DISABILITY IN AMERICA -- Copyright -- Preface -- Acknowledgments -- Contents -- Executive Summary -- TOWARD A COMPREHENSIVE APPROACH TO DISABILITY PREVENTION -- A Model of Disability -- Risk Factors -- Quality of Life -- The Disabling Process -- Developmental Disabilities -- Injury-Related Disabilities -- Disabilities Associated with Chronic Disease and Aging -- Secondary Conditions Associated with Disability -- RECOMMENDATIONS -- Organization and Coordination -- Leadership of the National Disability Prevention Program -- Advisory Committee -- Interagency Coordination and Periodic Review -- Surveillance -- Conceptual Framework -- A National Disability Surveillance System -- Research -- Coordinated Research Program -- Longitudinal Studies -- Relationship of Socioeconomic Status -- Interventions -- Access to Care and Preventive Services -- Accessible, Affordable Quality Care -- Access to Vocational Services -- Professional and Public Education -- Education of Professionals -- Education of Persons with Disabilities and Their Families, Personal Attendants, and Advocates -- 1 Introduction -- DISABILITY: DEFINITION AND CONCEPT -- PUBLIC HEALTH AND DISABILITY PREVENTION -- A Life Course Perspective -- SCOPE AND ORGANIZATION OF THE REPORT -- 2 Magnitude and Dimensions of Disability in the United States -- DATA SOURCES -- The National Health Interview Survey (NHIS) -- The ICD Survey of Disabled Americans -- Survey of Income and Program Participation (SIPP) -- National Long-Term Care Surveys (NLTCS) -- Supplement on Aging (SOA) and Longitudinal Study of Aging (LSOA) -- PREVALENCE OF DISABILITY -- NHIS Activity Limitation Data -- Other Perspectives -- TRENDS IN THE PREVALENCE OF DISABILITY -- CONDITIONS LEADING TO DISABILITY -- LIFE TABLE PERSPECTIVE -- ECONOMIC COST OF DISABILITY -- CONCLUSION -- 3 A Model for Disability and Disability Prevention.

CONCEPTUAL FRAMEWORK -- Pathology -- Impairment -- Functional Limitation -- Disability -- MODEL OF DISABILITY -- Risk Factors -- Biological Factors -- Environmental Factors -- Lifestyle and Behavioral Factors -- Quality of Life -- The Disabling Process -- Health Status -- Psychological Status -- Socioeconomic Status -- Educational Status and Vocational Training -- Climate -- Multiplicity of Conditions and Disabilities -- THE NEED FOR EPIDEMIOLOGY -- Data Needs -- Risk Factors -- The Need for Surveillance -- The Need for Priorities -- APPLYING TRADITIONAL PREVENTION STRATEGIES TO DISABILITY -- Primary Prevention -- Secondary Prevention -- Tertiary Prevention -- 4 Prevention of Developmental Disabilities -- PUBLIC HEALTH SIGNIFICANCE -- Epidemiology of Developmental Disabilities -- Hereditary Disorders -- Early Alterations of Embryonic Development -- Late Pregnancy or Perinatal Conditions -- Acquired Childhood Conditions -- Conditions of Unknown Origin -- Employing the New Model -- Functional Limitations -- Disability -- Secondary Conditions -- APPROACHES TO PREVENTION -- Health Care Interventions -- Prenatal and Well-Child Care -- Genetic Interventions -- Multidisciplinary Care -- Education -- Head Start and Comprehensive Day Care -- Community Educational Priorities -- Access to Public Education -- Environmental Interventions -- Environmental Control -- Accessibility and Adaptation -- Peer Support Groups -- OPPORTUNITIES AND NEEDS -- Organization and Coordination -- National Coordination -- State-based Coordination -- Surveillance and Epidemiology -- Centers for Disease Control -- National Center for Health Statistics -- National Institutes of Health -- Bureau of Maternal and Child Health and Resources Development -- Department of Education -- State- and Local-level Data Bases -- Other Important Data Bases on Developmental Disabilities -- Research.

