Recognizing Inequity: A Critical Step of Health Literacy for People With Disability

Abstract

Abstract Importance: Receiving accommodations may require a person with physical disability (PWPD) to recognize and address disparate care when it occurs. Objective: To explore whether PWPDs recognize disparate health care and how their experiences contribute to the development of strategies to access care. Design: In this qualitative study, we used grounded theory methods to explore perceptions of PWPDs regarding access to health care. Ten PWPDs participated in three semistructured focus group interviews. The analysis used multiple phases of analysis and methods to ensure rigor. Setting: Focus groups were held at an urban university campus. Participants: Four male and six female English speakers who identified as a PWPD in need of a mobility aid and who attended a primary health care visit in the past year. Results: Seven thematic categories emerged, representing a continuum of stages for recognizing health care as disparate and strategies to receiving equitable health care for PWPDs: (1) unrecognized experiences of normalization of disability discrimination (NODD), with a subtheme of medicalization; (2) knowing what you need; (3) noticing differences; (4) emerging understanding; (5) learning to take personal action; (6) NODD is systemic; and (7) taking control. Conclusions and Relevance: The findings of this study can be used on micro, meso, and macro levels to work toward equitable health care access and outcomes for clients. What This Article Adds: Occupational therapy practitioners can use these findings to understand the health literacy demands of PWPDs in efforts to access equitable health care and, when necessary, educate clients on their potential need for accommodation, rights to care, and development of strategies for requesting accommodations.