people with disabilities officially classified as a population experiencing health disparities

People with disabilities officially classified as a population experiencing health disparities

Written by Eliott Hamilton, Student Informatician

In September 2023, the National Institute on Minority Health and Health Disparities (NIMHD) officially classified people with disabilities as a population experiencing health disparities. This decision is a game changer for disability-inclusive research and highlights the pressing need to better understand and address the unique healthcare obstacles individuals with disabilities face.

What are Health Disparities?

A health disparity is a “health difference that adversely affects disadvantaged populations in comparison to a reference population, based on one or more health outcomes. All populations with health disparities are socially disadvantaged due in part to being subject to racist or discriminatory acts and are underserved in health care.”

Disparities in health outcomes are categorized as:

  • A higher likelihood of disease, an earlier onset of disease, or a more aggressive progression of disease
  • Increased mortality rates with certain health conditions, including premature mortality
  • Greater global burden of disease (GBD)
  • Lower outcomes on self-reported data tracking day-to-day functioning and symptom collections

For people with disabilities, health disparities can vary as widely as disabilities themselves, but many people within the disability community share experiences, like health conditions not taken seriously, poorer mental health, and reduced life expectancy due to limited treatment options.

What does NIMHD’s decision mean for people with disabilities?

The National Institute on Minority Health and Health Disparities (NIMHD)’s decision to recognize and research people with disabilities as a population that experiences health disparities is significant for several reasons: 

Recognition of Unique Challenges: People with disabilities often face unique health challenges related to their disabilities. These challenges can include higher rates of certain health conditions, barriers to accessing healthcare, and disparities in health outcomes. Recognizing disability as a category for health disparities research acknowledges the specific needs and experiences of this population.

Inclusivity in Research: By designating people with disabilities as a population with health disparities, the NIH is highlighting the importance of inclusivity in research. It emphasizes the need to include individuals with disabilities in health studies to better understand their health status, identify disparities, and develop interventions that address their specific needs.

Promoting Health Equity: The designation demonstrates the commitment to promoting health equity for all populations, including those with disabilities. It acknowledges disparities in health outcomes and healthcare access exist within the disability community and emphasizes the importance of addressing these inequities.

Policy Implications: The recognition of people with disabilities as a population with health disparities can have implications for policy development and resource allocation. It may lead to focused initiatives, interventions, and policies directed at improving the health and well-being of people with disabilities, thereby reducing disparities.

Advocacy and Awareness: The designation helps raise awareness about the unique health challenges faced by people with disabilities, fostering advocacy for their rights and healthcare needs. It encourages a broader understanding of health disparities beyond traditional demographic categories, recognizing disability as a significant factor

What Are the Future Implications?

With this decision to acknowledge people with disabilities as a researchable population, the NIMHD is specifically focusing on the need for additional, more inclusive research. Alongside this designation, the NIMHD announced new research funding designated to disability healthcare equity – incentivizing researchers to address unique health disparities the disability community faces.

In addition to understanding health outcomes specific to the disability community, funding research to address disability healthcare equity is the first step in supporting inclusive research in healthcare. Future studies by the NIMHD will likely incorporate a more accurately diverse representation of the general population. 

Representation of people with diverse disabilities in health disparities research leads to a better understanding of unique health needs, challenges disabled people face within their healthcare, and the wide range of disparities the community deals with daily.

Stigma Silenced: Stories Spoken, A Mental Health Podcast is coming soon!

Written by Bailey Patterson, Student Informatician

We are so excited to share the stories of those who have experienced stigma related to a mental health condition. 

The idea of a highly stigmatized story in the world of mental health disability is one of interest. In the past decade, leaps and bounds have been made in terms of speaking more openly about mental health. Nowadays, schools, businesses, and communities across the country are more aware of terms like “mental health days”, “stressors”, “depression”, and “anxiety”. This type of awareness makes discussing mental health commonplace and opens a new world of acceptance for people who experience things like anxiety and depression in their daily lives. 

