding, and inadequate coverage for repairs.

• Examples: Wheelchairs, walkers, and hearing aids.

• SDoH connection: Limited access reduces independence, mobility, and social participation.

How does Sarah Jama's experience demonstrate educational discrimination against people with disabilities?

• Examples: Excluded from physical education and school trips; encouraged to attend college instead of university.

• Barriers: Inadequate accommodations, exclusion, and systemic ableism.

• Solutions: Inclusive education, individualized accommodations, and teaching disability history.

• SDoH connection: Educational inequality can negatively affect future employment, income, independence, and health.

How does grashow does grassroots activism promote disability justice?

• Grassroots activism: Community-led action to create social and political change.

• Purpose: Empower people with disabilities, build community support, and hold governments accountable.

• Example: Hamilton's snow removal campaign challenged inaccessible sidewalks and influenced city budget discussions.

What is the connection between historical discrimination and institutionalization to present-day ableism?

• People with disabilities were historically segregated, institutionalized, and denied basic rights.

• Examples: Institutional abuse, forced sterilization policies, and loss of autonomy.

• These practices reflect deeply rooted systemic discrimination.