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(a) Design and construction. (1) Each facility or part of a facility constructed by, on behalf of, or for the use of a public entity shall be designed and constructed in such manner that the facility or part of the facility is readily accessible to and usable by individuals with disabilities, if the construction was commenced after January 26, 1992. (2) Exception for structural impracticability. (i) Full compliance with the requirements of this section is not required where a public entity can demonstrate that it is structurally impracticable to meet the requirements. Full compliance will be considered structurally impracticable only in those rare circumstances when the unique characteristics of terrain prevent the incorporation of accessibility features. (ii) If full compliance with this section would be structurally impracticable, compliance with this section is required to the extent that it is not structurally impracticable. In that case, any portion of the facility that can be made accessible shall be made accessible to the extent that it is not structurally impracticable. (iii) If providing accessibility in conformance with this section to individuals with certain disabilities (e.g., those who use wheelchairs) would be structurally impracticable, accessibility shall nonetheless be ensured to persons with other types of disabilities, (e.g., those who use crutches or who have sight, hearing, or mental impairments) in accordance with this section.
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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Immigration and health care are hotly debated and contentious issues. Policies that relate to both issues—to the health of newcomers—often reflect misimpressions about immigrants, and their impact on health care systems. Despite the fact that immigrants are typically younger and healthier than natives, and that many immigrants play a vital role as care-givers in their new lands, native citizens are often reluctant to extend basic health care to immigrants, choosing instead to let them suffer, to let them die prematurely, or to expedite their return to their home lands. Likewise, many nations turn against immigrants when epidemics such as Ebola strike, under the false belief that native populations can be kept well only if immigrants are kept out. In The Health of Newcomers, Patricia Illingworth and Wendy E. Parmet demonstrate how shortsighted and dangerous it is to craft health policy on the basis of ethnocentrism and xenophobia. Because health is a global public good and people benefit from the health of neighbor and stranger alike, it is in everyone’s interest to ensure the health of all. Drawing on rigorous legal and ethical arguments and empirical studies, as well as deeply personal stories of immigrant struggles, Illingworth and Parmet make the compelling case that global phenomena such as poverty, the medical brain drain, organ tourism, and climate change ought to inform the health policy we craft for newcomers and natives alike.
This revised title II regulation integrates the Department of Justice's new regulatory provisions with the text of the existing title II regulation that was unchanged by the 2010 revisions. Includes a section for guidance and analysis.
In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.