However, the mainstream mental health awareness movement has left behind a large group of people. It is no secret that highly stigmatized mental health disabilities have not received the same much needed acceptance in order to reduce the marginalization the people with these disabilities experience. People diagnosed with schizophrenia, personality disorders, bipolar disorders, psychotic disorders, OCD, dissociative disorders, people who have experienced involuntary commitment, and more have stories that have been pushed into the shadows of larger conversations. 

This podcast is where we want to expand the scope of the mental health awareness conversation. This podcast seeks to highlight and center conversations about these highly stigmatized disabilities by bringing people with lived experiences to the forefront. We want to create a space where people with highly stigmatized diagnoses can speak honestly and openly about themselves, their experiences with their condition be it positive and/or negative, the treatment, stigmatization, systemic barriers and violence, and marginalization they face due to their disability and how this affects them overall as human beings. 

The road to a liberatory future for all people with mental health disabilities is long. Many systemic and interpersonal factors weave together to create the specific type marginalization this group faces. This podcast and the conversations it highlights will only be one step in the right direction, but it is with hope that the barriers and oppressions discussed in these conversations will inspire broader action that this podcast is made. It is also our hope to capture and share disabled joy. Both of these elements are part of the whole of the disabled identity, which we hope to give space and power to in Stigma Silenced: A Mental Health Podcast. 


Check out the Sphere website to listen to new episodes as they become available.

Minority Stress & LGBTQIA2S+ Mental Health

Written by Eliott Hamilton, Student Informatician

Terms to Know

  • LGBTQIA2S+ – Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, Two-Spirit, + (representing all other Queer & Trans identities not represented in the acronym
  • Heterosexism – prejudice against any non-heterosexual form of behavior, relationship, or community, particularly the denigration of lesbians, gay men, and those who are bisexual or transgender.
  • GSRM – Gender, Sexual, & Romantic Minorities
  • Transgender – An adjective describing a person who does not identify with the gender they were assigned at birth
  • Cisgender – An adjective describing a person who does identify with the gender they were assigned at birth
  • Nonbinary – An adjective describing anyone who identifies as a gender outside of the man/woman binary. This term can be used as an individual identity or as an umbrella term for many gender identities that do not fall within the gender binary.
  • Marginalization – The process through which an individual or group with distinctive qualities becomes identified as one that is not accepted fully into the larger group.
  • Multiply Marginalized – An adjective describing a person who is a part of two or more marginalized groups.
  • BIPOC – Black, Indigenous, & people of color
  • AAPI – Asian American and Pacific Islanders

What is Minority Stress Theory?

Minority Stress Theory describes the additional stress that members of marginalized communities experience due to stigma.

Stigma and Minority Stress

Stigmatization is driven by imbalances in social, economic, and political power. It also furthers these imbalances by limiting opportunities for stigmatized groups while reducing barriers for socially dominant group.

The Process of Stigma: 1. Labeling: Human differences are identified and labeled. 2. Stereotyping: Labeled differences are linked to undesirable characteristics within the dominant culture. 3. “Othering:” Stigmatized groups and individuals are separated out from the rest of society, creating an “us vs. them” mentality. 4. Discrimination: “Othered” groups and individuals experience discrimination which leads to unequal access to resources.

How is minority stress different?

Minority stress is additional stress that adds to the regular stressors everyone faces. Regular stressors, such as applying for jobs or looking for housing, are also made worse by minority stress.

Minority Stress and Mental Health

People from the LGBTQIA2S+ community are more likely to experience harassment, bullying, discrimination, and even violent hate crimes, such as assault, than cisgender and heterosexual people. Experiencing and witnessing discrimination related to LGBTQIA2S+ identity can lead to feelings of isolation and fear.

LGBTQIA2S+ youth are exposed to harmful rhetoric about their identities through peers, media, and sometimes, family, leading to low self-esteem and internalized homophobia & transphobia.

These experiences lead to hyper-vigilance and increase the risk of depression, anxiety, and suicidal idealization, harming the overall health of romantic, sexual, and gender diverse communities.

Legislation, Location, and Minority Stress

Minority stress is experienced to different degrees depending on geographic location and dominant cultures. Those living in states or countries where LGBTQIA2S+ identity is highly politicized or criminalized are more likely to be impacted by minority stress.

