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Nothing About Us Without Us: Disability Oppression and Empowerment

Usage Factor – 2015/2016 The Springer Journal Usage Factor 2015/16 was calculated as suggested by the COUNTER Code of Practice for Usage Factors. It is the median value of the number of downloads in 2015/16 for all articles published online in that particular journal during the same time period. The Usage Factor calculation is based on COUNTER-compliant usage data on the SpringerLink platform. (Counting Online Usage of NeTworked Electronic Resources) standards. 113 Speed

Eating and Weight Disorders. Studies on Anorexia, Bulimia and Obesity

More than sixty-one million Americans have disabilities, and increasing evidence documents that they experience health care disparities. Although many factors likely contribute to these disparities, one little-studied but potential cause involves physicians' perceptions of people with disability. In our survey of 714 practicing US physicians nationwide, 82.4 percent reported that people with significant disability have worse quality of life than nondisabled people. Only 40.7 percent of physicians were very confident about their ability to provide the same quality of care to patients with disability, just 56.5 percent strongly agreed that they welcomed patients with disability into their practices, and 18.1 percent strongly agreed that the health care system often treats these patients unfairly. More than thirty years after the Americans with Disabilities Act of 1990 was enacted, these findings about physicians' perceptions of this population raise questions about ensuring equitable care to people with disability. Potentially biased views among physicians could contribute to persistent health care disparities affecting people with disability.

Physicians' Perceptions Of People With Disability And Their Health Care.

America is in the midst of a well-advertised ‘‘obesity epidemic.’’ It appears we have lost our war on obesity. Diets do not work for the vast majority of people, although the diet industry begs to disagree. In fact, dieting promotes weight gain, according to Linda Bacon, PhD. Her answer to the American weight problem ‘‘has nothing to do with dieting or self-denial and everything to do with eating and self-affirmation.’’ Health At Every Size: The Surprising Truth About Your Weight is not a weight-loss book, not a diet book, not an exercise program, nor does it contain any recipes. Backed by solid, welldocumented research, Bacon provides the reader with historical background, scientific evidence, and tools to help break free from an obsession with weight, and to see the $50 billion weight-loss industry for what it is—an industry that makes money perpetuating our preoccupation with food and our obsessive fear of becoming fat. Health at Every Size (HAES) is a health movement concept that predates Bacon’s book, and this book is Bacon’s perspective on the HAES movement, whose basic tenants are self-acceptance, physical activity, and normalized eating. The HAES philosophy promotes the concept that a person’s appropriate, healthy weight cannot be determined from a chart or a scale but rather is the weight a person settles into while maintaining a healthy, physical lifestyle including eating according to internally directed signals of hunger, appetite, and satiety. Linda Bacon earned her doctorate in physiology from the University of California, Davis, specializing in weight regulation. She holds graduate degrees in both psychology (specializing in eating disorders and body image) and exercise science (specializing in metabolism) and has professional experience as a researcher, clinical psychotherapist, exercise physiologist, and educator. She is an assistant researcher in the Nutrition Department at the University of California, Davis, and teaches nutrition in the Biology Department at City College of San Francisco. She conducts training for health professionals on the latest research in weight regulation. Reading Bacon’s preface and introduction, one might surmise that the book is the product of years of personal battles with body and weight issues and efforts to make sense of a disconnect between the disciplines she studied with regard to the science of weight regulation, cultural assumptions, and ‘‘expert’’ advice from the health field. The ‘‘surprising truth’’ described in her subtitle reflects her opinion that the public and most health care professionals have been misguided by the media and that commonly believed ‘‘assumptions’’ about ‘‘overweight’’ are not supported by the results of recent research. Our obsession with weight produces ‘‘collateral damage’’ such as eating disorders and an unhealthy association with food. Bacon asserts that our present state of knowledge indicates that a healthy lifestyle (good nutrition and physical fitness) is a better indicator of health than personal weight. Eating whole, healthy foods (as opposed to the myriad more profitable processed food products) and learning to honor our bodies by eating intuitively without the aids of weight loss products do not benefit the weight loss industry and, therefore, are downplayed in the media. This book covers a lot of territory: the politics of the food industry, the science of weight regulation, taste engineering, the psychology of our relationship with food, cultural influences, the physiologic and genetic influences on how much we will weigh, and the effects ‘‘fast food’’ and highly processed foods have on weight regulation. A large portion of the book is spent busting the assumed health risks for the ‘‘overweight.’’ Although Bacon does not deny the health risks associated with ‘‘obese’’ individuals with body mass index (BMI) more than 35, she states that scientific research indicates the risks for those labeled ‘‘overweight’’ with BMI 25 to 30 are grossly exaggerated and that the efforts taken to achieve ‘‘ideal’’ weight (eg, yo-yo dieting, extremely low calorie diets, weight-loss drugs) have resulted in health risks independent of body weight. Included in the appendix are form letters intended to aid those choosing to follow the HAES concept, such as ‘‘Friends and Family: How You Can Best Support Me in Good Health,’’ and form messages for various audiences explaining the need to switch the public’s focus to health and well-being as opposed to weight. Also included is an extensive resource guide. Written in a style equally accessible to the general public and health care professionals, Bacon provides information on health and weight regulation that is not well publicized. In support of her position, Bacon includes 437 references. Embracing a commonsense approach to weight regulation, the HAES concept has become a movement gaining attention. This book is a timely and long-overdue must-read not just for dieters but also for health care professionals who give advice about weight loss.

