Arianny Ramirez, right, a Clinical Research Coordinator in the Spinal Cord Injury Program at The Mount Sinai Hospital, demonstrates patient care in a staff training video with physical therapist Alexandra McGivern.
Intersectionality is a crucial consideration as providers treat patients and understand their needs inside and outside health care facilities, said Arianny Ramirez, a Clinical Research Coordinator in the Spinal Cord Injury Program at The Mount Sinai Hospital, who was the featured speaker for a virtual talk hosted by the Office for Diversity and Inclusion (ODI) at Mount Sinai. The session, “Health Care Disparities and Women with Disabilities,” is available here.
The talk was part of the Raising Disability Awareness Virtual Talk Series, launched by ODI in 2020 for Disability Awareness Month, featured speakers from around the Mount Sinai Health System and the community to promote an inclusive and equitable workplace and health care environment for people with disabilities.
Arianny Ramirez
Ms. Ramirez, a woman of color with a physical disability, discussed health care challenges at both a personal level and a population level. She said the health care community must work together to understand the intersection of sexism, racism, and ableism, and its effect on women with disabilities. “The biggest obstacles I face in my life as a woman with a disability are the barriers and limits society places on me,” she said.
After an accidental fall that paralyzed her from the waist down at age 18, Mrs. Ramirez realized that her life and the lives of many others would be easier if the world were designed with disabilities in mind.
According to the Centers for Disease Control and Prevention, about 36 million women in the United States have disabilities. This number is expected to continue growing, says Mrs. Ramirez, and “women with disabilities face more difficulty than women without disabilities in accessing health care screenings.” Routine physical exams, mammogram, Pap smears, sexually transmitted infection (STI) testing, and eye exams are just a few of the screenings that are more challenging to access for women with disabilities.
Physical and attitudinal barriers often prevent this population from seeking and receiving equitable and appropriate health care. The necessary equipment, machinery, and devices to care for these women are not always present in doctors’ offices, Mrs. Ramirez said of clinical care in the United States.
Additionally, stereotypes and discrimination are often directed toward people with disabilities in health care settings, making them feel uncomfortable and excluded, and there are limited training and guidelines in place to address the specific needs of women with disabilities.
“Let’s start with our physical barriers,” Mrs. Ramirez said. “They consist of a lack of adaptive examination tables and scales, inaccessible testing rooms, and inaccessible diagnostic equipment. Over 90 percent of physicians’ offices do not have wheelchair-accessible scales.”
The Mount Sinai Health System is working to address these disparities with a variety of measures, including a course created by the Department of Rehabilitation and Human Performance for Mount Sinai physicians and other providers in fields such as family medicine, internal medicine, obstetrics and gynecology, and emergency medicine. Mount Sinai employees can register for the course, “Improving Health Care Access for Women with Spinal Cord Injury” on Mount Sinai’s PEAK site.
Mount Sinai’s Spinal Cord Injury Research Center also offers information to the public about support groups, exercise, and clinical trials, including one addressing access for women with spinal cord injuries.
Ultimately, Mrs. Ramirez called for the public to consider the world from a different perspective.
“I invite all of you to just look around your environment. Whether it’s in the office, the structure that you live in, you work in, or your commute, and think ‘what if I did have a disability? What if I did have knee surgery and there wasn’t a lip in the sidewalk that I couldn’t get over or something?’” she said. “Be mindful of the experiences other people are having and remember that a disability can happen to anyone. One can become disabled at any point in your life, and you can be a part of this community in the future as well. If you do your part and advocate for structural change, this can improve the environment around us and open the door for women with disabilities to get the care they need and live their lives.”
Speaking as a woman with a disability and a professional in rehabilitation, Ms. Ramirez called on the health care community to take four measures: Increase professional education, training, and technical assistance so providers understand disability cultural competency; implement new monitoring and accountability laws and practices to increase oversight; use accreditations to ensure health care facilities comply with accessibility guidelines; and create a universal design that can be applied to any facility to care for and welcome people with disabilities uniformly.
“Until ableism becomes a conscious thought in nondisabled people’s minds, only then will true equality be achieved,” she said.