Support from family, peers, educators, and healthcare providers significantly lowers the risk of mental health impacts and suicidal ideation.

Intersectionality

Multiply marginalized members of the LGBTQIA2S+ community, such as people with disabilities, BIPOC, AAPI, Jewish, or Muslim sexual and gender diverse individuals, are more likely to experience minority stress and often experience minority stress for each of their marginalized identities.

Members of the trans & non-binary community are more impacted by minority stress compared to cisgender members of the LGBTQIA2S+ community. Gender Stress Theory, based on Minority Stress Theory, describes the additional stress that gender diverse communities experience due to stigma.

Healthy Coping Strategies/Minimizing Harm

Minimizing the effects of minority stress is important for the mental and physical health of romantic, sexual, and gender diverse communities. Some healthy coping strategies include:

  • Connect with Others: Minority stress can lead to feelings of isolation and make social settings seem overwhelming. However, staying connected with other members of the community and people you trust is important for mental health. Try socializing with small groups in safe environments or joining a community support group to make new friends.
  • Unplug: Social media and news sources are often flooded with content related to anti-LGBTQIA2S+ legislation, leading to constant exposure to minority stress. Be sure to take intentional breaks from social media and news sources. Try putting your phone on silent and curling up with a good book or spending time in nature.
  • Prioritize your Physical Health: Minority stress can be draining, overwhelming, and takes a toll on physical health over time. Try investing in your health by staying hydrated, getting enough sleep, or moving your body in ways that feel good to you. Trying a new healthy recipe can also be a fun way to invest in your physical health.
  • Find a Creative Outlet: Sometimes words aren’t enough. Try finding a creative way to express yourself, whether that is dancing, painting, or playing an instrument. Creativity can help you process the emotions related to minority stress.
  • Talk to a Professional: Identity based discrimination is challenging to process. Be sure to check in with yourself often, and reach out to a mental health professional for support if you are struggling. Resources can be found through the UK Counseling Center or at libguides.uky.edu/LGBTQ/counseling.

https://doi.org/10.1016/j.pcl.2016.07.003

https://doi.org/10.2174/2210676611666211105120645

https://doi.org/10.1080/00918369.2019.1591789

https://doi.org/10.1111/sltb.12856

https://www.apa.org/pi/aids/resources/exchange/2012/04/minority-stress

https://doi.org/10.1016/j.socscimed.2008.03.012

https://stacks.cdc.gov/view/cdc/33691

https://dictionary.apa.org/heterosexism

https://dictionary.apa.org/marginalization

“I hate being treated like an emergency waiting to happen.” UK student Bailey Patterson speaks on her experience with suicide and wanting to help others

The following article discusses suicide, suicidal ideation, miscarriage, and sexual abuse, which some readers may find distressing. 


Bailey Patterson was 4 or 5 when she began struggling with suicidal thoughts. 

“Things like ‘I wish I’d never been born,’ ‘I don’t want to be here,’ ‘I wish I would die,’” Patterson, a senior Interdisciplinary Disability Studies major at UK who identifies as multiply disabled, said. “Those thoughts progressed as life threw me more curveballs, where I was pretty actively having suicidal thoughts probably every day of my life when I was in middle school and high school. Still, I would never have a plan, it was just pretty aggressive thoughts.” 

That lasted until she was 16, when a friend had experienced a traumatic event for which Patterson felt responsible. Her mother interrupted her first suicide attempt shortly after that.

Patterson is not alone in struggling with suicidal thoughts. According to the American Foundation for Suicide Prevention, suicide is the 11th leading cause of death in the US. The World Health Organization reports that it is the fourth leading cause of death among 15 to 29-year-olds. The CDC reports that 12.3 million American adults have serious suicidal thoughts and 1.7 million attempt suicide. In 2022, 49,449 people died by suicide. 

Patterson considers herself chronically suicidal, but stresses that suicide is a complex issue. Mental illness is often a component of it – according to the National Alliance on Mental Illness, 46 percent of people who die by suicide have a known mental health condition – but Patterson stresses that there are other extenuating circumstances. She remembers her first stay as an inpatient in a mental health facility. The only other patients in her ward were girls, ages 12 to 17.

