A Conversation with Dr. Brian Armour About Oral Health of People with and Without Disabilities

Patient - teeth checkBrian Armour, PhD is an economist with the Centers for Disease Control and Prevention (CDC). He has spent over 15 years in health services research, including work on helping design the CDC Disability and Health Data (http://dhds.cdc.gov/). We asked Brian to discuss findings from the study he led, entitled “A Profile of State-level Differences in the Oral Health of People with and Without Disabilities, in the U.S., in 2004” (Armour BS, Swanson M, Waldman HB, Perlman SP. Public Health Rep. 2008 Jan-Feb;123(1):67-75).

Why did you want to study state-level differences in oral health of people with disabilities?
While there have been disability-specific studies about oral health, no state-level analysis of the oral health of people with disabilities was available. We wanted to assess the oral health of people with disabilities in each state.

Oral health is as important as other types of health care; and good oral health improves general health, self-esteem, communication, nutrition, and quality of life.

What did you discover?
In the year we observed, people with disabilities were less likely than people without disabilities to visit a dentist or dental clinic. They were more likely to have experienced tooth loss.

Our study showed very different results among states. People with disabilities from Mississippi were much less likely than people with disabilities in Connecticut to have visited the dentist or dental clinic in the last year. Only four percent of people with disabilities in the District of Columbia reported having tooth loss as opposed to almost 19 percent of people with disabilities in Kentucky.

What does this mean for people with disabilities and their families?
It is important for everyone, especially for people with disabilities, to practice good oral health habits, like brushing their teeth regularly and flossing. People who need help finding good oral health habits can visit the “Oral Health” section of the CDC website.

Sometimes, people with disabilities – particularly intellectual or developmental disabilities – need assistance from their families and caregivers to help them practice good oral health. If caregivers need tips on how to promote good oral heath, they can check out “Dental Care Every Day: A Caregiver’s Guide” from the National Institute on Health.

A Conversation with Brian Armour About Disability Prevalence Among Healthy Weight, Overweight, and Obese Adults

Patient-assessors-weist-measure

Brian Armour, PhD is an economist with the Centers for Disease Control and Prevention (CDC).  He has spent over 15 years in health services research, including work on helping design the CDC Disability and Health Data System (http://dhds.cdc.gov/). We asked Brian to discuss findings from the study he led, entitled Estimating Disability Prevalence Among Adults by Body Mass Index: 2003–2009 National Health Interview Survey” (Armour BS, Courtney-Long E, Campbell VA, Wethington HR. Prev Chronic Dis. 2012; 9: E178. Published online 2012 December 27).

In your article, you assess the number of people who are obese, overweight, or healthy weight and who report having a disability. Why do you think it is important to look at whether people who have weight issues also have disabilities?
This information can help public health programs better recognize the need to design obesity prevention and treatment programs that are inclusive of people with disabilities.

What did you find out?
We found that 41 percent of US adults who are obese also reported having a disability. We also found out that mobility limitation was one of the most frequently reported types of disability among people who are obese.

What does this mean for public health programs?
Public health programs should be considering the needs of those with disabilities when designing their obesity prevention and treatment programs. There are many resources public health organizations can use to help make sure that they are thinking of the needs of people with disabilities. Two good resources include the “Disability Inclusion” section on the CDC’s website as well as the Inclusive Community Health Implementation Package (iChip) program run by the National Center on Health and Physical Activity for People with Disabilities (NCHPAD).

Do you have any recommendations for people with disabilities on how to maintain their weight and avoid becoming obese?
Everyone is different, but it is important that we all are physically active, eat better, and talk to a doctor when not feeling well! People who need help keeping a healthy weight can check out the “Healthy Weight” section of the CDC website for tools to use to help maintain a healthy weight.

Is there anything else you want to say?
Identifying health issues that people with disabilities experience is important, but we also need to help improve the health of people with disabilities by promoting inclusion. This means making sure that people with disabilities are included in all aspects of community life—in our gyms, healthy eating programs, walking paths, transportation and more.

