Racial and ethnic minority communities are expanding at a much greater rate than the existing majority of white Americans. The U.S. Census Bureau recently released a report estimating the results of the 2020 census. The estimate anticipates that four of every 10 residents in the United States are from a non-white racial or ethnic group. It is expected that in the past decade the white population in the United States will show the first decline in our history in actual numbers. Not unexpectedly, as ethnic diversity in the United States has increased, so too has the number of individuals with disabilities from diverse ethnic backgrounds.
People with disabilities also mirror our country’s growing diversity in many other ways including with respect to gender, socio-economic status, education, and other areas of participation. Unfortunately, people with disabilities from minority communities can face unique barriers to achieving self-determination, independence, and inclusion. People from racial or ethnic minority groups who also have a disability are sometimes said to live with a "double burden" from the greater health, financial, and social challenges caused by the merging of their two worlds.
Areas of impact of the double burden on minorities with disabilities
The impact of the double burden is experienced in all areas of the lives of minorities with disabilities. The most glaring impacts may be seen in the resulting reduced access in the following areas:
- Adequate health care: Double burden outcomes are often seen in the inequities related to preventable and premature deaths and institutionalizations. Financial, societal, and cultural and overall systemic roadblocks to quality healthcare can be dramatic. African Americans for example undergo proportionately higher rates of amputations which limit activity and accessibility generally. Indications are that healthcare access and lower utilization hit those with the double burden racially most significantly presumably due to discrimination against those with disabilities.
- Education: It is well settled that a good education is crucial in helping all people to obtain better jobs and increased wages which can lead to an increase in access in all phases of life including quality healthcare, particularly preventative care. Minority children are disproportionately seen in special education classrooms and punished more frequently by teachers than non-minority students. This can in turn start a cycle as minorities more often become entrapped in the juvenile justice system.
- Housing: Those with a double burden more frequently face housing discrimination or find access to only below standard housing options. With this, minorities with disabilities also experience higher rates of homelessness. A typical monthly Social Security check often does not even cover average rent expenses. Truly accessible and quality housing is understandably more costly because the buildings are newer and thus more expensive. Additionally, accessible housing is sometimes located unreasonably far from transportation, particularly the type that is needed by people with certain disabilities.
- Safety: People with disabilities are victims of violent crime more often than people without disabilities. This applies in all racial groups. Impaired physical, sensory, and mental abilities make people with disabilities more subject to exploitation, abuse, and violence generally.
The Developmental Disabilities Assistance and Bill of Rights Act of 2000
Among other things, the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act) was enacted to provide that people with disabilities and their families can avail themselves of services and support resources that move them ever closer to experiencing self-determination, independence, and community inclusion.
As stressed in this article, Americans with disabilities comprise a broad group of people with a wide range of different cultures, backgrounds, and experiences. The DD Act addresses this fact head on by insisting that services specifically are delivered "in a manner that is responsive to the beliefs, interpersonal styles, attitudes, language, and behaviors of individuals who are receiving the services."
The DD Act stresses the importance of addressing the double burden dilemma by improving our levels of cultural competence.
What is cultural competence and why is it important?
Cultural competence, simply put, is the capability to meaningfully understand, work, and build real relationships with people who belong to different cultural communities.
Cultural background can include the beliefs, customs, and behaviors of people from various groups. Gaining cultural competence is a lifelong process of increasing self-awareness, developing social skills and behaviors around diversity, and gaining the ability to advocate for others. It goes beyond tolerance, which implies that one is simply willing to overlook differences. Instead, it includes recognizing and respecting diversity through our words and actions in all contexts.
As highlighted above, though the United States has always been a culturally diverse nation, in the past decade the United States has experienced historic shifts in the makeup of our population. More than half of the population will soon identify as ethnic minorities. Cultural competence must keep up with these trends if the struggles of minorities with disabilities are to be overcome.
Continuing to develop a high level of cultural competence particularly among our leaders in the business, healthcare and government arenas, is one of the keys to successfully addressing the double burden. What the Reverend Jesse Jackson said over two decades ago, is even truer today:
People with disabilities have always been excluded from the bounty of our nation's resources. Minorities with disabilities, in particular, have been the most disenfranchised of the disenfranchised. It is time that we bring them into the fold as full, first-class participants in our society.