“At risk” and “vulnerable”! Reflections on inequities and the impact of COVID-19 on disabled people

Abstract

This professional perspective provides background knowledge and evidence to support reflection on disability outcomes internationally and in Aotearoa New Zealand. Over one billion people live with disability worldwide. Approximately 4.5% of the world’s population live with significant difficulties in function, activity, and participation. In Aotearoa New Zealand, approximately 1.1 million (24%) people have a disability, making disability the largest minority group. Yet disabled people face extreme health inequities. These are exacerbated when response planning and service delivery during times of humanitarian emergency, such as COVID-19, fail to include and consider the impact decisions will have for disabled people. Disabled people are more “at risk” of contracting COVID-19, and some disabled people are “at risk” of poorer health outcomes from COVID-19. However, “vulnerability” arises from the continuation and exacerbation of discriminatory policies, including health professionals’ conscious and unconscious biases, in times of crisis but also within conventional health service delivery. As part of the health system, it is perhaps timely for physiotherapists to reflect upon their knowledge of the health inequities disabled people experience, and to consider personal and collective bias. There are strategies physiotherapists might adopt to challenge interpersonal, internalised, and institutional bias. These steps will help affirm disability inclusiveness at all levels of the health system and support a human rights expectation that all New Zealanders should have equitable health outcomes.