Disabled persons

残疾人
  • 文章类型: Journal Article
    Latin America is one of the most unequal regions in the world. Due to colonization and occupation of the territory, structural inequalities mark people\'s living and health conditions. In health, we can observe how different dimensions of inequalities condition access and user experience in the service. This scoping review aimed to map and analyze the expressions of inequalities in access to health services in Latin American countries from the scientific production of the last ten years, from which 272 articles were selected. The categorical analysis classified articles into five dimensions, which characterize the expressions of inequalities in access to health services: socioeconomic, geospatial, ethnic/racial, gender, and people with disabilities. The most frequent access barriers were socioeconomic or ability to pay, geographic or transportation difficulty, availability of services, cultural/ethnic, communication, and architecture. The main conditioning factors of health inequalities were income, schooling, transportation, and living conditions. Combating health inequalities requires proposing structuring and sectorial policies.
    A América Latina é uma das regiões mais desiguais do mundo. Desigualdades estruturais, fruto dos processos de colonização e ocupação do território, marcam as condições de vida e saúde das pessoas. Na saúde, é possível observar como diferentes dimensões das desigualdades condicionam o acesso e a experiência do usuário no serviço. Objetivou-se mapear e analisar as expressões das desigualdades no acesso aos serviços de saúde nos países da América Latina a partir da produção científica dos últimos dez anos. O desenho de estudo foi a revisão de escopo, por meio da qual foram selecionados 272 artigos. A análise categorial permitiu a classificação dos artigos em cinco dimensões, que caracterizam as expressões das desigualdades no acesso aos serviços de saúde: socioeconômica, geoespacial, étnica/racial, gênero e de pessoas com deficiência. As barreiras de acesso mais frequentes foram: socioeconômica ou capacidade de pagamento; geográfica ou dificuldade de transporte; disponibilidade de serviços; cultural/étnica; comunicação; e arquitetônica. Os principais fatores condicionantes das desigualdades em saúde foram renda, escolaridade, transporte e condições de moradia. O enfrentamento das desigualdades em saúde requer a proposição de políticas estruturantes e setoriais.
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  • 文章类型: Journal Article
    国家残疾保险计划(NDIS)开创了澳大利亚残疾服务的变革性时代,需要新的劳动力模型来满足不断变化的参与者需求。治疗助理用于增加劳动力短缺地区的治疗服务能力。支持这一新兴劳动力所需的治理安排在文献中受到的关注有限。这篇综述研究了农村环境中治理的关键组成部分和背景因素,特别是在农村和偏远地区的专职医疗专业人员的指导下,重点关注治疗支持工作者。遵循残疾的社会模式和国际功能分类,残疾与健康,用现实主义的观点分析了26篇论文(重复数据删除后),主要是澳大利亚和定性的,强调员工能力,培训,和证书。成功的衡量标准通常被模糊地定义,大多数论文侧重于员工改进,很少侧重于客户或组织改进。一致的人员配备,角色清晰,社区合作,和支持性领导被认为是成功治理农村地区残疾治疗支持工作者的有利环境。能力(软技能)发展投资,量身定制的培训,能力评估,证明,和监督被确定为关键活动,当与标识的启用上下文耦合时,可能会影响员工,客户和组织成果。需要进一步研究,以探索治理安排的长期影响,教育计划问责制,以及旨在提高员工能力的活动。
    The National Disability Insurance Scheme (NDIS) ushered in a transformative era in disability services in Australia, requiring new workforce models to meet evolving participant needs. Therapy Assistants are utilised to increase the capacity of therapy services in areas of workforce shortage. The governance arrangements required to support this emergent workforce have received limited attention in the literature. This review examined the key components and contextual factors of governance in rural settings, specifically focusing on therapy support workers under the guidance of allied health professionals in rural and remote areas. Guided by the social model of disability and the International Classification of Functioning, Disability and Health, a realist perspective was used to analyse 26 papers (after deduplication), mostly Australian and qualitative, with an emphasis on staff capabilities, training, and credentialling. Success measures were often vaguely defined, with most papers focusing on staff improvement and few focusing on client or organisational improvement. Consistent staffing, role clarity, community collaboration, and supportive leadership were identified as enabling contexts for successful governance of disability therapy support workers in rural areas. Investment in capability (soft skills) development, tailored training, competency assessment, credentialling, and supervision were identified as key activities that, when coupled with the identified enabling contexts, were likely to influence staff, client and organisational outcomes. Further research is warranted to explore long-term impacts of governance arrangements, educational program accountability, and activities targeted at enhancing staff capabilities.