What is Disability? The Department of Justice Releases Revised Regulations to Implement the Requirements of the ADA Amendments Act of 2008

On August 10, 2016, the Department of Justice (DOJ) released the much anticipated final rule revising the Department’s Americans with Disabilities Act (ADA) Title II (public services) and Title III (public accommodation) regulations to implement the requirements of the ADA Amendments Act of 20009 (ADAAA). The final rule will take effect on October 11, 2016.

The new DOJ regulations provide significant clarification for who is covered under the ADA. The final rule clarifies that those with disabilities from cancer, attention deficit hyperactivity disorder, learning disabilities, and other conditions should be protected under the ADA.

In addition to clarifying the term disability, the final rule provides a non-exhaustive list in defining major life activities, and adds rules of construction to be applied when determining whether an impairment substantially limits a major life activity.  DOJ states that the goal is to ensure the ADA is construed broadly in favor of expansive coverage, thereby meeting the original Congressional intent.

Although the ADAA is already in effect and applies to all entities covered under Title II and Title III (employment) of the ADA, DOJ’s changes to the regulations will assist in the interpretation and application of the ADAAA. The ADAAA’s provisions regarding the definition of disability will also apply to Title I of the ADA.

The final rule includes clear language that individuals with intellectual disabilities are covered under the ADA and the ADAAA. The analysis in the rule makes it clear the intent of Congress was to protect individuals with I/DD even where a mitigating measure, medication, etc., might lessen the impact of an individual’s disability.

The Arc Commends Department of Justice’s Report on Investigation of the Baltimore City Police Department

Washington, DC – Last week, the Department of Justice’s (DOJ) Civil Rights Division released a report following an investigation into the past conduct of the Baltimore City Police Department (BPD). DOJ concluded that there is “reasonable cause to believe that BPD engaged in a pattern or practice of conduct that violates the Constitution or federal law” by engaging in unconstitutional stops, searches, and arrests; using enforcement strategies that produce severe and unjustified disparities in the rates of stops, searches, and arrests of African-Americans; using excessive force; and retaliating against people engaging in constitutionally-protected expression. Among these troubling findings, The Arc noted that the treatment of individuals with disabilities by law enforcement was included in the report, which featured a full section on the use of unreasonable force against individuals with disabilities highlighting that “BPD officers repeatedly fail to make reasonable modifications necessary to avoid discrimination in violation of Title II of the Americans with Disabilities Act of 1990 (ADA).”

Among other things, the investigation recommended that BPD offer crisis intervention training, previously offered to only new recruits, to veteran officers as well. DOJ noted that such training helps officers “identify whether an individual is in crisis or engaging in behavior related to a disability, to interact effectively with people with disabilities, to de-escalate a crisis, and to connect the individual with local resources to provide treatment or support.”

“Far too often, people with intellectual and developmental disabilities are in situations with law enforcement that unnecessarily escalate because officers aren’t trained in crisis prevention or how to recognize and accommodate various disabilities. This is not only happening in Maryland, it is a serious problem nationwide. We have got to flip the script when it comes to law enforcement training so that police departments understand that recognizing and appropriately accommodating disability in the line of duty is not optional, but is a fundamental aspect of their compliance with civil rights laws, such as the ADA. The recommendations in this report should be adopted across the country, so that we can break the cycle of discrimination that many minorities, including people with disabilities, face, and make our communities safer and more just for all,” said Leigh Ann Davis, Director, Criminal Justice Initiatives, The Arc.

The report found that BPD officers “have escalated interactions that did not initially involve criminal behavior, resulting in the arrest of, or use of force against, individuals in crisis, or with mental health disabilities or I/DD, or unnecessary hospitalization of the person with mental health disabilities or I/DD.” These unnecessary hospitalizations often violate the “integration mandate” of the ADA and the landmark Olmstead decision, which require public entities to administer services, programs, and activities for people with disabilities in the most integrated setting appropriate and prohibits unjustified institutionalization of people with disabilities.

