International Day of Persons with Disabilities
December 3rd marks the International Day of Persons with Disabilities. The United Nations proclaimed this day of recognition in 1992 and organizes a themed program each year addressing key concerns and goals for supporting people with disabilities. The theme for 2023 is “United in action to rescue and achieve the SDGs (Sustainable Development Goals) for, with, and by persons with disabilities”.
1 in 4 adults in the United States (61 million) have a disability, with 7.6 million of those adults residing in California. Adults with disabilities experience substance use disorders (SUD) at 2-4 times the rate of the general population. Adults with disabilities are approximately four times more likely to experience depression and three times more likely to experience suicidal ideation than adults without disabilities. Suicidal ideation and attempts vary between types of disability as well – research has shown that individuals with cognitive limitation and complex activity limitation (such as limited ability to live independently) are more likely to experience suicidal ideation and attempts compared to individuals with other types of disabilities.
People with disabilities can face increased barriers to accessing protective factors including stable housing, financial wellbeing, and accessibility in the community. The Center on Disability’s Public Health Institute in California released a guideline for disability inclusion with recommendations on how to increase accessibility. Including people with disabilities throughout program implementation, including development and evaluation, brings an important perspective into effective programming. Ensuring affordability and accommodations for people with disabilities supports a broader reach of services.
California’s Department of Developmental Services supports an array of programs to help meet the needs of folks with disabilities including supported employment, housing, and crisis services. Programming that supports access to protective factors including financial stability, physical and mental health services, and the ability to participate in the community can help reduce risk of substance use and the impact of mental health needs.
SDOH Fundamentals: Economic stability and SUD risk
Economic Stability, one of the five Social Determinants of Health (SDOH)*, is affiliated with many risk factors. Lack of economic stability is also affiliated with lack of access to safe housing, healthy foods, and adequate health care. Poverty is also a risk factor for increased substance use in adults and youth alike. According to the 2022 US Census, 12.2% of the population in California lives in poverty. Single mother households face the highest income inequality with 1/3 of single mother households earning below the poverty line, and Latino, American Indian/Alaska Native, and African American single mothers facing even higher income disparity.
Healthy People 2030’s objectives towards economic stability include reducing the proportion of people living in poverty, increasing employment in working-age people, and reducing food insecurity, among others. Addressing these economic factors should decrease substance use. California’s Department of Community Services and Development (CSD) is implementing federal initiatives like the Community Services Block Grant (CSBG) to reduce poverty and help low-income individuals and families achieve self-sufficiency. CSBG provides community agencies with funds to provide employment services, housing services, assistance with utility bills, and other services to help California citizens gain and maintain economic stability.
For more information about how CSD aims to improve health outcomes by reducing poverty, you can view a list of their programs here: https://www.csd.ca.gov/programs
*Language around SDOH is shifting from “Determinants” to “Drivers”, as “Determinants” implies there is no way to change the outcomes of our environment.
Holiday wellness & self-care: addressing microaggressions and promoting SUD wellness during the holiday season
The holiday season gives us the opportunity to connect with loved ones and celebrate our traditions. But this time of the year also comes with stress – travel, increased expenses, and time with family can take a toll on our well-being. It’s important for us to actively prepare for self-care, including boundary setting, in advance of our holiday plans.
Current world events can spark challenging conversations and cause tension between family members with whom we may not see eye-to-eye. We might encounter microaggressions, or subtle insults that tend to be directed towards members of marginalized groups. Unlike macroaggressions, these comments are sometimes unintentional, or the perpetrator might not perceive the harm they’re doing. When being on the receiving end of a microaggression or witnessing one, we are faced with two options: confront the person, or let it go. Here are tips to help us make the right choice that aligns with our values while not causing undue stress for ourselves.
First, consider if the conversation will be productive enough to justify the stress of engaging in it. If not, take the chance to step away. You can let that person know you need to take a break from the conversation for the sake of your relationship with them. If you believe the person will be receptive, you can respond to a microaggression by asking “What did you mean by that?”. This question gives the person a chance to reflect on what they said or explain themselves. From there you will still want to consider your priorities. You can set expectations or a time limit for the conversation or make a plan to revisit it under different circumstances.
Holidays can bring additional challenges to folks experiencing substance use disorders. Survey data shows that alcohol consumption increases during the weeks between Thanksgiving and the new year, and situations where alcohol is present may come with heightened social pressures. Planning ahead for social events and practicing self-care can help reduce some of that stress. Sticking to a routine while traveling, taking walks, meditating, or journaling can help us stay centered. Bringing non-alcoholic beverages to an event or making an exit plan can help when faced with triggers around substance use.