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Institute of Medicine Issues Report on Disability in America

April 24th, 2007

The Future of Disability in America concludes that immediate action is essential for the nation to avoid harm and to help people with disabilities lead independent and productive lives. The report, developed by a committee of 14 experts including Trace Center Director Gregg Vanderheiden, contains chapters on definition and disability monitoring, disability trends, health care transitions for young people, secondary conditions and aging with disability, the environmental context of disability (with particular focus on health care facilities), assistive and mainstream technologies, access to health insurance, coverage of assistive technologies and personal assistive services, and organization and support of disability research.

Today more than 40 million Americans live with a disability. If we consider people who now have disabilities, people who are likely to develop disabilities, and people who are or will be affected by the disabilities of family members and others close to them, then disability will affect the lives of most Americans. Members of the baby boom generation face an especially uncertain future as they grow older, as their risk of disability increases, and as programs such as Social Security and Medicare face serious funding challenges.

The United States faces important decisions that could reduce – or increase – the extent to which people can live independently and be involved in their communities. The report contends that inaction may lead to a diminished quality of life, increased stress on individuals and families, and lost productivity.

Some progress has been made since the 1990s. The growth of assistive and mainstream electronic technologies allows many people to interact more easily with their environment. However, the report finds that professionals are not always well-informed about the ways that assistive technologies can enhance people’s independence and productivity. In addition, many aspects of the environment contribute to limitations associated with disability – for example, inaccessible transportation systems and workplaces, restrictive health insurance policies, and telecommunications and computer technologies that do not consider people with vision, hearing, or other disabilities.

Key recommendations in the area of assistive and accessible technologies include:

  • Federal agencies that support research on assistive technologies should collaborate on a program of research to improve strategies to identify, develop, and bring to market new or better assistive technologies for people with disabilities. Such research should involve consumers, manufacturers, medical and technical experts, and other relevant agencies and stakeholders.
  • Congress should direct the Access Board to collaborate with relevant public and private groups to develop a plan for establishing accessibility standards for important mainstream and general use products and technologies. The plan should propose criteria and processes for designating high-priority product areas for standard setting; identify existing public or private standards or guidelines that might be useful in setting standards; and include medical equipment as an initial priority area.
  • The Centers for Disease Control and Prevention, working with the National Institute on Disability and Rehabilitation Research, should launch a major public health campaign to increase public and health professional awareness and acceptance of assistive technologies and accessible mainstream technologies that can benefit people with different kinds of disabilities.

The Future of Disability in America report is viewable online with pre-orders accepted for print and pdf versions. The study was sponsored by the Centers for Disease Control and Prevention, National Institute for Disability and Rehabilitation Research, and National Center for Medical Rehabilitation Research. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. Read the National Academies press release and report brief, which includes a full committee roster.

Long-term funding for the Trace Center’s research and development related to accessibility of information technology and telecommunications has been provided by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education, as part of the Rehabilitation Engineering Research Centers program. See About the Trace Center (link is external) for more information.