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  • 文章类型: Journal Article
    目的:本研究的目的是总结ICF病灶,超越身体结构和功能,并分析在对青少年和年轻人(AYAs)的研究中评估过的CP处于成年过渡阶段的人群。
    方法:Medline,EMBASE,PsycINFO,使用与脑瘫相关的术语搜索和CINAHL数据库,青少年/年轻人,健康发展,参与,和独立。考虑了2014年至2021年以英语发表的包括患有CP(13-30岁)的年轻人的研究。使用纳入研究中报告的评估方法来确定ICF病灶并评估谁。
    结果:在这项研究中,回顾了86项研究。ICF的主要焦点是活动和参与(51%的研究),个人因素(23%),ICF未涵盖(14%),ICF未定义(9%),环境因素是最不集中的ICF成分(3%)。大多数研究直接评估AYAs(49%的研究)。
    结论:与活动和参与相关的结构是研究的主要研究重点,需要更多地关注环境因素。AYAs是信息的主要来源,其他关键人物的观点也得到了重视。为了弥合儿童保健和成人保健之间的差距,必须采取更广泛的健康发展视野和探索AYA发展问题的方法。
    OBJECTIVE: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood.
    METHODS: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13-30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed.
    RESULTS: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies).
    CONCLUSIONS: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
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  • 文章类型: Journal Article
    背景:可持续发展目标强调边缘化群体和社区的公平医疗服务。在低收入和中等收入国家(LMICs),结婚生子的残疾妇女(WWD)人数正在迅速增加。然而,这些妇女在中低收入国家寻求围产期护理方面面临多方面的挑战。这项范围审查的目的是记录WWD寻求围产期护理的主要促进者和障碍。我们还将为低收入国家的残疾妇女提出包容性围产期保健服务战略。
    方法:我们将对2010年至2023年在LMIC中对功能性残疾妇女寻求围产期护理的促进者和障碍进行定性和混合方法研究的同行评审和灰色文献(已发表报告)进行范围审查。将在Medline/PubMed进行电子搜索,Scopus和GoogleScholar数据库。两名研究人员将根据标题独立评估研究是否符合入选资格标准,摘要和全文回顾。
    背景:此范围界定审查基于已发表的文献,不需要伦理批准。研究结果将发表在同行评审的期刊上,并在与生殖健康有关的会议上发表。残疾和包容性健康论坛。
    BACKGROUND: The Sustainable Development Goals have put emphasis on equitable healthcare access for marginalised groups and communities. The number of women with disabilities (WWD) to marry and have children is rapidly increasing in low- and middle-income countries (LMICs). However, these women experience multifaceted challenges to seeking perinatal care in LMICs. The objective of this scoping review is to document key facilitators and barriers to seeking perinatal care by WWD. We also will propose strategies for inclusive perinatal healthcare services for women with disabilities in LMICs.
    METHODS: We will conduct a scoping review of peer-reviewed and grey literature (published reports) of qualitative and mixed-methods studies on facilitators and barriers to seeking perinatal care for women with functional disabilities from 2010 to 2023 in LMICs. An electronic search will be conducted on Medline/PubMed, Scopus and Google Scholar databases. Two researchers will independently assess whether studies meet the eligibility criteria for inclusion based on the title, abstract and a full-text review.
    BACKGROUND: This scoping review is based on published literature and does not require ethics approval. Findings will be published in peer-reviewed journals and presented at conferences related to reproductive health, disability and inclusive health forums.
