• DOI:10.1001/jama.299.3.332
• Corpus ID: 36429265

Turning the disability tide: the importance of definitions.

@article{Iezzoni2008TurningTD,
  title={Turning the disability tide: the importance of definitions.},
  author={Lisa I. Iezzoni and Vicki A Freedman},
  journal={JAMA},
  year={2008},
  volume={299 3},
  pages={
          332-4
        }
}

• L. Iezzoni, V. Freedman
• Published 23 January 2008
• Medicine
• JAMA

FORTY MILLION TO 50 MILLION INDIVIDUALS IN THE UNITED States now live with potentially disabling conditions. According to the Institute of Medicine (IOM), this number will likely increase substantially in coming decades. Aging baby boomers will fuel much of this growth as this enormous cohort enters age ranges with the greatest disease and disability risks. Although rates of some serious limitations among elderly individuals have declined, sobering reports warn of higher rates of potentially impairing conditions among children and working-age adults. These latter trends are multifaceted with diverse contributors, including major therapeutic breakthroughs that now save lives of severely impaired individuals who would once have died and increasing prevalence of overweight and obesity among youth and young adults, along with associated problems such as diabetes. As recent reports suggest, overweight and obesity cause particular concerns not only because they are associated with increased mortality risks, but also because they increase the risk of functional limitations. Such predictions carry an aura of inevitably; even baby boomers cannot escape the march of time. Fears that trends will erode individuals’ independence and ability to participate fully in daily life, as well as increase medical and caregiving costs, raise the stakes. Can the United States counter the forces that may significantly swell the numbers of individuals living with disability? Various sectors have mobilized to do just that, with varying levels of success. These include the National Institutes of Health, which has provided billions of dollars for research to reduce mortality and morbidity; the health care delivery system, which provides acute, chronic, and palliative care services; and the Centers for Disease Control and Prevention along with other public health efforts targeting health promotion and maximizing wellness. However, the United States has not yet concentrated its collective resources—its people, public policies, institutions, communities, and dollars—to avert the impending wave of population disability. Finding a basis from which to start this massive mobilization presents a daunting challenge. As have others, we argue that devising strategies to confront disability must first start by defining disability. Definitions implicitly connote goals, which in turn suggest potential solutions and targets for action. When it comes to preventing or deterring disability, this definition matters.