M. A. Nosek & D. K. Simmons / Californian Journal of Health Promotion 2007, Volume 5, Special Issue (Health Disparities & Social Justice), 68-81 People with Disabilities as a Health Disparities Population: The Case of Sexual and Reproductive Health Disparities Margaret A. Nosek 1 and Darrell K. Simmons 2 1 Baylor College of Medicine 2 University of Texas, M.D. Anderson Cancer Center Abstract Disability has yet to achieve its proper place in the discussion of health disparities. Several major Federal initiatives to remove health disparities have only addressed disability as a consequence of poverty, low education levels, lack of access to health care, and other disparity factors, but fail to acknowledge people with disabilities as a health disparity population. Whereas policymakers and health disparities researchers regard disability as an indicator of reduced quality of life, rehabilitation researchers focus on maximizing health and quality of life in the context of disability. This article discusses the characteristics and possible causes of health disparities experienced by people with disabilities, illustrated with examples from sexuality and reproductive health. The authors offer six pathways for eliminating the health disparities faced by people with disabilities: 1) Include information about wellness in the context of disability in the education of physicians and other health care providers, 2) Offer empowerment opportunities to people with disabilities, 3) Promote compliance with the Americans with Disabilities Act, 4) Remove barriers to participation by people with disabilities in health research and education, 5) Acknowledge people with disabilities as a health disparities population and include their issues in national health care policy, and 6) Encourage media coverage of health issues for people with disabilities and the portrayal of successful, healthy people with disabilities in publicity related to all health topics. © 2007 Californian Journal of Health Promotion. All rights reserved. Keywords: health disparities, disability, reproductive health, underserved populations Disability has yet to achieve its proper place in the discussion of health disparities. If health disparities are to be understood as marked distinctions in the quality or character (Merriam- Webster, Inc., n.d.) of the health of individuals or specific groups, then people with disabilities should be classified as a group experiencing health disparities. As a major national health policy and service focus, issues related to people with disabilities are almost completely ignored unless they happen to fall within the domain of another protected group, such as racial and ethnic minorities, the homeless, migrants, or women. In the 2006 National Health Disparities Report issued by the agency for Health Care Research and Quality (U.S. Department of Health and Human Services, 2006), one page out of 212 is devoted to the health concerns of people with disabilities, and that is limited to oral health only. The Minority Health and Health Disparities Research and Education Act of 2000 (Kennedy, 2000) requires the National Center on Minority Health and Health Disparities at the National Institutes of Health to issue reports on its plan and budget to reduce and ultimately eliminate health disparities. Although its mission is to address health disparities among minorities and other health disparity populations (defined as population groups who suffer from health disparities when compared to the general population), disability is only mentioned in terms of its detection, diagnosis, prevention, treatment, or efforts to delay its onset or progression as it contributes to health disparities (Zerhouni & Ruffin, 2002) with no mention of people with disabilities as a population of interest. People with disabilities are also not acknowledged as a health disparity population by the Health Disparities Collaboratives under the Health Resources and 68