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  • 文章类型: Journal Article
    背景:在世界各地,残疾人权利运动和残疾人社会模式强调社会参与对残疾人的重要性。身体残疾的人有高和复杂的支持需求,往往需要支持进入他们的社区,然而,对这一人群的支持和社会参与之间的相互作用知之甚少。因此,本范围审查的目的是探索与残疾成人支持和社会参与之间相互作用相关的文献,并了解文献中可能需要进一步研究以最大限度地提高质量支持和社会参与的存在的差距。
    方法:此范围审查将根据Arksey和O\'Malley概述的范围审查指南进行和报告,后来由Levac等人修改,以及系统审查和荟萃分析的首选报告项目:范围审查的扩展。将在MEDLINE进行彻底的数据库搜索,PsycINFO,CINAHL和Scopus。搜索将仅限于从2013年开始以英文发表的论文。引文将上传到Covidence中,并由两名独立审稿人进行筛选。数据提取将提取有关参与者的数据,住房,支持和研究特点,以及与研究问题相关的定性和定量数据。将使用叙述性综合来总结发现。将聘请至少三名有残疾经验的顾问进行审查,并为最终的范围审查文件做出贡献。
    背景:预计本次范围界定审查的结果将在同行评审的出版物中以及以简单的语言格式提供,以确保广泛受众的可访问性。此范围审查将不需要道德。
    BACKGROUND: Around the world, the disability rights movements and the social model of disability have placed emphasis on the importance of social participation for people with disability. People with physical disability who have high and complex support needs often need support to access their communities, however, very little is known about the interaction between support and social participation for this population of people. Therefore, the aim of this scoping review is to explore the literature related to the interaction between support and social participation for adults with disability and understand any existing gaps in the literature where further research may be required in order to maximise quality support and social participation.
    METHODS: This scoping review will be conducted and reported according to scoping review guidelines outlined by Arksey and O\'Malley and later modified by Levac et al, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews. Thorough database searches will be conducted across MEDLINE, PsycINFO, CINAHL and Scopus. The search will be limited to papers published in English from 2013 onwards. Citations will be uploaded into Covidence and screened by two independent reviewers. Data extraction will extract data regarding participants, housing, support and study characteristics, as well as qualitative and quantitative data relevant to the research question. A narrative synthesis will be used to summarise findings. A minimum of three consultants with lived experience of disability will be engaged to review and contribute to the final scoping review paper.
    BACKGROUND: It is anticipated that the findings of this scoping review will be made available in peer-reviewed publications and also in plain language formats to ensure accessibility to a wide range of audiences. Ethics will not be required for this scoping review.
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  • 文章类型: Journal Article
    残疾人比普通人群更容易患抑郁症。这项研究试图绘制当前抑郁症知识的证据,干预策略,和残疾人的评估工具。这项审查是根据Arksey和O'Malley的范围审查方法框架进行的。对四个英文数据库进行了电子搜索:PubMed,科克伦图书馆,PsycINFO,和WebofScience。原始搜索返回1802个结果,来自WebofScience的1,116,626来自PubMed,25来自科克伦,和35来自PsycINFO。删除重复项后,为标题和摘要筛选过程选择了786篇文章。最后,112份全文出版物被视为合格,41篇论文被纳入本次范围审查中进行分析。选择的大部分研究(32;78.04%)是横截面的,其中14人(34.14%)报告一般残疾,12(29.26%)使用患者健康问卷(PHQ-9)来测量抑郁症,14人(34.14%)进行了干预,包括认知行为疗法,心理咨询,社会支持,和身体活动。所有干预措施都成功降低了抑郁症的严重程度。认知行为疗法和心理咨询是广泛使用的干预措施,对降低抑郁症有显著影响。需要更多的随机对照试验,他们应该关注特定残疾的个人,提供特定残疾的护理,以提高残疾人的生活质量。
    Individuals with disabilities are more vulnerable to depression development than the general population. This study sought to map the evidence on current knowledge of depression, intervention strategies, and assessment tools among people with disabilities. This review was conducted following Arksey and O\'Malley\'s scoping review methodology framework. An electronic search was performed on four English databases: PubMed, Cochrane Library, PsycINFO, and Web of Science. The original search returned 1802 results, with 1,116 from Web of Science, 626 from PubMed, 25 from Cochrane, and 35 from PsycINFO. After removing duplicates, 786 articles were chosen for the title and abstract screening processes. Finally, 112 full-text publications were deemed eligible, with 41 papers being included in this scoping review for analysis. A large proportion (32; 78.04%) of the studies chosen were cross-sectional, 14 (34.14%) of them reported general disability, 12 (29.26%) used a patient health questionnaire (PHQ-9) to measure depression, and 14 (34.14%) had interventions, including cognitive behavioral therapy, psychological counseling, social support, and physical activity. All interventions successfully reduced the severity of the depression. Cognitive behavioral therapies and psychological counseling were widely used interventions that had a significant impact on reducing depression. More randomized controlled trials are required, and they should focus on individuals with specific disabilities to provide disability-specific care that can improve the quality of life for disabled individuals.
