Law and social determinants of health: How public health law can decrease health disparities among the disability population

Following the passage of Medicare and the Civil Rights Act, the US integrated most hospitals within 30 days. With a rich history of 50 years of legislation, case law, and policies designed to improve the human rights, inclusion, health, and participation of the disability population, one would expect to see a similar dramatic change to a more inclusive society with a healthy disability population. Yet as a population, people with disabilities continue to experience significant health disparities as measured by typical social determinants of health, including poverty, obesity, smoking, and access to health care. As a body of law, disability law has been unsuccessful at improving the health of the disability population. The Affordable Care Act acknowledges the existence of disability health disparities but provides only a brief glimpse of ideas to address them, absent a strong commitment to carry them out.

Public health law can address these issues for the disability population, yet most ignore the very existence of disability health disparities – in spite of data. This paper provides a historical overview of major disability legislation, case law and policies, and how they developed into a body of law that promote the public’s health. It discusses the data on the social determinants of health for this population. Finally, it provides a proposed comprehensive model of public health law that integrates the health needs of the disability population to address health disparity issues and proposed policies that can complement existing disability laws to address disability health disparities.