“The findings in the report are disturbing. It is particularly painful reading this report on the heels of the 26th Anniversary of the ADA. The Arc Maryland stands ready to assist with necessary training to police officers to appropriately respond to people with I/DD. We urge BPD to implement specialized training and de-escalation techniques as tactics to reform the system and better serve people with disabilities, African Americans, and any other member of the community that interacts with the criminal justice system,” said Poetri Deal, Director of Public Policy & Advocacy, The Arc Maryland.

Steve Morgan, Executive Director, The Arc Baltimore, said: “The BPD is already working with us to extend the crisis intervention training, previously offered to select officers only, to the entire force. We are working together to address the recommendations, expand their knowledge, and improve community relations.”

The Arc runs the National Center for Criminal Justice and Disability (NCCJD), the first national effort of its kind to bring together both victim and suspect/offender issues involving people with intellectual and developmental disabilities (or I/DD) under one roof.

NCCJD is a national clearinghouse for information and training on the topic of people with I/DD as victims, witnesses and suspects or offenders of crime. The Center provides training and technical assistance, an online resource library, white papers, and more. The Center created Pathways to Justice,® a comprehensive training program facilitated through chapters of The Arc, which assists officers to both identify disability, and know how to respond in ways that keep all parties as safe as possible. Pathways to Justice utilizes a multi-disciplinary response that provides a foundation for a collaborative approach among community partners.

Read more about The Arc’s take on criminal justice reform and people with I/DD in our recent blog in the Huffington Post.

The Arc advocates for and serves people with intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of more than 650 chapters across the country, including 11 in Maryland, promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

On Mother’s Day – A Conversation with Mom and Board Member of The Arc, Kelly Piacenti

Kelly Piacenti with son and daughterKelly Piacenti is a mom to four – Allie, Olivia, Nick, and Frankie. Kelly is the Assistant Vice President, MetLife Center for Special Needs Planning, and a member of The Arc’s national board of directors. This Mother’s Day, we caught up with Kelly about what being a mom of a child with significant disabilities means to her, and how The Arc is a part of her life.

How did you and your family get to know The Arc?

Back in college, I worked in a group home in Massachusetts. I was going to school to become a social worker, and for four years I worked with people with intellectual and developmental disabilities. I used to take those individuals to activities run by The Arc. So I knew about The Arc long before I had Nick.

When Nick was born, they told us to expect him to live a few months. Then they said to set our sights on 2. On January 7th, my Nick turned 14. He has defied the experts.

In my line of work, I travel all over the country and I get to see what chapters of The Arc are doing. Most recently, I visited The Arc of Hawaii and The Arc of Anchorage.

What does it mean to be a mom of a child with very significant disability?

I thought I had it all before Nick – two kids, a house, both my husband and I had great careers – but Nick really put life into perspective. For a while, you feel like everything is falling apart – but then we woke up, and realized what Nick gives us.

Nick’s smile means a whole lot more than many people’s words. He gives us the ability to focus in on what’s important. I just want all my kids to be happy and I want to provide them a good quality of life. The things I worried about before – spills on the rug, getting someone to soccer on time – I don’t worry about now. Nick has taught me more than I’ve taught anyone else as a mom.

As a member of The Arc’s national board, I’m all about the people with I/DD and the families that don’t feel like they have a voice. There’s a core group that just need support – information, a way to talk to each other, a connection.

My family is very fortunate. I’m there on the board to advocate for people like Nick that don’t have the resources, time, or energy to fight for what they need. Before Nick came into our lives, I didn’t have this in me – Nick gave me this ability, this drive.

What type of support do you receive from The Arc and from others in your family and community?

I’m a member of my local chapter, The Arc Morris in Morris Plains, New Jersey. I’m involved because I get so much information from The Arc locally and nationally. Nick doesn’t get services from my chapter – he may never – but it’s valuable to my family because of the depth and breadth of knowledge within The Arc’s network. I read The Arc’s website because I know it’s a fantastic source of information on all kinds of topics out there. I respond to their Action Alerts because while Nick may not be receiving the services in jeopardy now, he may down the line.

When families of children with significant disabilities call me, they crave information. I tell them The Arc’s website is the place to go.