Access to Care and Preventive Services -- Public Programs for Persons with Developmental Disabilities -- Public Programs for Families with Socioeconomic Disadvantage -- Professional Education -- 5 Prevention of Injury-Related Disability -- INJURY IN AMERICA: MAGNITUDE OF THE PROBLEM -- CENTRAL NERVOUS SYSTEM INJURIES -- Traumatic Brain Injury: Incidence and Outcomes -- Spinal Cord Injury: Incidence and Outcomes -- Temporal Changes in Patterns of Injury and Outcome -- SURVEILLANCE: COUNTING THE SURVIVORS AND ASSESSING THEIR NEEDS -- PRIMARY PREVENTION: THE STRATEGY OF CHOICE -- A SYSTEMS APPROACH TO ACUTE CARE AND REHABILITATION -- The Systems Approach -- Emergency Medical Services -- Acute (Medical) Rehabilitation -- Psychosocial and Vocational Rehabilitation and Lifelong Comprehensive Follow-up -- 6 Prevention of Disability Associated with Chronic Diseases and Aging -- MAGNITUDE OF THE PROBLEM -- Prevalence of Chronic Conditions -- Chronic Conditions Causing Disability -- Multiple Chronic Conditions -- Limitation in Basic Life Activities -- LIFE COURSE PERSPECTIVE ON DISABILITY AND ITS PREVENTION -- A Dynamic View of Disability as a Process -- Aging Differently -- DEVISING APPROACHES TO PREVENTION -- Perspective on Preventing Disability Among People with Chronic Disease -- Needs and Opportunities -- Composition and Organization of Services -- Education -- 7 Prevention of Secondary Conditions -- MODEL OF SECONDARY CONDITIONS -- Surveillance and Epidemiological Understanding -- Mental Health Conditions -- COMPONENTS OF A COMPREHENSIVE PREVENTION PROGRAM -- Organization and Delivery of Services -- Independent Living Centers -- Assistive Technologies -- Health Promotion -- Nutrition, Exercise, and Medications -- Education and Information -- Public Education -- Education of Health Care Professionals -- Education of People with Disability.

Environmental Considerations -- PROTOCOLS FOR THE PREVENTION OF SECONDARY CONDITIONS -- Definition of Disability Category -- Specification of Health Maintenance and Medical Interventions -- Specification of Rehabilitation Interventions -- Specification of Assistive Technologies -- Specification of Environmental Changes -- Specification of Elements in the Social Support Network -- 8 A Comprehensive Approach to Disability Prevention: Obstacles and Opportunities -- DEMEDICALIZATION -- NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES -- CLINICAL PREVENTIVE SERVICES -- FEDERAL PROGRAMS AND POLICIES -- Social Security Disability Insurance and Rehabilitation -- Access to Medical Care and Preventive Services -- Insurance Status -- Types of Health Care Services -- THE NEED FOR COORDINATION -- Rehabilitation Research -- Disability Prevention -- Public- and Private-Sector Partnerships -- Public and Professional Education -- The Sum of the Parts -- 9 Recommendations -- ORGANIZATION AND COORDINATION -- Leadership of the National Disability Prevention Program -- Advisory Committee -- Interagency Coordination and Periodic Review -- SURVEILLANCE -- Conceptual Framework -- A National Disability Surveillance System -- National Surveys -- Disability Index -- RESEARCH -- Coordinated Research Program -- Longitudinal Studies -- Relationship of Socioeconomic Status -- Interventions -- Research Training -- ACCESS TO CARE AND PREVENTIVE SERVICES -- Accessible, Affordable Quality Care -- Building Capacity -- Access to Vocational Services -- PROFESSIONAL AND PUBLIC EDUCATION -- Education of Professionals -- Education of the General Public -- Education of Persons with Disabilities and Their Families, Personal Attendants, and Advocates -- References -- APPENDIXES -- A Disability Concepts Revisited: Implications for Prevention -- CONCEPTUAL HISTORY.

A CONCEPTUAL FRAMEWORK -- A FRAMEWORK FROM THE WORLD HEALTH ORGANIZATION -- ASSESSMENT OF FRAMEWORKS -- B Dissent and Response -- PART1: DISSENT FROM THE REPORT OF THE COMMITTEE -- Critique of the Report -- Critique of the Process -- PART 2: THE COMMITTEE'S RESPONSE TO THE DISSENT BY DEBORAH STONE -- C Committee Biographies -- Index.