A recent study by the Department of Research, Studies, Evaluation and Statistics (Drees) reveals that 54% of disabled people living at home report poor health. Karine Pouchain-Grépinet, national health advisor for APF France handicap, deciphers the causes of this inequality and calls for measures to improve access to care and support for people with disabilities.
What do you think of the 54% of disabled people reporting poor health? Is this an expected or surprising figure?
Karine Pouchain-Grépinet: We did not expect this increase. In 2021, this figure was 50%. But this remains consistent when we know the difficulties of access to care in France for people with disabilities.
Has this situation worsened in recent years?
K. P-G. : There is a general deterioration in access to care in France, accentuated by social and territorial inequalities. People with disabilities are particularly affected, because they face specific difficulties linked to their situation.
A tumor is detected at 1.8 cm on average in an able-bodied woman, compared to 3.5 cm in a woman with a disability, which reduces the chances of survival.
What are the main difficulties encountered by people with disabilities in accessing quality care?
K. P-G. : Lack of accessibility. For example, for a woman in a wheelchair, breast cancer screening is complicated because mammograms are not suitable for examination in a seated position. And the technicians are not trained. This leads to delays in diagnoses : a tumor is detected at 1.8 cm on average in an able-bodied woman, compared to 3.5 cm in a woman with a disability, which reduces the chances of survival and requires heavier treatments. People with autistic disorders require specific adjustments: lighting, noise reduction, etc. which are rarely planned.
Why do 15% of people with disabilities forgo medical care, compared to only 7% for the rest of the population?
K. P-G. : The major obstacle is the lack of information. Many disabled people give up their consultation when they discover on site that the office is not adapted to their needs. To remedy this, we created a directory on Santé.fr, in collaboration with the Ministry of Health, in order to list the equipment and accessibility of medical practices. For the moment 8,000 firms have registered, this is an insufficient number.
-Is the financial aspect an obstacle?
K. P-G. : Many disabled people live on social minimums. The allowance for disabled adults (AAH) does not give right to free universal supplementary health insurance and 13% of AAH holders do not have supplementary health insurance. In addition, to the visible out-of-pocket costs are added the hidden costs of certain medications or materials not reimbursed. These costs amount to 1,500 euros per year, which pushes many people to forgo care.
The study also shows that obesity is more common among people with disabilities, why?
K. P-G. : Drug treatments, particularly in the case of psychological disabilities, often lead to weight gain. Furthermore, access to sports practices is more complicated due to the lack of structures, trained personnel and the fear of social rejection.
What is the place of APF France Handicap in this fight? What types of actions do you carry out?
K. P-G. : We act on two fronts: on the one hand, on the ground, by providing direct support to the populations concerned, and on the other hand, by lobbying ministries and parliamentarians to ensure that the needs of people with disabilities are met. taken into account in official texts.
If you had one immediate measure to propose to the public authorities, what would it be?
K. P-G. : Training of health professionals. Today, disability is almost absent from the medical curriculum, with the exception of a few optional modules. It is urgent to ensure that future generations are better trained. Also strengthen access to information to direct patients towards professionals truly suited to their needs.
Do you see any reason to hope for improvement in the medium or long term?
K. P-G. : Some initiatives are very promising! I am thinking of the HandiConsult centers, which offer systems adapted for people with severe disabilities, with trained staff and well-designed locations, or the disability advisors in companies and hospitals, who also facilitate access to care. This progress is going in the right direction!
