Disability in America

Disability in America

Toward a National Agenda for Prevention

  • Author: Tarlov, Alvin R.; Pope, Andrew M.
  • Publisher: National Academies Press
  • ISBN: 9780309043786
  • eISBN Pdf: 9780309582919
  • Place of publication:  United States
  • Year of digital publication: 1991
  • Month: January
  • Pages: 377
  • Language: English

Disability in America presents a five-prong strategy for reducing the incidence and prevalence of disability as well as its personal, social, and economic consequences. Although the preferred goal is to avoid potentially disabling conditions, the authoring committee focuses on the need to prevent or reverse the progression that leads to disability and reduced quality of life in persons with potentially disabling conditions.

Calling for a coherent national program to focus on prevention, the committee sets forth specific recommendations for federal agencies, state and local programs, and the private sector. This comprehensive agenda addresses the need for improved methods for collecting disability data, specific research questions, directions for university training, reform in insurance coverage, prenatal care, vocational training, and a host of other arenas for action.

  • DISABILITY IN AMERICA
  • Copyright
  • Preface
  • Acknowledgments
  • Contents
  • Executive Summary
    • TOWARD A COMPREHENSIVE APPROACH TO DISABILITY PREVENTION
      • A Model of Disability
        • Risk Factors
        • Quality of Life
        • The Disabling Process
      • Developmental Disabilities
      • Injury-Related Disabilities
      • Disabilities Associated with Chronic Disease and Aging
      • Secondary Conditions Associated with Disability
    • RECOMMENDATIONS
      • Organization and Coordination
        • Leadership of the National Disability Prevention Program
        • Advisory Committee
        • Interagency Coordination and Periodic Review
      • Surveillance
        • Conceptual Framework
        • A National Disability Surveillance System
      • Research
        • Coordinated Research Program
        • Longitudinal Studies
        • Relationship of Socioeconomic Status
        • Interventions
      • Access to Care and Preventive Services
        • Accessible, Affordable Quality Care
        • Access to Vocational Services
      • Professional and Public Education
        • Education of Professionals
        • Education of Persons with Disabilities and Their Families, Personal Attendants, and Advocates
  • 1 Introduction
    • DISABILITY: DEFINITION AND CONCEPT
    • PUBLIC HEALTH AND DISABILITY PREVENTION
      • A Life Course Perspective
    • SCOPE AND ORGANIZATION OF THE REPORT
  • 2 Magnitude and Dimensions of Disability in the United States
    • DATA SOURCES
      • The National Health Interview Survey (NHIS)
      • The ICD Survey of Disabled Americans
      • Survey of Income and Program Participation (SIPP)
      • National Long-Term Care Surveys (NLTCS)
      • Supplement on Aging (SOA) and Longitudinal Study of Aging (LSOA)
    • PREVALENCE OF DISABILITY
      • NHIS Activity Limitation Data
      • Other Perspectives
    • TRENDS IN THE PREVALENCE OF DISABILITY
    • CONDITIONS LEADING TO DISABILITY
    • LIFE TABLE PERSPECTIVE
    • ECONOMIC COST OF DISABILITY
    • CONCLUSION
  • 3 A Model for Disability and Disability Prevention
    • CONCEPTUAL FRAMEWORK
      • Pathology
      • Impairment
      • Functional Limitation
      • Disability
    • MODEL OF DISABILITY
      • Risk Factors
        • Biological Factors
        • Environmental Factors
        • Lifestyle and Behavioral Factors
      • Quality of Life
      • The Disabling Process
        • Health Status
        • Psychological Status
        • Socioeconomic Status
        • Educational Status and Vocational Training
        • Climate
        • Multiplicity of Conditions and Disabilities
    • THE NEED FOR EPIDEMIOLOGY
      • Data Needs
        • Risk Factors
        • The Need for Surveillance
        • The Need for Priorities
    • APPLYING TRADITIONAL PREVENTION STRATEGIES TO DISABILITY
      • Primary Prevention
      • Secondary Prevention
      • Tertiary Prevention
  • 4 Prevention of Developmental Disabilities
    • PUBLIC HEALTH SIGNIFICANCE
      • Epidemiology of Developmental Disabilities
        • Hereditary Disorders
        • Early Alterations of Embryonic Development
        • Late Pregnancy or Perinatal Conditions
        • Acquired Childhood Conditions
        • Conditions of Unknown Origin
      • Employing the New Model
        • Functional Limitations
        • Disability
        • Secondary Conditions
    • APPROACHES TO PREVENTION
      • Health Care Interventions
        • Prenatal and Well-Child Care
        • Genetic Interventions
        • Multidisciplinary Care
      • Education
        • Head Start and Comprehensive Day Care
        • Community Educational Priorities
        • Access to Public Education
      • Environmental Interventions
        • Environmental Control
        • Accessibility and Adaptation
      • Peer Support Groups
    • OPPORTUNITIES AND NEEDS