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  • 文章类型: Journal Article
    目标:有强有力的证据表明,辅助行动技术可以提高职业绩效,社会参与,残疾人的教育和就业机会以及整体生活质量。然而,残疾人在获得移动产品和相关服务方面仍然面临障碍。这篇综述旨在总结和综合:(1)理论,用于理解移动辅助技术访问的模型和框架,(2)获取的决定因素和(3)知识差距。
    方法:使用Arksey和O\'Malley的五步框架进行范围审查。
    方法:我们搜索了MEDLINE,EMBASE,2000年至2024年间出版的护理和相关健康文献和SCOPUS数据库的累积指数。我们搜索了截至2024年3月20日发表的文章。
    方法:我们在同行评审的期刊中纳入了英文发表的文献,这些文献报道了(a)提供移动辅助技术的障碍,(b)包括至少一项理论,2000年至2024年之间的模型或框架和(C)。
    方法:我们提取了研究特征,理论,模型,框架用法,研究建议,关于移动辅助技术障碍和理论命题的主要发现。我们在特纳方法的指导下进行了理论综合。
    结果:我们收录了18篇文章,使用了8种理论,模型和框架,合成9个命题。综合理论强调,流动性对人类的繁荣至关重要,某些健康状况可能会对行动施加限制。这种影响可以通过两个直接决定因素来减轻:(1)提供适当的服务和(2)全面提供服务。政策和成本间接影响这些服务。环境和个人因素也会影响这些服务的使用。无效地解决这些决定因素可能会限制对移动辅助技术的访问和随后的残疾。
    结论:我们的综合模型描述了提供基于证据的移动辅助技术的逻辑,我们确定了可以作为未来工作目标的访问的决定因素,以改善移动辅助技术的提供。
    OBJECTIVE: There is strong evidence that mobility-assistive technologies improve occupational performance, social participation, educational and employment access and overall quality of life in people with disabilities. However, people with disabilities still face barriers in accessing mobility products and related services. This review aims to summarise and synthesise: (1) theories, models and frameworks that have been used to understand mobility-assistive technology access, (2) determinants of access and (3) gaps in knowledge.
    METHODS: A scoping review using the five-step framework by Arksey and O\'Malley.
    METHODS: We searched the MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and SCOPUS databases for publications published between 2000 and 2024. We searched for articles published up to 20 March 2024.
    METHODS: We included English-published literature in peer-reviewed journals that reported (a) barriers to the provision of mobility-assistive technologies, (b) including at least one theory, model or framework and (c) between 2000 and 2024.
    METHODS: We extracted the study characteristics, theories, models, framework usage, research recommendations, key findings on mobility-assistive technology barriers and theoretical propositions. We conduct a theoretical synthesis guided by Turner\'s approach.
    RESULTS: We included 18 articles that used 8 theories, models and frameworks, synthesised into 9 propositions. The synthesised theory emphasises that mobility is essential for human flourishing, and that certain health conditions may impose restrictions on mobility. This impact can be alleviated by two direct determinants: (1) the provision of suitable services and (2) their comprehensive provision. Policies and costs influence these services indirectly. Environmental and personal factors also affect the use of these services. Ineffectively addressing these determinants can limit access to mobility-assistive technologies and subsequent disabilities.
