Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1349-008 Lisbon, Portugal.
Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA 02215, USA.
Int J Environ Res Public Health. 2021 Jun 8;18(12):6178. doi: 10.3390/ijerph18126178.
People with disabilities may be disproportionally affected by the COVID-19 pandemic. We synthesize the literature on broader health and social impacts on people with disabilities arising from lockdown-related measures.
Scoping review with thematic analysis. Up to mid-September 2020, seven scientific databases and three pre-print servers were searched to identify empirical or perspective papers addressing lockdown-related disparities experienced by people with disabilities. Snowballing searches and experts' consultation also occurred. Two independent reviewers took eligibility decisions and performed data extractions.
Out of 1026 unique references, 85 addressed lockdown-related disparities experienced by people with disabilities. Ten primary and two central themes were identified: (1) Disrupted access to healthcare (other than for COVID-19); (2) Reduced physical activity leading to health and functional decline; (3) From physical distance and inactivity to social isolation and loneliness; (4) Disruption of personal assistance and community support networks; (5) Children with disabilities disproportionally affected by school closures; (6) Psychological consequences of disrupted routines, activities, and support; (7) Family and informal caregiver burden and stress; (8) Risks of maltreatment, violence, and self-harm; (9) Reduced employment and/or income exacerbating disparities; and (10) Digital divide in access to health, education, and support services. Lack of disability-inclusive response and emergency preparedness and structural, pre-pandemic disparities were the central themes.
Lockdown-related measures to contain the COVID-19 pandemic can disproportionally affect people with disabilities with broader impact on their health and social grounds. Lack of disability-inclusive response and emergency preparedness and pre-pandemic disparities created structural disadvantages, exacerbated during the pandemic. Both structural disparities and their pandemic ramifications require the development and implementation of disability-inclusive public health and policy measures.
残疾人可能会受到 COVID-19 大流行的不成比例的影响。我们综合了与因封锁相关的措施对残疾人的更广泛健康和社会影响有关的文献。
范围综述和主题分析。截至 2020 年 9 月中旬,在七个科学数据库和三个预印本服务器中搜索了针对残疾人因封锁而经历的差异的经验或透视论文。还进行了滚雪球搜索和专家咨询。两名独立的评审员做出了合格性决定并进行了数据提取。
在 1026 个独特的参考文献中,有 85 个涉及残疾人因封锁而经历的差异。确定了十个主要和两个中心主题:(1)医疗保健获取中断(COVID-19 除外);(2)身体活动减少导致健康和功能下降;(3)从身体距离和不活动到社会孤立和孤独;(4)个人协助和社区支持网络中断;(5)因学校关闭而不成比例地受到影响的残疾儿童;(6)日常活动、支持中断的心理后果;(7)家庭和非正式照顾者的负担和压力;(8)虐待、暴力和自残的风险;(9)就业和/或收入减少加剧了差异;(10)获取健康、教育和支持服务方面的数字鸿沟。缺乏对残疾问题的包容性应对以及应急准备和结构上的、大流行前的差异是中心主题。
遏制 COVID-19 大流行的封锁相关措施可能会不成比例地影响残疾人,对他们的健康和社会产生更广泛的影响。缺乏对残疾问题的包容性应对以及应急准备和大流行前的差异造成了结构性劣势,在大流行期间进一步加剧。结构性差异及其大流行的影响都需要制定和实施对残疾问题具有包容性的公共卫生和政策措施。