Equity in health and functioning for adults from marginalized communities with physical, cognitive, sensory and developmental disabilities
Through a newly funded Equity Center, the University of Michigan Center for Disability Health and Wellness (CDHW) will collaborate with outside organizations and investigators dedicated to enhancing the health and functioning of individuals with disabilities – particularly those from marginalized and underserved communities - through research, education, program development and policy change. The Equity Center will work to identify and address health care disparities experienced by individuals with physical, cognitive, sensory, and developmental disabilities from marginalized backgrounds through a series of interrelated research projects and rigorous training, knowledge translation, and technical assistance activities.
Principles of cultural competence, cultural humility, and direct engagement and involvement of individuals with disabilities will be embedded. Synergistic research will include three research projects using existing data and two projects developing interventions to change behaviors of healthcare providers and systems:
1. Annual analysis and review of publicly accessible national surveys to examine and visualize rates of healthcare disparities among individuals with disabilities in the United States from various subpopulations (“Dashboard”)
2. Relationship of social determinants of health and health utilization among Medicare and Medicaid enrolled people with intellectual and developmental disabilities
3. An examination of HIV prevention and risk behaviors among individuals with disabilities, including accessibility of community-based HIV testing programs
4. An integrative team-based program in primary care designed to address virtual health care access and medication safety and quality
5: The development of an Equity Tool and Implementation Process targeted to Healthcare Systems that will operationalize, report, and encourage healthcare systems to enhance health outcomes for individuals with disabilities
While all projects will include individuals with physical, cognitive, sensory, and developmental disabilities, analyses and development activities will be tailored to specifically identify factors that result in increased disparities among traditionally marginalized populations, and the system-change or policy recommendations to reduce disparities.
Anticipated outcomes include an enhanced awareness of health care disparities experienced by people with disabilities including increased understanding and documentation of the relationship of marginalization, social determinants of health, systematic racism and implicit bias, with health and functioning outcomes. The expected products are interventions that will serve as the basis for the training, technical assistance, and dissemination activities, including 1) research-related publications, presentations, infographics and brief videos; 2) in-person and virtual training to enhance skills in working with patients with disabilties from marginalized communities; 3) tipsheets and practical protocols for enhancing accessibility in healthcare; and 3) active and regularly updated websites and social media accounts. Training activities will focus in two core areas – medical education and capacity building. All information will be accessible and products available in multiple languages.
The Equity Center will partner with the Center for Health and Research Transformation (CHRT) at the University of Michigan to enhance the capacity of trainees, community organizations, and researchers across the United States to create evidence-based policy changes related to equity and disability health. CHRT will conduct policy training workshops/symposia via webinars several times throughout the course of the grant, focusing on highlighting knowledge and skills about the policymaking and advocacy process. All trainings will be accessible through ASL interpreters, open captioning, braille materials, wheelchair ramps, and more.