Guest blog post by Dr. Meg Ann Traci, RTC:Rural Knowledge Broker
The devastating and disproportionate rates of novel coronavirus (COVID-19) cases and deaths in institutional settings continues to be part of the national crisis. With data from the 23 states that publicly report data on deaths within long term care facilities, such as nursing homes, skilled nursing facilities and assisted living facilities, the Kaiser Family Foundation estimates more than one in four COVID-19 related deaths in those states (27%) occurred in such settings. The threat within these medical and personal care settings put people with disabilities and others unable to maintain and manage independence in the community, at increased risk. In rural areas, the threat to such institutionalized populations is likely even greater.
Additionally, local and national news headline stories revealed the increased burden of the virus among residents and workers in group quarters such as prisons, nursing homes, and juvenile group homes (non-correctional). The high rates of infection and deaths at a long term care facility in Kirkland, Washington, caught the nation’s attention and refocused the public health response efforts on institutional settings.
Because people living in institutional settings are more likely to report disabilities than the general population and these settings are not evenly distributed between urban and rural areas across the United States, rural people with disabilities have a lot at stake in efforts to address the pandemic and outbreaks in institutional settings.
“Not only do you have to travel far to get to beds,” Grieman said, “You’re going to a place where there are more people, where there is also an outbreak, and those beds may also still be in high demand. So, that’s what I find particularly disconcerting.”
RTC:Rural Project Director Lillie Grieman in a recent news article on Public News Service, on why rural people with disabilities are at higher risk during the COVID-19 pandemic.
Rural people with disabilities and barriers to hospital access
Rural people with disabilities face many barriers to accessing health care, particularly Intensive Care Units and hospital beds. Hospital capacity varies greatly, as does the prevalence of people with disabilities. Typically, there are fewer hospital beds and higher rates of disability in rural places than urban ones.
Project Director Lillie Greiman discusses some of these barriers in a recent news article- read or listen to the news story through the following link:
Recent models from ProPublica, Imperial College, and others predict that millions of people who contract COVID-19 will be hospitalized and many hospitals across the country may not be prepared to treat the influx of patients.
People with disabilities are particularly vulnerable to impacts from COVID-19, both directly and indirectly. While data about how this virus will impact the health and well-being of people with disabilities is currently limited, people with disabilities are often at greater risk of chronic health conditions, and thus may be more susceptible to infection. People with disabilities also face disruptions in services for daily needs, which could exacerbate conditions unrelated to COVID-19.
Overall, individuals who experience disability are at greater risk for being hospitalized either because they have contracted COVID-19 or because pre-existing health conditions have worsened.
Understanding the needs of a community is imperative to effectively plan for any type of emergency response, be it natural disaster or a pandemic. As people around the world are dealing with the COVID-19 pandemic, the needs of people with disabilities should not be overlooked or go unaddressed as members of those communities. To assess the impact of COVID on people with disabilities and their needs, it’s important to understand the prevalence of disability by the functional limitations of people living with disabilities experience in their communities.
According to the American
Community Survey, about 41 million, or 13%, of Americans have at
least one type of disability (ACS 2015). The vast majority (38 million) live in
households with other people and a significant number of people with
disabilities live in group quarters, which includes dormitories, nursing homes,
Approximately 78 million people without disabilities live in
households with a member who experiences a disability. This means that nearly
25% of the US population lives in a household with a member with a disability.
On February 11, 2020, RTC:Rural Director Catherine Ipsen and Research Associate Lillie Greiman presented as part of a panel at the Annual Disability Statistics Compendium. Their presentation was titled “Uncovering the intersection of rural and disability.”
Christiane von Reichert, professor of Geography at the University of Montana and a RTC:Rural research partner, was also part of the panel. Her presentation was titled “Using the ACS PUMS to examine disability and migration.”
RTC:Rural’s Disability in America State Profile
Map Series is well underway! We have maps for 17 states posted on
the website so far, and more are coming soon. In the next two months general
disability maps for every state (for example, Montana
and Puerto Rico
will be complete and available on the RTC:Rural website. Once the general
disability rate maps are completed, we will work to produce maps showing different
topics for each state. These include:
Disability rates among females and males
People with vision, cognitive, mobility, self-care, and Independent Living difficulties
Veterans with disabilities
People with disabilities in poverty
Employment, unemployment, and out of labor force rates among people with disabilities
Understanding the needs of a
community is imperative in order to effectively plan for natural disaster
emergency response. As Hurricane Dorian heads toward the Florida coast,
national, state and local community emergency planners are working to evacuate
and shelter thousands of people who are fleeing their homes.
People with disabilities are one of
many vulnerable groups especially at risk during natural disasters. In times of
emergency, people will evacuate with their households, and will need to shelter
with their households. It is not acceptable to separate families and households
in times of crisis. Many family
members are caregivers, so shelters need to be accessible so
that people with disabilities and their families and caregivers can stay
RTC:Rural is excited to share that we’re relaunching #MapMonday, our weekly map series. Every Monday, we’ll share a new map on our social media channels. Follow RTC:Rural on Facebook, Twitter, or LinkedIn so you don’t miss a map! (But don’t worry if you do miss one—they’re all available on our website).
In the coming weeks, we’ll share maps with overall disability rates, disability rates by difficulty and functional limitation (such as vision, hearing, mobility, and self-care difficulty), veterans, poverty, and employment rates. Continue reading →
“The purpose of the Research Review was to showcase research projects that harness administrative data to improve services for people with disabilities,” Ipsen said. “In addition to representatives from the Rehabilitation Services Administration (RSA), Social Security Administration (SSA), and the Department of Housing and Urban Development (HUD), several researchers described projects that used administrative data to answer and inform research questions.” Continue reading →