Perry Lecturer Calls for “Radical Change” in Preventing Disabilities

It’s a lifelong passion he’s focused on changing.

As the 35th J. Warren Perry lecturer, Jette— a 1973 alumnus of the University at Buffalo’s physical therapy program—used a three-pronged approach touching on epidemiology, highlighting some disturbing trends and advocating for a radical future in the public health sphere.

The biggest challenge? No set definition exists, he said. What constitutes a disability in the United States is a secret.

“Definitions matter,” he said. “Definitions implicitly will indicate suggested potential solutions and targets for action.”

Jette said public health hasn’t been quick to recognize the issue. While the Americans with Disabilities Act, in 1990, sought to address many concerns, it has taken until this year for the National Institutes of Health to recognize persons with disabilities as a population with health disparities.

The National Health and Aging Trends Study, started in 2011, is studying disability, he said. It's using consistent measures for comparison across multiple decades taken from previous studies.

Jette called that tactic “very smart.”

These studies, Jette said, point to an increasing prevalence for both men and women.

Categorized across three different severities, trends show all rates decreased between 1982 and 2004, then increased again by 2011.

A 2021 update showed some more positive trends, Jette said, like how a greater percentage of individuals with disabilities are accommodating their disabilities with devices meant to ease their burden. And, he added, the use of hospice care for end-of-life services has also increased, itself a great sign.

Still, he said, compared to whites, minority populations are less likely to successfully accommodate and more likely to require assistance, causing higher rates of experiencing an unmet need.

Addressing these concerns, Jette argued, would take a more population-centered approach.

Similar to how public health officials targeted smoking cessation, Jette said changing the public perception of disabilities through positive messaging, increasing ease of access to amenities, promoting physical activity and providing new opportunities for those who suffer could all help.

It’s an approach also addressing one of the key barriers hampering the more accepted models used today: reversion. “As soon as you pull back on the intervention,” he said, “the patient reverts back to baseline. It happens all the time. “I think we need to be much more radical,” Jette said.