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It is disappointing that we live in one of the most well-developed countries, yet not all individuals have the same healthcare quality. It stated, “Disability is an emerging field within the public health and accounts for more than 12% of the US population” (Krahn, Walker, & Correa-De-Araujo, 2015). Living in rural Oklahoma, we see all kinds of health disparities, from the elderly, low-income, homeless, disabled, and American Indians on reservations, to name a few. Healthcare/homecare for the physically disabled, such as those who use wheelchairs, hits home. My brother is wheelchair-bound due to an accident in his twenties. Getting adequate care for him is impossible unless he goes into a nursing home, yet who would want to live there as a young adult? And the cost of an assisted living home is horrendous. He is a quadriplegic and needs assistance, yet he lives independently. The cost of everything for the “handicapped” or assisted devices is impractical. Most physically disabled/disabled individuals are on a low or fixed income, on Medicare/Medicaid, yet can’t afford assisted devices or quality personal/healthcare to help them. They succumbed to others for personal care, such as bowel programs, changing urine catheters or colostomy bags, showers, wound care (such as pressure wounds), and adequate nutrition. Getting good care in rural locations is an issue I have seen firsthand while working in home health. It is stated “adults with disabilities are 4 times more likely to report their health to be fair or poor than people with no disabilities (Krahn, Walker, & Correa-De-Araujo, 2015).
Access to quality health care is limited to physically impaired individuals, especially if they live in rural areas. And they have issues taking care of themselves, and their living conditions are not always very habitable. Skin breakdown and pressure sores are typical in physically disabled individuals, and they are highly susceptible to infections, especially catheter-related ones. The main issue is getting adequate care and nutrition to stay healthy to prevent skin breakdown and disease free due to being immunocompromised from the lack of circulation. 
As a Nurse practitioner, one can lobby for better access to health care for these individuals. There needs to be more funding to assist these individuals in getting the adequate care they deserve. Home health aides need more training to identify skin breakdown and become educated on the importance of an adequate diet/nutrition. It is stated ‘there is a growing emphasis on the social accountability of the medical field for training health professionals to serve disadvantaged patients better” (Andermann & CLEAR Collaboration, 2016). At the local and state level, it’s lobbying for more funding for the home health organization to hire and train quality individuals to care for the physically disabled. Professional nurses have the numbers and voice to make a difference. We need to learn how to channel it and the direction to make a positive change. Enhancing the nurses’ capability to participate in policy development and activities is a vital aspect of the continuous promotion of health services (Hajizadeh, et al. 2021). 
Andermann, A., & CLEAR Collaboration (2016). Taking action on the social determinants of
health in clinical practice: a framework for health professionals. CMAJ : Canadian 
Medical Association journal = journal de l’Association medicale canadienne, 188(17-
18), E474–E483. https://doi.org/10.1503/cmaj.160177
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an 
unrecognized health disparity population. American journal of public health, 105 Suppl 2
(Suppl 2), S198–S206. https://doi.org/10.2105/AJPH.2014.302182
Hajizadeh, A., Zamanzadeh, V., Kakemam, E. et al. (2021). Factors influencing nurses 
participation in the health policy-making process: a systematic review. BMC Nurs 20, 
28. https://doi.org/10.1186/s12912-021-00648-6

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