Taking Action to Include a Disability Perspective in the Public Health Workforce

November 06, 2023 | Adriane K. Griffen, Adrianna Evans

People with disabilities are a part of every community. WHO estimates that 1.3 billion, or about one in every six, people have a disability. In the United States, CDC estimates that figure to be one in four. People who have a disability have experienced historical marginalization and discrimination in areas such as healthcare, education, public health, emergency preparedness and response, and employment. As such, people who have a disability are a key group to include in conversations about diversity, equity, and inclusion (DEI).

The COVID-19 pandemic further emphasized the need for including people with disabilities in public health planning. Negative biases and attitudes led to exclusion of people with disabilities from vaccine prioritization, lack of accessibility at vaccination sites and websites, and inequitable allocation of resources through crisis standards of care. Earlier and improved engagement and inclusion of disability voices in pandemic response could have identified these issues and pointed to more equitable solutions.

It has never been more important for public health to better understand the disability community and quickly build skills and resources to better serve them. So, it is critical to both include more people living with disabilities in the public health workforce and help the current workforce focus through a DEI lens.

Skill-Building Across the Workforce

Current public health education does not systematically teach disability inclusion. Yet, well-rounded public health leaders must be familiar with how to include a disability perspective. Experts detail several core competencies to accomplish this goal, as identified in Including People with Disabilities: Public Health Workforce Competencies. These Competencies align with the Association of Schools and Programs of Public Health and Council for Education for Public Health learning domains, service standards in public health departments, and the Core Competencies for Public Health Professionals.

In addition to the core competencies, there are five key ways to support including people who have disabilities in public health efforts:

• Exemplify facilitative leadership where humble leaders recognize what they may not know, conduct their own research and education and seek input from people who have a disability. This sets the expectation that the process is inclusive from the beginning.
• Take advantage of timing and resources since no one has time or money to waste, especially in public health. Fit disability inclusion efforts into appropriate opportunities for partners and provide information on aims for your work in advance. Know and actively network with partner groups in the disability community. Working collaboratively will allow for joint identification of the best timing and resources available or needed to work together.
• Foster systematic reflection by encouraging individual, collective and agency reflection on disability inclusion. Follow an action learning or a PDSA cycle and share your reflections with peers or others to learn from one another.
• Use all available resources since public health practitioners are often in the position of figuring out how to get everything done within constrained resources. What supports from within the disability community can you access? What partners are already doing work related to your goals? Thinking of support more globally will help to be aware of all the resources available and support efforts to include people with disabilities.
• Demonstrate a personal commitment to disability inclusion by modeling the way for other public health practitioners who want to support positive change. Alignment with personal commitment and interest contributes to successful outcomes in serving the whole community.

Disabilities in the Public Health Workforce

People with disabilities can offer both lived experience and rich public health expertise to the public health workforce. Historical barriers and negative interactions with the healthcare and public health systems may prevent people with disabilities from searching and applying for public health positions. We must first acknowledge these past harms, then intentionally work to address their impact.

Creating a more disability inclusive work environment can encourage people with disabilities to enter the public health workforce. Promoting positions on disability focused job sites and clearly stating accommodations in announcements can be helpful. A key strategy is to offer accommodations in keeping with the Americans with Disabilities Act (ADA). Accommodations can reduce barriers for people with disabilities to perform a job. This can be as simple as allowing someone to work from home or adjusting a product or software package.

Accessible communication also demonstrates inclusion in a workplace. Some examples of accessible communication include using websites that meet accessibility standards, using accessible tools, and providing captioning and American Sign Language (ASL) interpretation for meetings. If a workplace demonstrates disability inclusion, it may encourage people with disabilities to apply.

Demonstrating that there are opportunities for achievement and advancement may also attract people with disabilities into the workforce. Creating a pipeline for people with disabilities to enter public health leadership roles can also promote representation in the workforce. With people with disabilities in leadership roles, organizations and health agencies can better identify barriers people with disabilities face in trying to enter the workforce and create strategies to overcome those barriers. Additionally, public health agencies and organizations can build a recruitment base by connecting with student disability groups to provide education about public health careers.

Disability Perspective in the Public Health Workforce

Inclusion of people with disabilities is a system-wide improvement that the public health field is poised to make. “Nothing about us without us” is a familiar call to action for the disability rights movement. No one understands the needs of the disability community better than the disability community itself. When people with disabilities are included in the development of policies and practices as fellow public health professionals, they bring a valuable perspective to better serve communities and promote equity and accessibility for all.

Additional Resources

• Including People with Disabilities Public Health Workforce Competencies
• ASTHO 10 Essential Questions for Disability Inclusion in Health Agencies
• NACCHO Health and Disability 101
• Society of Public Health Educators (SOPHE): Resolution for Disability, Ableism, and Health Equity in Public Health Education and Health Promotion Practice
• Inclusively
• Reasonable Accommodations in the Workplace
• Lesson 5 of Prepared4ALL: Whole Community Inclusive Emergency Planning
• Foundational Principles for Sustainable Inclusion of People with Intellectual Disabilities (PDF)

This article first appeared in the Diverse Executives Leading in Public Health (DELPH) Magazine, Issue 2. Learn more about DELPH’s leadership development initiative by visiting DELPH program page.