What support would you like to receive that you aren’t receiving — how can we at The Arc do better to include people with the most significant disabilities and their moms and families in our work and our lives?

I talk to a lot of families with family members with significant disabilities in my role with The Arc and my career at MetLife. Many of them discount organizations like The Arc because they don’t utilize the services they provide. But they also need information, and a connection – and The Arc provides that.

I think we need an online place to communicate – a blog or forum where families can talk to each other. For those of us who are parents of children with significant disabilities, it’s all about the quality of life and seeing what’s out there. We need to connect and we can lean on The Arc’s expertise. From The Arc, I follow what’s going on with states setting up ABLE accounts, where there could be sibling group opportunities for my other kids – it’s about seeing what’s out there for us.

The Arc can and should capture the interest and engagement of all families. Do we know who is on our site at 2am looking for information, but may not be connected to a chapter? We don’t – and we should be reaching those people and engaging them.

I think all families can get involved with our advocacy work. Our Action Center is full of information to educate yourself about the policy issues that impact all people with I/DD. It’s just a matter of making those connections to these silent families.

The Arc Responds to Warren Hill’s Appeal Denial by the Supreme Court

The Arc released the following statement following news that the United States Supreme Court declined to consider Warren Hill’s appeal to halt his execution because he has intellectual disability (ID). Hill’s lawyers filed the petition directly to the Supreme Court, stating that they had evidence proving Hill has ID. In 2002, the Supreme Court ruled in the Atkins v. Virginia case that executing inmates with ID is unconstitutional. However, in Georgia (where Hill is on trial), ID must be proven by the defendant “beyond a reasonable doubt,” the strictest standard in the country.

“We are extremely disappointed that the Supreme Court has chosen not to accept Warren Hill’s appeal. The high court was the last chance for a man unjustly sentenced to death, and their inaction will cost Mr. Hill his life.  They failed to order a halt to the execution despite their prior ruling in Atkins v. Virginia that established that it is unconstitutional to execute an inmate with intellectual disability,” said Peter V. Berns, CEO of The Arc.

The Arc, the nation’s largest civil rights organization for people with intellectual and developmental disabilities (I/DD), has been involved in this case through filing an amicus brief before the Supreme Court in earlier proceedings, and supporting Hill’s defense team through letters to the Georgia Board of Pardons and Paroles and the District Attorney urging his sentence be commuted to life without parole.

 

The Arc Applauds Stay of Execution of Warren Hill, Vows to Continue Legal Advocacy Efforts

Washington, DC – This evening, the state of Georgia was scheduled to execute Warren Hill, a man who experts unanimously determined has an intellectual disability, which should have ruled out the death penalty per a 2002 Supreme Court ruling, Atkins v. Virginia.  But this afternoon, a Fulton County, Georgia judge stayed the execution and scheduled a hearing for this Thursday to hear the defense team’s challenge of the constitutionality of a new state law that shields the identities of the lethal injection drug’s manufacturer and physician who prescribes it.

“Today, Georgia came too close to ignoring experts and crossing the line drawn by a more than decade-old Supreme Court ruling protecting people with intellectual disability in our justice system.  While we breathe a sigh of relief for now, this battle is far from over for Mr. Hill and many more people with disabilities who may be at risk of unjust punishment.  This stay of execution was granted on another state legal matter in the case, not Mr. Hill’s disability.  The Arc is committed to fighting for the rights of people with intellectual and developmental disabilities, and we will continue our legal advocacy work to make sure that the U.S. Supreme Court ruling on this issue is followed in jurisdictions across the country,” said Peter Berns, CEO of The Arc.

Hill’s legal team had also appealed to the U.S. Supreme Court to step in to stop the execution on the grounds of the Atkins v. Virginia decision, while simultaneously pursuing the state law issue.  The U.S. Supreme Court has not responded to this request yet.

The Arc, the nation’s largest civil rights organization for people with intellectual and developmental disabilities (I/DD), has been involved in this case filing an amicus brief before the Supreme Court in earlier proceedings, and supporting Hill’s defense team through letters to the Georgia Board of Pardons and Paroles and the District Attorney urging his sentence be commuted to life without parole. In this most recent effort, The Arc called for the Supreme Court to step in and issue a stay to prevent the state of Georgia from executing Hill.