    CONCLUSIONS: Our synthetic model describes the logic of providing evidence-based mobility-assistive technologies, and we identify the determinants of access that can act as targets for future work to improve the provision of mobility-assistive technologies.
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  • 文章类型: Journal Article
    This review aims to disclose the gaps and needs for acknowledging the rights to experience motherhood of women with disabilities. To do so, we map how much is known about these women\'s experience with motherhood, shedding light on their sexual and reproductive rights. The present work followed the scoping review by the Joanna Briggs Institute (JBI). This research is structured by elaborating the question, identifying the relevant studies, selecting the studies, extracting the data, sorting, summarizing, and creating reports based on the results. Results: we found 1050 articles, of which 53 were selected for the analysis. considering the different themes, we generated three axes: (1) infantilization, dehumanization, and discredit in the experience of motherhood; (2) obstetric ableism - an expression of violence in obstetrics; (3) reproductive justice - politicize motherhood and care. The study showed the urgent need to regard women with disabilities as people having the right to make sexual and reproductive health choices. Health professionals need permanent education to acknowledge and guarantee such a need as interweaving relationships to reach decision-making and autonomy.
    Nesta revisão, buscamos identificar lacunas e necessidades para o reconhecimento do direito das mulheres com deficiência ao exercício da maternidade. Objetivamos mapear o conhecimento referente às experiências com a maternidade dessas mulheres, ressaltando a produção de conhecimento relacionada aos direitos sexuais e reprodutivos. Realizamos uma revisão de escopo conforme o Joanna Briggs Institute (JBI). A pesquisa se sustentou na: formulação da questão; identificação dos estudos relevantes; seleção dos estudos; extração de dados; separação, sumarização e relatório dos resultados. Resultados: identificamos 1.050 artigos e selecionamos 53 para análise. A separação dos temas convergentes gerou três eixos: (1) infantilização, desumanização e descrédito na experiência da maternidade; (2) capacitismo obstétrico: uma expressão da violência obstétrica; (3) justiça reprodutiva: politizar a maternidade e o cuidado. Concluímos pela urgência de considerar as mulheres com deficiência com direitos de escolhas nas questões referentes à sua saúde sexual e reprodutiva. Os profissionais de saúde precisam de educação permanente para reconhecer e garantir as necessidades como relações de interdependência para decisões e autonomia.
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  • 文章类型: Journal Article
    金融排斥是一个影响卫生公平的人权问题。有证据表明,残疾人和中低收入国家(LMIC)的经济排斥加剧。金融准入的障碍包括对服务的需求有限,银行业在迎合残疾人方面的不足,信息技术(ICT)和基础设施的获取不足。
    这项范围界定审查旨在确定LMIC残疾人金融包容性的障碍和促进者。作为次要目标,该研究探讨了金融教育和ICT利用作为增强金融包容性的可行策略的潜力。
    这篇综述利用Arksey和O\'Malley框架和PRISMA清单进行系统的文献检查和数据提取。WHO的环境因素指导分析提出潜在的干预措施并提出建议。
    该评论分析了来自全球不同地区和领域的26种出版物,包括金融,business,技术,健康和残疾政策。它为残疾人确定了一致的金融包容性障碍,产生了一系列跨态度的全球建议,环境,技术,服务,和政策。
    建议包括使用ICT,数字创新和多方利益相关者合作,以解决残疾人遇到的财务障碍。这些努力,植根于社会正义,旨在将LMIC中的残疾人纳入重要的金融部门参与者,促进健康和公平。
    主要发现:残疾人在金融包容性方面存在全球准入障碍和推动因素。改善获取的建议包括消除污名和态度障碍,从事以用户为中心的金融服务设计,提供金融教育并确保辅助技术和ICT的可及性,以及银行的物理环境。补充知识:本研究回顾了文献,并提供了残疾人金融包容性的全球概述。以及关于普遍适用的行动以加强获取的建议。全球卫生对政策和行动的影响:确定金融包容性的障碍并提出克服这些障碍的战略,为致力于改善残疾人获得金融服务的政策制定者和倡导者提供了宝贵的指导。
    UNASSIGNED: Financial exclusion is a human rights issue affecting health equity. Evidence demonstrates that financial exclusion is exacerbated for people with disability and those in low- to middle-income countries (LMIC). Barriers to financial access include limited demand for services, banking inadequacies in catering to people with disability, and insufficiently accessible information technologies (ICT) and infrastructure.
