Historically, the role of public health has focused on prevention of disabilities. For example, the Centers for Disease Control promotes the use of folic acid in pregnant women and those who are trying to become pregnant to reduce the risks associated with the underdevelopment of a fetus's brain and spinal cord. It also urges people to protect themselves and their families from traumatic brain injury through the use of helmets during sports and seatbelts in cars.
Despite these efforts, as an article in Public Health Reports points out, people still are born with or develop disabilities. Therefore, it is important for public health professionals to focus on the needs and well-being of people living with disabilities, and to make research efforts and interventions accessible to this population.
Definitions of "disability" vary widely and have changed a great deal over time. "Early medical models viewed disability as a defect to be remediated or prevented," writes Katherine McDonald, PhD and Dora Raymaker, MS. "More recent models advance disability as a limitation in function." They say, "Social models frame disability as something [created by] barriers embedded in social, political, and built environments." For example, imagine that a person who uses a wheelchair has available in their neighborhood appropriately designed houses, buses, and places of business. While their physical status may be the same, that person's ability to carry out daily activities is different than a person surrounded by facilities without features such as elevators, ramps, and accessible restrooms.
Public health practitioners are exploring ways to design programs, interventions, and research to better suit the needs of people with disabilities. There are some parallels to the disadvantages faced by other populations that experience health disparities. Healthcare providers may lack adequate training about effective ways to provide care for people with disabilities; for example, they may neglect to offer preventive services. Without input from the community, researchers may fail to address the health concerns and priorities of people with disabilities. In addition, people with disabilities may hesitate to engage in research due to a history of mistreatment and abuse by scientific professionals.