Women in the U.S. with physical &/or sensory disabilities more likely to be sterilized than women without disabilities

Source: Disability and Health Journal



Female sterilization accounts for 50% of all contraceptive use in the U.S. The extent to which U.S. women with physical and/or sensory disabilities have undergone female sterilization is unknown.


Our primary objective was to determine the prevalence of sterilization for women with physical/sensory disabilities, and compare this to the prevalence for women without disabilities. We also compared use of long-acting reversible contraceptive (LARC) methods between women with and without disabilities.


We conducted a secondary analysis of data from the National Survey of Family Growth 2011–2013, a population-based survey of U.S. women aged 15–44. Bivariate comparisons between women with and without disabilities by female sterilization and LARC use were conducted using chi-square tests. Using logistic regression, we estimated the odds of female sterilization based upon disability status.


Women with physical/sensory disabilities accounted for 9.3% of the total sample (N = 4966). Among women with disabilities only, 28.2% had undergone female sterilization, representing 1.2 million women nationally. LARC use was lower among women with disabilities than those without disabilities (5.4%, 9.3%, respectively, p < 0.01). After adjusting for age, race/ethnicity, education, insurance, marital status, parity, and self-reported health, women with disabilities had higher odds of sterilization (OR 1.36, 95% CI 1.03, 1.79).


The odds of female sterilization is higher among women with physical/sensory disabilities than those without disabilities. Future research is necessary to understand factors contributing to this finding, including possible underutilization of LARC methods.

“They just said inappropriate contact.” What do service users hear when staff talk about sex and relationships?

Source: JARID



Research into how people with intellectual disabilities (ID) pursue intimate relationships in care settings presents some contradictory findings; despite increasingly liberal staff views, service users experience significant restrictions. This study attempts to explore this gap within a secure hospital, examining service user’s representations of staff discourses about sexuality and intimate relationships.


Semi-structured interviews with eight service users with intellectual disability were analysed using critical discourse analysis.


Analysis enabled construction of 11 themes falling into three categories. Dominant discourses appeared to maintain the integrity of the institution, enable staff to occupy a position of power and demonstrate service users’ responses to perceived control.


Discourses around sex appear to serve the interests of staff and the hospital, while being restrictive and often incomprehensible to service users. Implications for service development, and future research directions, are considered in the context of “Transforming Care.”

Let’s talk about dental inequality in America

Source: The Week (Excerpted from an article that originally appeared in The Washington Post)

Mary Jordan and Kevin Sullivan

Two hours before sunrise, Dee Matello joined the line outside the Wicomico Civic Center in Salisbury, Maryland, where hundreds of people in hoodies, heavy coats, and wool blankets braced against the wind.

Inside, reclining dental chairs were arrayed in rows across the arena’s vast floor. Days later, the venue would host Disney on Ice. On this Friday morning, dentists arriving from five states were getting ready to fix the teeth of the first 1,000 people in line.

Matello was No. 503. The small-business owner, who supports President Donald Trump, had a cracked molar, no dental insurance, and a nagging soreness that had forced her to chew on the right side of her mouth for years.

Although her toothache wasn’t why she voted for Trump, it was a constant reminder of one reason she did: the feeling that she had been abandoned, left struggling to meet basic needs in a country full of fantastically rich people.

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Good Food Great Kids-Making Practice and Policy Work for Farm to Early Childcare & Education

Source: PFC social impact advisors

Good Food Great Kids-Making Practice and Policy Work for Farm to Early Childcare & Education

According to Harvard University’s Center on the Developing Child, “The science of child development now helps us to see healthy development as a causal chain— policies and programs across the public and private sectors affect the capacities of caregivers and communities to strengthen three foundations of healthy development: stable, responsive relationships; safe, supportive environments; and appropriate nutrition.” These foundations impact physiological mechanisms that have lifelong impacts on cognitive development, physical growth, and behavioral outcomes.3

Report Purpose

It is with this spirit in mind that we will explore opportunities for learning from and leveraging policy development and implementation to continue to create a base of knowledge that can help practitioners from across sectors build bridges to support better health and educational opportunities for vulnerable children and their families. The following policy overview, developed in partnership with the National Farm to School Network and the BUILD Initiative, is intended both to share a broad spectrum of existing information about various experiences in building farm to ECE-supportive policies and begin to point out how forging greater connections between current policies and the work of farm to ECE can benefit early childcare centers, children, and families.

The Good Food, Great Kids* case studies are part of a series developed by pfc Social Impact Advisors for public use and dissemination via the book Good, Evil, Wicked: The Art, Science, and Business of Giving (Stanford University Press 2017), among other publicly accessible media. Information presented was gathered through desk research and 53 interviews with practitioners, policy and issue-area experts, funders, and other local and national stakeholders in the farm to early childcare and education and farm to school sectors. *This report borrows the phrase good food from the W.K. Kellogg Foundation, which defines good food as food that is “healthy, sustainable, fair, and affordable.”

Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with ID

To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Source: Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities – Kuijper – 2017 – Journal of Applied Research in Intellectual Disabilities – Wiley Online Library



In this study, we investigated intellectual disability support professionals’ knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use.


Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate.


A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training.


To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Pain and pain assessment in people with ID

Pain and pain assessment in people with intellectual disability: Issues and challenges in practice

Source: Pain and pain assessment in people with intellectual disability: Issues and challenges in practice – Doody – 2017 – British Journal of Learning Disabilities – Wiley Online Library

Accessible summary

  • Pain is difficult to identify when people cannot communicate.
  • If pain is not identified, it cannot be managed and causes stress.
  • Pain assessment is essential in order to identify pain.
  • Pain assessment requires a combination of knowledge, health assessments and observations.



Individuals with intellectual disability experience the same chronic diseases and conditions as the general population, but are more likely to have physical and psychological co-morbidities, resulting in a higher risk of experiencing pain and having more frequent or severe pain.


This position paper aims to highlight the importance of pain assessment for people with intellectual disability.


As people with intellectual disability live within the community and/or remain in the family home, they are accessing a wide range of healthcare services. This necessitates that nurses across all care settings are knowledgeable regarding appropriate/alternative pain assessment methods for people with intellectual disability. While many pain assessment tools are available for use with the intellectual disability population, they are often not well established or infrequently used to establish their validity.


Although self-report is the gold standard in pain assessment, pain assessment for people with intellectual disability is often challenging as they may be unable to self-report their pain due to their levels of communication or cognitive ability. Assessment requires a combination of approaches amalgamating: pain assessment, health assessment and observation of behaviours.

Waiting for health equity: A graphic novel

About the Project

Today, we can accurately predict a Coloradan’s health outcomes and access to health care based on factors like their race, income, or ZIP code. This is unacceptable, because it means that people of color, Coloradans with less economic opportunity, those living in communities with fewer resources, and others, face increased barriers to good health simply due to their life circumstances. How did this happen?

Colorado—just like the rest of the US—has a long, well-documented history of oppressive policies and practices that have led to significant, persistent, and preventable health disparities, or differences in health outcomes across certain groups. In order to tackle these injustices, we must understand their root causes, such as institutional racism (the policies and practices within institutions that, intentionally or not, produce outcomes that negatively impact people of color) and poverty. Waiting for Health Equity is a graphic novel that aims to start new conversations about the complex challenges Colorado faces in working toward health equity.

Use these supplementary materials to structure your conversations:

For more information or to request a printed copy, please contact our Director of Communications, Sarah McAfee.

The Role of Families As Caregivers & Guides for Whole Health & Wellness

Health care providers often focus on serving either children or adults. While this focus may mean more tailored approaches to care for the individual patient, it may be a missed opportunity to address the role of family on health outcomes.

Source: Multi-Generational Approach to Care Overview 

Taking a multi-generational approach involves changing the focus of how the patient is viewed within the system. Health care providers may be serving a child, but must work with the family to address any issues. Often, caregivers or parents see their child’s pediatrician more than they see their own primary care provider. Therefore, they may feel more comfortable bringing up their own health concerns or accessing community supports in this setting.

Caring for the whole family requires a system of care coordination that can support an array of services, involving a variety of health care professionals. Integrated primary care and behavioral health settings help facilitate this approach to care and leverage the community resources needed to support the whole family.


ASAN Releases Plain-Language Medicaid Toolkit

A Self-Advocate’s Guide to Medicaid

Medicaid is the biggest health care program in the country. It’s an important part of the United States health care system. But a lot of the information out there about Medicaid and attempts to change it can be difficult to understand and navigate. That’s why ASAN is proud to announce the release of our plain language resource “A Self-Advocate’s Guide to Medicaid.” This resource was developed in collaboration with the Autism Services, Education, Resources and Training Collaborative (ASERT), and with funding from the Special Hope Foundation.

The Easy Read Edition is split into parts. Each part has its own glossary, and there is also a separate glossary with all of the terms from every section. Click on the title of any of the parts below to download it:

Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities

Adults with intellectual and developmental disabilities may face challenges to staying physically active. Rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%).

Source: Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities



Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles.


(a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD.


We compared adults with IDD from the 2011–2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U.S. population on meeting PA guidelines. We examined the association of demographic, diagnostic, mobility, health and community participation variables with meeting PA guidelines by adults with IDD.


The rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%). Among adults with IDD, at-risk groups included those with more severe disability, Down syndrome, mobility impairments, obesity, poor health, mental illness, no independent access to community exercise, and less frequent participation in community exercise. Going out for exercise was the only form of community participation associated with meeting PA guidelines. People who accessed the community for exercise independently (i.e., alone) were more likely to meet PA guidelines.


Interventions aimed at increasing PA for people with IDD should consider these factors in their design.