https://journals.sagepub.com/doi/pdf/10.1177/2156587211426574

Book Review: Health at Every Size: The Surprising Truth About Your Weight

Perceived control plays an important role in shaping development throughout adulthood and old age. Using data from the adult lifespan sample of the national German Socio-Economic Panel (SOEP; N > 10,000, covering 25 years of measurement), we explored long-term antecedents, correlates, and outcomes of perceived control and examined if associations differ with age. Targeting correlates and antecedents of control, findings indicated that higher concurrent levels of social participation, life satisfaction, and self-rated health as well as more positive changes in social participation over the preceding 11 years were each predictive of between-person differences in perceived control. Targeting health outcomes of control, survival analyses revealed that perceived control predicted 14-year hazard rates for disability (n = 996 became disabled) and mortality (n = 1,382 died). The effect for mortality, but not for disability, was independent of socio-demographic and psychosocial factors. Overall, we found very limited support for age-differential associations. Our results provide further impetus to thoroughly examine processes involved in antecedent-consequent relations among perceived control, facets of social life, well-being, and health.

Long-Term Antecedents and Outcomes of Perceived Control

Purpose/objective Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes. Results While on average, provider's explicit attitudes (M = 4.41) indicated little prejudice, their implicit attitudes (M = 0.54) revealed they moderately preferred nondisabled people-they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability). Conclusions/implications This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Explicit and implicit disability attitudes of healthcare providers.

The impact of people with disabilities choosing their services on quality of life outcomes.

People with disabilities (PWD) are a health disparities population who experience well-documented physical, structural, attitudinal, and financial barriers to health care. The disability rights com...

https://journals.sagepub.com/doi/pdf/10.1177/1179572719844759

Our Peers—Empowerment and Navigational Support (OP-ENS): Development of a Peer Health Navigator Intervention to Support Medicaid Beneficiaries With Physical Disabilities:

Purpose: Where and how rehabilitation and long-term services and supports (LTSS) occur for individuals with brain injury (BI) has shifted dramatically over the last few decades. Medicaid Home and Community Based Services (HCBS) 1915(c) waivers allow states to offer LTSS that is tailored to the needs of underserved populations in the community rather than institutional settings. Method: This study examined how states utilized waivers to provide for people with BI. Results: Findings revealed only 15 states had waivers for people with BI in fiscal year 2016. Conclusions: Of those waivers for people with BI, there were vast differences across states and services.

Community-Based Services for People With Brain Injury: A National Analysis

IMPORTANCE Discrimination based on disability-ableism-is pervasive and affects the opportunities of people with disabilities to fully engage in society. OBJECTIVE The aim of this study was to explore the impact of occupational therapy graduate education on students' explicit and implicit disability attitudes throughout their graduate education. DESIGN Longitudinal observational study, measuring occupational therapy students' attitudes on an annual basis. SETTING Three Midwestern graduate occupational therapy programs. PARTICIPANTS Occupational therapy students (N = 67). Outcomes and Measures: Participants completed the Symbolic Ableism Scale (to measure their explicit disability attitudes) and the Disability Attitude Implicit Association Test (to measure their implicit disability attitudes) on an annual basis, from when they entered their occupational therapy program to when they graduated. RESULTS The students' explicit attitudes decreased (i.e., became more favorable) throughout their education; however, their implicit attitudes did not change. In fact, most students (68%) were implicitly ableist at graduation. CONCLUSIONS AND RELEVANCE Occupational therapy education programs have an important role to play in terms of intervening with students' beliefs and preconceived assumptions about disability. Our finding suggests that occupational therapy programs may fail to intervene with students' ableist attitudes. What This Article Adds: Little longitudinal research has examined how students' implicit disability bias may be affected by their academic experience. Our findings about ableism among occupational therapy students should open the door for further dialogue on the existence of ableism in program content, its potential impact on future client interactions, and the development of approaches to address it.

Laura VanPuymbrouck

Papers

Explicit and implicit disability attitudes of healthcare providers.

The impact of people with disabilities choosing their services on quality of life outcomes.

Our Peers—Empowerment and Navigational Support (OP-ENS): Development of a Peer Health Navigator Intervention to Support Medicaid Beneficiaries With Physical Disabilities:

Community-Based Services for People With Brain Injury: A National Analysis

Impact of Occupational Therapy Education on Students' Disability Attitudes: A Longitudinal Study.