Structural ableism in public health and healthcare: a definition and conceptual framework
Structural ableism has received limited attention in the public health and health services literature as a determinant of health outcomes and disparities.1,2 This is notable for several reasons. First, disabled people represent an estimated 16% of the world's population,3 and a sizable portion of the healthcare system exists to provide services to disabled people. For example, in the United States (U.S.), 36% of healthcare expenditures are related to disability.4 Second, interpersonal disability-based discrimination remains prevalent.5 In the healthcare system, explicit and implicit biases toward disability are pervasive, suggesting this is an important sector to examine the effects of structural ableism.6,7 Third, significant health inequities exist for and among disabled people which relate at least in part to discrimination, inaccessibility, and other barriers that disabled people experience throughout health systems and society.8, 9, 10 To-date, structural ableism has received greater attention in other fields, such as in prior literature by disability studies and disability justice scholars.