PLACE MATTERS: A personal story about making Oregon more inclusive – Tillamook County Leader

25November 2020

By West Livaudais West Livaudais is assisting to make Oregon more inclusive and available for people who deal with specials needs. As someone who copes with an impairment and operates at the Oregon Office on Special Needs and Health at OHSU, he shares his story in Place Matters Oregon’s very first visitor blog site. West checks out the day-to-day challenges of coping with a disability and his services for significant modification in policies, systems and programs to make Oregon more inclusive and available.”The valuable nugget in all of this is that individuals are ready– they want to be more inclusive, they want to find out,

“West said. Location Matters Oregon/PMO: To start with, thank you so much for being our first visitor for the Place Matters Oregon (PMO) blog site. Will you tell us a bit about your background and your work?

West: Before I started at Oregon Health & & Science University (OHSU), I operated in Guatemala as the maternal and child health program planner for Medical Teams International, a non-governmental not-for-profit based in Portland. That’s where my interest in public health and community health started. That’s likewise where my journey towards spinal cord injury started when I was hit by a truck and broke my hip. I was flown to a U.S. healthcare facility for surgery. Throughout my course of care, I got a hospital-infection in my spinal column. 10 days later on I awakened in the ICU immobilized. This absolutely galvanized my focus. I finished my public health degree at OHSU and have actually worked in special needs and the health system. Around 2015 I began a nonprofit called the Oregon Spine Injury Connection that promotes health, constructs neighborhood, and produces opportunities for individuals with spinal cord injuries in Oregon and SW Washington.

The Oregon Office on Disability and Health at OHSU

Currently, I work at the Oregon Workplace on Impairment and Health at OHSU where I take pleasure in advocating for systems-level modification that contributes to Oregon’s health care transformation efforts. I advocate for policies and systems-and environmental-changes that make healthy options and access to health care easier for individuals with specials needs. PMO: Can you provide us an example of

your work? West: Sure. I am a member of the Health Equity Committee of the Oregon Health Policy Board. We examine and propose policies that advance health equity. Among our current accomplishments was suggesting a definition of health equity that OHA adopted. The definition includes individuals with specials needs, which may seem apparent, but it wasn’t too long back when state and federal public health entities weren’t even collecting information on individuals with specials needs. This meaning will have downstream impacts throughout OHA and the state. PMO: What are the significant barriers that individuals with impairments face? From our work developing the brand-new Place Matters Oregon videos now on the website, we understand there are physical barriers, but thereare also more invisible barriers. And all of these barriers have an effect on variations for persistentdisease. Would you inform us about the physical barriers initially? West: Individuals living in Oregon with impairments are 3x more likely to report having diabetes, over 4x most likely to report having heart problem, twice as likely to be physically inactive in the last one month and nearly 2.5 x most likely to reportbeing depressed than Oregonians without impairments. For the many part, these health conditions are avoidable and aren’t a result of one’s special needs. As a person with a disability, I experience multiple physical barriers every day that hinder my capability to be active and take part in society. As an example, if a person with a physical disability wishes to take part in an exercise program at the fitness center, they will likely come across various barriers. They may discover impassable pathways, bus stops or street crossings, or face an absence of available, budget friendly, hassle-free public transportation. The gym might not be available, or might not have adapted equipment or experienced staff to support adaptive workout activities. This may be specifically real in more backwoods or financially depressed locations of Oregon. There is exemption at every level. People with an impairment in fact can and do exercise; it’s not that they pick not to but for numerous it’s a gain access to problem. These barriers add to Oregonians with impairments being less physically active. And if these are barriers an individual with a special needs deals with going to the gym, think of how physical barriers hinder a person’s ability to access healthcare. We know being less active due to physical barriers, or any barriers for that matter, can add to having a greater BMI, which can contribute to diabetes. This is, in fact, what we see among Oregonians with disabilities. They are less most likely to be physically active, more likely to develop diabetes, and more likely to rate their health as bad or fair than their able-bodied counterparts. Physical barriers also contribute to social isolation and anxiety, as well as a significantly higher occurrence of persistent illness for people dealing with impairments. This example highlights how physical and developed environment barriers can contribute to the prevalence of persistent disease among Oregonians with disabilities. Oregonians with impairments are less likely to have the basic things we all require to be healthy. These include education, employment and income. PMO: And now let’s relocate to those more unnoticeable barriers, things that are social and cultural, ideal? What is your point of view on this, particularly considering that you not just work in this field, but you are experiencing it yourself? West: OK, I’ll use another example. It’s mind boggling to me that these systemic barriers against people with specials needs still exist. Medicaid possession income constraints, which are set by the Centers for Medicaid and Medicare, unjustly penalize employees with a special needs who require long-lasting supports and services. In order to be qualified for long-lasting supports and services through Medicaid, an individual in Oregon with a special needs must limit their countable assets to$ 5,000 and income to less than 250%of the Federal Poverty Line, which is $32,000 for a family of 1 or $55,000

for a family of 3. By limiting a handicapped worker’s capability to earn and conserve, the state has closed all paths to prosperity in the best-case scenario, and indentured that family to


