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For almost fifty years, federal civil rights laws such as Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) of 1990 and the ADA Amendments Act of 2008, and Section 1557 and other provisions of the 2010 Patient Protection and Affordable Care Act have prohibited discrimination against Americans with disabilities, including in health care. Despite these laws, disabled Americans continue to experience disparities in health and health care, from preventive care to home and community-based services. In its 2022 Health Equity Framework for People with Disabilities, the National Council on Disability highlighted some of these disparities and recommended remedies. To explore these concerns, this article examines disability inequities and potential solutions within six areas. It concludes by recommending the ratification of the 2006 United Nations Convention on the Rights of Persons with Disabilities to reinvigorate US efforts to maximize the health and dignity of disabled Americans and support their full participation in the community. [ABSTRACT FROM AUTHOR]

Physicians from underrepresented groups are at greater risk of experiencing mistreatment from coworkers and patients, including offensive remarks, physical harm, threats of physical harm, and unwanted sexual advances. These can have far-reaching negative consequences for the physicians' personal and professional lives. This study used data from a nationally representative sample of physicians to examine workplace mistreatment experienced by physicians with disabilities and determine whether physicians with disabilities are more likely to experience mistreatment in their workplace than physicians without disabilities. Compared with their nondisabled peers, physicians with disabilities had a significantly higher likelihood of experiencing every type of mistreatment from both patients and coworkers. Our findings suggest the need for disability-focused anti-mistreatment policies and practices. [ABSTRACT FROM AUTHOR]

The article discusses a telephone survey of outpatient physicians in the U.S. to determine the extent to which they understand their legal obligations to patients under the American With Disabilities Act (ADA). Topics covered include their understanding of their responsibility in ensuring the provision of equitable care to patients with disability, their perceived risk of ADA lawsuits, and the associations among physician characteristics, their knowledge of ADA, and perceived lawsuit risk.

Disability civil rights laws require equitable treatment of the approximately sixty-one million Americans with disability. However, federal reports and numerous research studies indicate that this diverse and growing population often experiences health care disparities. To examine one possible contributing factor, we interviewed practicing physicians to explore their knowledge of their obligations to accommodate patients with disability under federal civil rights law. Interviewees reported having had little formal training about, and demonstrated superficial or incorrect understanding of, their obligations in three potentially problematic areas: deciding which accommodations their practices should implement, refusing patients with disability, and holding patients accountable for costs of accommodations. The fact that practicing physicians might not fully understand their legal responsibilities when caring for people with disability may contribute to persisting inequity in their care, and it suggests that further education in the Americans with Disabilities Act and other disability civil rights laws may be warranted. [ABSTRACT FROM AUTHOR]

The article discusses how employers should handle the special needs that an employee with a chronic disease might have which can continue for years after an illness is diagnosed. Topics include the case of Kim Hall, an event planner who underwent surgery and chemotherapy for colorectal cancer, definition of chronic disease, and the creation of workplace accommodation tool kits by Job Accommodation Network (JAN) and others to help supervisors understand the concept of accommodation.

In many respects, employers are well positioned to take a leading role in helping create a culture of health. Employers have access to many programs that could be beneficial to their employees' health. The potential for financial gains related to health improvement may motivate employers to offer these programs, and if the gains are realized, they may help finance the programs. At the same time, employers' involvement in such programs may create substantial risks. Enthusiasm about the financial and health gains that wellness programs might yield coexists with concerns about health costs shouldered by employees, the possibility of employment discrimination, and the potential for employers' invasion of employees' privacy. A fragmented regulatory regime, including a recently issued final rule under the Americans with Disabilities Act, has been created to address these concerns. Whether the regime strikes the right balance between wellness program benefits and risks remains to he determined. [ABSTRACT FROM AUTHOR]

The recovery movement, which broadly recognizes the ability of people with mental illnesses to participate in the mainstream of society, stems from a confluence of factors, including longitudinal data showing that many people eventually recover from serious mental illness. Perhaps as important to the emergence and growth of the recovery movement has been the increasing role that people "in recovery" have played in advocating for person-centered care, greater self-determination for those with mental illnesses, and an enhanced focus on restoring functioning for individuals above and beyond symptom reduction. The Americans with Disabilities Act of 1990 redefined serious forms of mental illness as disabilities, which led to the development of a range of accommodations to enable people with psychiatric disabilities to live in their own homes, work, go to school, and perform other normative adult roles such as parent and parishioner even while suffering symptoms. The Affordable Care Act provides additional levers for expanding the use of peer health navigators and shifting care to a collaborative model in which people can play active roles in their own care. While stigma and discrimination continue to pose formidable obstacles, the foundations have been laid for mental health practice to come closer to resembling health care for other medical conditions. [ABSTRACT FROM AUTHOR]