“There was a really common thread about gender-based violence,” she said. “Several of the girls on the ward had been sexually abused by older men.” 

Patterson noted that she thinks this ties into a major factor in suicide that is commonly overlooked.

“There’s this narrative in popular culture that if someone is suicidal, it’s because they don’t see the value in their lives or they’re depressed, and you can do this that and the other to make it go away. You can take long walks and you can eat healthier and you’ll feel less depressed,” she said. “For many people, the cause of the suicidal thoughts or the depression is the situation they’re living in. There are people living in current abusive situations that they feel they have no way of escaping from, there are people who are dealing with interpersonal violence or abuse, there are people who are homeless, there are people who are in poverty, there are people who are experiencing systemic interpersonal racism and sexism and bigotry. Those things are not things that you can walk and eat better to get rid of.”

That means that addressing those issues will help also help address the risk of suicide among marginalized populations. Patterson believes that addressing those issues while promoting mental health will do a lot to solve the problem.  

“I feel like if we understood that and worked towards those goals while also keeping in mind personal wellness and self-care and things like that, that would be a big help,” she said. “A lot of people are overlooking some of the greatest causes of distress that are leading people to be suicidal.”

She also remembers difficult times and experiences for both her and the others she met during her two inpatient stays. Among them, she particularly recalls a patient with a fear of needles being given medication by injection against her wishes when that patient felt there were other ways to administer similar medication and another woman on her second trip to inpatient services who had been pregnant when she was checked in and miscarried after being given a medication early in her stay.

That experience awakened in Patterson a desire to help others with the same struggles. Now, she channels that into standing against abuse and the loss of autonomy in psychiatric settings. Currently, Bailey is a Student Informatician with SPHERE at HDI, Officer of the Disabled and Ill Student Coalition, and an activism and research advocate in the Mad Pride and Psychiatric Survivors movements.

“The feeling of solidarity with these other with these other people who were also experiencing something similar to what I was in the moment, being there, hearing their stories changed my life,” she said. “That was the first moment where I thought ‘this is important and I want to do something about this for the rest of my life.’”

Helping others is one of the ways in which she deals with the frequent thoughts of suicide that she still experiences – and feels like she will always experience. 

“I manage, like a lot of us do,” she said. “Take it one day at a time and try to take care of myself as best I can, but I do not foresee a life for myself where I do not feel suicidal in some degree most days of my life. That’s probably just the way it is for me. That’s something that I’m going to have to continue to manage for the rest of my life, and I think that’s ok.”

She’s found a few coping mechanisms that can help when the thoughts get particularly bad. 

“One of the things that I do is I try to imagine a time in the future where I am happy,” she said. “That can be really hard, especially when you’re very depressed, but I have a couple of things in my mind, scenarios where I could be doing this thing that would be a happy moment for me. I try to really picture it and stay in that moment…then I try with all my might to believe that could happen for me one day. That’s my best coping mechanism thus far.” 

And if someone close to you is struggling with suicidal thoughts, Patterson stressed that one of the best ways to help is to keep treating them like a human being. 

“Anyone who hears that their loved one is going to have emotions that come up for them, but I think the number one thing you can do is not freak out,” she said. “You should be there, and you should attend to the problems…I sometimes get the feeling that we are treated like a danger. I hate being treated like an emergency waiting to happen. I think the best thing you can do is just be calm and present for that person and realize that the person speaking to you is the person you’ve known.”

Warning signs of suicide may include: 

  • No longer participating in things they enjoy
  • Feeling sad all or most of the time
  • Talking about dying or wishing not to be alive
  • Feeling hopeless or feeling like one has no purpose
  • Withdrawing from social groups or saying goodbye
  • Giving away important items

If you are struggling with suicidal thoughts, help is available. You can call the suicide and crisis lifeline at 988 or text SAVE to the Crisis Text Line at 741741. Both services are free and available 24/7. If someone is in immediate danger call 911 or go to your local Emergency Room.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.