hardship in harder situations. That person can never ever take a pay raise, even if they merit it, without running the risk of losing their health benefits. These policies are regressive and prejudiced versus individuals with disabilities. Think of if your private medical insurance payer dramatically limited your earnings and properties in exchange for covering your cholesterol medication. Undoubtedly, we ‘d think that is unjust. This is the circumstance some Oregon employees with specials needs face. Because they need long-lasting assistances and services, like a personal care attendant to help them with the activities of their life, they are forced to survive on limited properties and income. And sadly, no other private or employee-based insurance coverage will pay for a round-the-clock personal care attendant to support an employee with a disability. It’s not the person with an impairment’s fault, however Oregon’s Medicaid property and earnings eligibility requirements discriminate against them, barring them from totally taking part in rewarding work or advancing in their jobs. The downstream impact of these policies is it’s more difficult for people with specials needs to advance into management, upper management or executive positions. These limitations need to be eliminated, but without individuals with specials needs in positions of power, it’s even harder for us to make systemic change. West and a good friend kayaking Estacada Lake. Other undetectable obstacles include attitudinal barriers, or preconception against people with a disability. People who deal with specials needs are most likely to be victims of violence than those without impairments. Attitudinal barriers likewise inform our cultural norms, worths, stories and images. There are no motion pictures with superheroes who are disabled; people coping with a disability are not represented as sexy or appealing. If you have an impairment, you can feel unwanted and treated as”other”from media, publications and culture. Those all inform what it indicates to be disabled. Individuals with disabilities have strengths much like others, and enhancing media representation with positive images and stories, like what the Paralympics has actually done, will continue to help battle stigma. I’m married. It’s not uncommon for individuals to say to my partner,”you’re brave”to have actually married somebody with impairments. Their biases, their attitudinal barriers, cause discrimination. PMO: Employment is one huge location where preconception is a difficulty for individuals coping with impairments. What are some common misunderstandings– about work or every day life– that you want to share and remedy for people reading this? West: One common misunderstanding is that productivity and creativity need to follow an uniform

procedure, say working 9 to 5 in an office. Now with COVID-19 and all of our innovation, many individuals are working from home, and performance and imagination seem to be exercising. Remarkably, this may make it easier for people dealing with an impairment to work because when working from house a person can protect their health while also remaining efficient. If I can handle my own work schedule from house, it’s so much simpler. I can be on a computer screen and it doesn’t matter where I am. While the work-from-home circumstance is more optimum and may help with more people with impairments working, I don’t believe it will eliminate stigma against impairment. Fifty-eight percent of workplace lodgings cost companies nothing. The rest cost usually just$500. PMO: This year– 2020– is the 30 th anniversary of the Americans with Disabilities Act(ADA). Because we’re speaking about how place impacts health at Location Matters Oregon, share your own point of view on how the ADA has actually shaped locations over the last 30 years and made them more accessible to individuals with disabilities.

Middle-aged Black woman is sitting at a work desk in a wheelchair, working on her office computer
West: I would divide up the ADA’s contributions into two categories– physical access and interactions gain access to.

Let‘s take a look at physical changes initially. These consist of disability parking requirements; an accessible path of travel from parking to the front door, into common locations, like washrooms; requirements for wheelchair access that include ramped or level entryways, doorway width requirements, particular door hardware, available bathrooms, accessible tables,

desks and benches; and more accessible counters, kiosks and self-service stations. Truly, universal design benefits all of us– consider people like a mom with a stroller, who now has a simpler time taking a walk due to the fact that of curb cuts on sidewalks. And communication gain access to implies needed signage for way-finding; and arrangement of some auxiliary aids and services in state and city government programs. The bottom line– better access equals addition and involvement for all. And it’s excellent to have point of view. In December, I went to Mexico City with my other half. The U.S. is not best but if you’ve ever taken a trip with anyone in a wheelchair in another country, it’s truly easy to notice the absence of things like uniform curb cuts or ramps that aren’t extremely steep. Airplane travel is not fantastic however it’s improving. ADA parking near to a building has probably kept me alive, because a wheelchair user is really tough to see behind an SUV when it’s backing out of an area.

It’s not simply for convenience however security. While the ADA is not perfect, we have actually made progress as a nation and have a foundation that we can continue to surpass. The Oregon Department of Parks & Entertainment is an excellent example of a state company trying to make things more inclusive. They have the best spirit as they work on improving routes, camping areas and boat ramps. That innovation warms my heart and provides me hope. Available path at Oregon’s Painted Hills PMO: What else would you like people to learn about dealing with an impairment, or the connection of place and health in supporting people with specials needs? West: I’m actually delighted that OHA decided to team up with OODH on this task. To me, it represents an initial step of acknowledging significant change in policies, systems and programs to make Oregon more inclusive and accessible. The important nugget in all of this is that Oregon is all set to alter, people are prepared– they want to be more inclusive; they wish to find out. From a professional point of view, I was humbled. We’re together and unified in wanting to make modification. Connect with West on LinkedIn: https://www.linkedin.com/in/west-livaudais-mph-65842559!.?.! or by e-mail: livaudai@ohsu.edu!.?.!. West Livaudais works at the Oregon Workplace on Impairment and Health( OODH), a public health program under the Institute on Advancement and Special Needs at the OregonHealth & Science University (OHSU ).

Thisis the first visitor blog by Place Matters Oregon– to learn more go to: https://placemattersoregon.com/ Let’s make healthier places for us all. Place Matters Oregon is an effort of the Oregon Health Authority. Our goals are to foster conversations among Oregonians about how location affects health and to motivate cumulative action that will make a healthy life available to all individuals in our state. Together, we can create more chances for each Oregonian– no matter what town or city we call home– to live a long

, healthy life. https://placemattersoregon.com/blog/a-personal-story-about-making-oregon-more-inclusive/ Source: tillamookcountypioneer.net

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