Rehabilitation service utilization models: Changes in the opportunity structure for disabled women

Abstract

The focus of this paper is the opportunity structure for rehabilitation and subsequent outcome for disabled women, in comparison with disabled men. From evidence cited in the literature the differential provision of rehabilitation and other supportive services to disabled women suggests variation in outcome, based on two analytic service utilization models of rehabilitation: medical and psychosocial. Aggregate trend data (1972 and 1978) were used in the analysis of adult disabled groups, by gender and selected disabling conditions. There are two striking results from the analysis of these data sets. One indicates that receipt of rehabilitation is greatly influenced by sociodemographic factors, particularly gender and age. A detailed examination of the combination effects of gender and other sociodemographic variables shows that there are subtleties, such as an interaction between race and gender and education and gender, as well as between age and gender, that put uneducated, younger, white women at a disadvantage in their access to rehabilitation resources. The analysis of these sociodemographic factors over two points in time, however, demonstrates what can be considered a diffusion of the distinctions of social inequality, probably due to changes in rehabilitation legislation that redefined eligibility criteria for rehabilitation services and expanded programme goals. The second result of note is that neither form of rehabilitation is associated with a positive outcome, in this case ability to work. In the earlier data set (1972), indications were that neither the medical model of rehabilitation nor the psychosocial model were effective in returning the individual to the work role. This was true for both men and women. Analysis of the second data set (1978), showed no differences for men; however, the psychosocial model does show movement in the preferred direction for women. The latter analysis also shows that race is no longer a predictor of inability to work. Since blacks and women show a higher proportion receiving psychosocial rehabilitation in 1978, these results suggest a trend towards the effectiveness of the psychosocial model –- that can only be verified by further data analysis.

Key Words:

• Disability
• Equity
• Rehabilitation
• Women

Additional information

Notes on contributors

B. M. Altman

It is with great sadness that we have to inform the readership of the Journal that shortly after completing the final editorial work on this Special Issue, Professor Kalman Jacob Mann was seriously injured in a car accident and subsequently died.

Professor Mann was responsible for establishing the two Hadassah Hospitals and Community Health Centres in Jerusalem and for the past 20 years headed the Presidium of Yad Sarah, Israel's largest community based, volunteer operated organization which provides a spectrum of free or nominal cost home care services nation-wide.

We offer our condolences to his family and friends, and trust that this Special Issue stands as a testament to his work in the field.