In 2002, the Supreme Court ruled in the Atkins v. Virginia case that executing inmates with intellectual disability (ID) is unconstitutional.  But in Georgia, ID must be proven “beyond a reasonable doubt” by the defendant, the strictest standard in the country.

Supreme Court Must Act to Save Georgia Man with Disability from Imminent Execution

Washington, DC – With just a few days before the scheduled execution of Warren Hill in Georgia, The Arc calls for the Supreme Court to step in and issue a stay to prevent the state of Georgia from executing Hill who experts have unanimously determined has an intellectual disability.

“Warren Hill is nearly out of time, and the Supreme Court has an obligation to act before his life is taken away from him unjustly.  The facts speak for themselves – experts have unanimously agreed that he has an intellectual disability, and the Supreme Court has ruled that people with intellectual disability cannot be executed.  There is no room for interpretation – the Supreme Court must act,” said Peter Berns, CEO of The Arc.

In 2002, the Supreme Court ruled in the Atkins v. Virginia case that executing inmates with intellectual disability (ID) is unconstitutional.  But in Georgia, ID must be proven “beyond a reasonable doubt,” one of the strictest standards in the country.  The Arc participated in an amicus brief before the Supreme Court in earlier proceedings in this case, and supported Hill’s defense team through letters to the Georgia Board of Pardons and Paroles and the District Attorney urging his sentence be commuted to life without parole.

“The entire disability community will be watching for the Supreme Court to issue a stay in this case.  It’s the right thing to do, and it upholds the Court’s previous ruling that executing a person with an intellectual disability is unconstitutional,” said Berns.

Fact Checking NPR: The Real Story about Social Security & People with Disabilities

National Public Radio logoA huge buzz has come out of a story called “Unfit for Work: The Startling Rise of Disability in America” that ran last week on This American Life and this week on National Public Radio (NPR). While this story about Social Security and people with disabilities raises interesting questions, it’s also very incomplete, and perpetuates negative stereotypes and misunderstandings about people with disabilities. The Arc’s network knows better!

Members of The Arc and families served by us know that Social Security disability programs provide an essential lifeline that keeps millions of Americans with severe disabilities from homelessness and deep poverty.  About 1 in 5 Americans live with a disability, and this report failed to show the importance these programs play in many of their lives.

Additionally, “Unfit to Work” failed to mention many of the key facts about these programs. Many listeners were left with the impression that the disabilities that qualify people for Social Security and Supplemental Security Income (SSI) are “squishy,” and that the “federal disability programs have become an extremely expensive default plan” for low-income Americans.

In reality, Social Security and SSI disability benefits are only available to children and adults with the most severe disabilities – it’s hard to qualify, and it can often take years. The recent growth in the programs is largely explained by demographics, and program costs are manageable. The Arc does support many improvements to these programs to make them better for beneficiaries and to strengthen their financing – and we also know they are a lifeline that must be preserved.

To learn more about this report and the inaccuracies in it please read this letter from The Consortium for Citizens with Disabilities, which The Arc has signed, and other perspectives:

Also, if you want to take action and tell NPR the real story about Social Security and individuals with disabilities, visit our action center.

What Did Obama Say About the Budget Battle?

You may have read our CEO Peter V. Berns’ reaction to President Obama’s speech on Wednesday about the budget battle being waged at the Federal level. You know that we at The Arc are unwavering in our conviction that we must preserve the social safety net for the most vulnerable Americans, including people with intellectual and developmental disabilities. We simply can’t balance the budget on the backs of individuals and families who need our support to meet the most basic needs of medical care, housing, employment and education opportunities, much less to meet their expectations that they be fully included and able to participate in their communities and in society. Now, you might want to read the full text of the President’s speech on the matter and judge for yourself where he falls on the subject. Tell us what you think. Is the President pursing the right path? Will he succeed against the opposition he faces in Congress?