      • Organization and Coordination
        • National Coordination
        • State-based Coordination
      • Surveillance and Epidemiology
        • Centers for Disease Control
        • National Center for Health Statistics
        • National Institutes of Health
        • Bureau of Maternal and Child Health and Resources Development
        • Department of Education
        • State- and Local-level Data Bases
        • Other Important Data Bases on Developmental Disabilities
      • Research
      • Access to Care and Preventive Services
        • Public Programs for Persons with Developmental Disabilities
        • Public Programs for Families with Socioeconomic Disadvantage
      • Professional Education
  • 5 Prevention of Injury-Related Disability
    • INJURY IN AMERICA: MAGNITUDE OF THE PROBLEM
    • CENTRAL NERVOUS SYSTEM INJURIES
      • Traumatic Brain Injury: Incidence and Outcomes
      • Spinal Cord Injury: Incidence and Outcomes
      • Temporal Changes in Patterns of Injury and Outcome
    • SURVEILLANCE: COUNTING THE SURVIVORS AND ASSESSING THEIR NEEDS
    • PRIMARY PREVENTION: THE STRATEGY OF CHOICE
    • A SYSTEMS APPROACH TO ACUTE CARE AND REHABILITATION
      • The Systems Approach
        • Emergency Medical Services
        • Acute (Medical) Rehabilitation
        • Psychosocial and Vocational Rehabilitation and Lifelong Comprehensive Follow-up
  • 6 Prevention of Disability Associated with Chronic Diseases and Aging
    • MAGNITUDE OF THE PROBLEM
      • Prevalence of Chronic Conditions
        • Chronic Conditions Causing Disability
      • Multiple Chronic Conditions
      • Limitation in Basic Life Activities
    • LIFE COURSE PERSPECTIVE ON DISABILITY AND ITS PREVENTION
      • A Dynamic View of Disability as a Process
      • Aging Differently
    • DEVISING APPROACHES TO PREVENTION
      • Perspective on Preventing Disability Among People with Chronic Disease
      • Needs and Opportunities
      • Composition and Organization of Services
      • Education
  • 7 Prevention of Secondary Conditions
    • MODEL OF SECONDARY CONDITIONS
      • Surveillance and Epidemiological Understanding
      • Mental Health Conditions
    • COMPONENTS OF A COMPREHENSIVE PREVENTION PROGRAM
      • Organization and Delivery of Services
        • Independent Living Centers
      • Assistive Technologies
      • Health Promotion
        • Nutrition, Exercise, and Medications
      • Education and Information
        • Public Education
        • Education of Health Care Professionals
        • Education of People with Disability
      • Environmental Considerations
    • PROTOCOLS FOR THE PREVENTION OF SECONDARY CONDITIONS
      • Definition of Disability Category
      • Specification of Health Maintenance and Medical Interventions
      • Specification of Rehabilitation Interventions
      • Specification of Assistive Technologies
      • Specification of Environmental Changes
      • Specification of Elements in the Social Support Network
  • 8 A Comprehensive Approach to Disability Prevention: Obstacles and Opportunities
    • DEMEDICALIZATION
    • NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES
    • CLINICAL PREVENTIVE SERVICES
    • FEDERAL PROGRAMS AND POLICIES
      • Social Security Disability Insurance and Rehabilitation
      • Access to Medical Care and Preventive Services
        • Insurance Status
        • Types of Health Care Services
    • THE NEED FOR COORDINATION
      • Rehabilitation Research
      • Disability Prevention
      • Public- and Private-Sector Partnerships
      • Public and Professional Education
      • The Sum of the Parts
  • 9 Recommendations
    • ORGANIZATION AND COORDINATION
      • Leadership of the National Disability Prevention Program
      • Advisory Committee
      • Interagency Coordination and Periodic Review
    • SURVEILLANCE
      • Conceptual Framework
      • A National Disability Surveillance System
      • National Surveys
      • Disability Index
    • RESEARCH
      • Coordinated Research Program
      • Longitudinal Studies
      • Relationship of Socioeconomic Status
      • Interventions
      • Research Training
    • ACCESS TO CARE AND PREVENTIVE SERVICES
      • Accessible, Affordable Quality Care
      • Building Capacity
      • Access to Vocational Services
    • PROFESSIONAL AND PUBLIC EDUCATION
      • Education of Professionals
      • Education of the General Public
      • Education of Persons with Disabilities and Their Families, Personal Attendants, and Advocates
  • References
  • APPENDIXES
    • A Disability Concepts Revisited: Implications for Prevention
      • CONCEPTUAL HISTORY
      • A CONCEPTUAL FRAMEWORK
      • A FRAMEWORK FROM THE WORLD HEALTH ORGANIZATION
      • ASSESSMENT OF FRAMEWORKS
    • B Dissent and Response
      • PART1: DISSENT FROM THE REPORT OF THE COMMITTEE
        • Critique of the Report
        • Critique of the Process
      • PART 2: THE COMMITTEE'S RESPONSE TO THE DISSENT BY DEBORAH STONE
    • C Committee Biographies
  • Index

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