    UNASSIGNED: This scoping review sought to identify barriers to and facilitators of financial inclusion for people with disability in LMIC. As a secondary objective, the study explored the potential of financial education and ICT utilisation as viable strategies for enhancing financial inclusion.
    UNASSIGNED: This review utilised the Arksey and O\'Malley framework and PRISMA Checklist for systematic literature examination and data extraction. The WHO\'s Environmental Factors guided the analysis to propose potential interventions and to generate recommendations.
    UNASSIGNED: The review analysed 26 publications from various global regions and fields including finance, business, technology, health and disability policy. It identified consistent financial inclusion barriers for people with disability, resulting in a set of global recommendations across attitudes, environment, technology, services, and policy.
    UNASSIGNED: Recommendations include using ICT, digital innovation and multi-stakeholder collaboration to address the financial barriers experienced by people with disability. These efforts, rooted in social justice, aim to include people with disability in LMIC as valued financial sector participants, promoting health and equity.
    Main findings: There are global access barriers and enablers to financial inclusion for people living with disability. Recommendations to improve access include countering stigma and attitudinal barriers, engaging in user centred design of financial services,providing financial education and ensuring accessibility of assistive technology and ICT, along with the physical environment of the bank.Added knowledge: This study reviews the literature and offers a global overview of financial inclusion for people with disabilities, along with recommendations for universally applicable actions to enhance access.Global health impact for policy and action: Identifying barriers to financial inclusion and suggesting strategies to overcome them provides valuable guidance for policymakers and advocates working to improve access to financial services for people with disability.
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  • 文章类型: Journal Article
    在过去的三十年里,健康公平已经成为记录的指导框架,解释,并告知促进人口健康。随着这些发展,学者们扩大了公共卫生的视野,使压迫系统成为焦点。此外,一些残疾和健康领域的研究人员主张利用基于社会的框架来调查残疾人的健康。然而,命名能力主义,更不用说将其用于健康的实证研究,仍然很少。本文批判性地回顾了人口健康研究中作为残疾人健康社会决定因素的能力研究。首先,我们通过回顾过去来提供这种文学的现状。我们简要追溯了研究残疾和健康的传统方法的历史,以及对主导这项工作的个性化镜头的批评中出现的替代方法。接下来,我们描绘了能力主义在社会层面的运作。我们描述了在人口健康中如何研究能力水平的分析水平(内省,人际关系,机构,和结构)和感兴趣的措施。最后,我们讨论了阻碍人口健康研究的障碍和有希望的途径,这些研究促进了残疾人的健康公平。
    Over the past three decades, health equity has become a guiding framework for documenting, explaining, and informing the promotion of population health. With these developments, scholars have widened public health\'s aperture, bringing systems of oppression sharply into focus. Additionally, some researchers in disability and health have advocated for utilizing socially grounded frameworks to investigate the health of disabled people. Yet, naming ableism, much less operationalizing it for the empirical study of health, remains scant. This paper critically reviews the study of ableism as a social determinant of disabled people\'s health within population health research. First, we provide an orientation to the present state of this literature by looking to the past. We briefly trace a history of traditional approaches to studying disability and health and alternatives that have emerged from critiques of the individualized lens that has dominated this work. Next, we delineate the operation of ableism across social levels. We characterize how ableism has been studied in population health in terms of levels of analysis (intrapersonal, interpersonal, institutional, and structural) and measures of interest. To conclude, we discuss hinderances to and promising avenues toward population health research that advances health equity for disabled people.
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