Siniša Franjić*
1Independent Researcher
*Correspondence: Siniša Franjić, Independent Researcher, Europe, Email: sinisa.franjic@gmail.com
Received: 05 December 2025; Accepted: 22 December 2025; Published: 29 December 2025.
Citation: Siniša, Franjić. “ Disability and Health Promotion.” J Healthc Adv Nur (2025): 133. DOI: 10.59462/3068-1758.3.3.133
Copyright: © 2025 Franjić S. This is an open-ac cess article distributed under the terms of the Cre ative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
The International Day of Persons with Disabilities is observed annually on December 3rd, aiming primarily to enhance the living standards of individuals with dis abilities by fostering collaboration and forming allianc es among existing disability associations. This initiative not only lessens the effects of social exclusion but also raises public awareness about the existence of persons with disabilities within the community and the challeng es they face daily, while highlighting the opportunities available to them. Individuals with disabilities are those who experience long-term physical, mental, intellectual, or sensory challenges that, when combined with various barriers, can hinder their ability to participate fully and equally in society with others. Disabilities are not always apparent; certain issues such as mental health condi tions, chronic pain, and intellectual disabilities are of ten “invisible” yet profoundly impact the quality of life for those with disabilities and their families. Hence, it is cru cial to empathize with individuals who need assistance, either occasionally or constantly, to foster a deeper un derstanding of their experiences and the importance of accommodating individuals with disabilities, taking into account their unique traits, functional nuances, as well as the restrictions stemming from their impairments and conditions, alongside the barriers positioned by contemporary society. By shifting perspectives, society can cultivate tolerance, respect for diversity, patience, compassion, and understanding, ultimately fostering an informed and empathetic community where people with disabilities are empowered to participate as equal and active members with appropriate support.
Keywords:
Disabilities; Persons with Disabilities; Ap proach; Injury; Health Promotion
Introduction
As the population ages, the prevalence of disability is on the rise, with more individuals either living with pre existing or newly acquired disabilities [1]. People who have disabilities tend to report health issues more frequently compared to those without disabilities. The focus of health promotion for older individuals is to prevent or postpone the development of diseases and disabilities through the identification of risk factors and the application of strategies promoting healthy aging.
The objectives of health promotion strategies for older adults are to (1) preserve and enhance functional capabilities, (2) support and improve self-care practices, and (3) encourage engagement with social networks. Efforts aimed at addressing lifestyle factors that can be modified among all older adults include increasing physical activity levels, decreasing smoking and alcohol intake, and encouraging participation in educational and community-based activities. Health promotion initiatives spearheaded by family and community caregivers can aid those aging with disabilities in reducing the risks of age-associated health issues, preventing the decline of functional abilities, and maintaining significant societal roles.
Risk factors
Living with a disability frequently raises the likelihood of developing additional health issues [1]. Common health problems related to disabilities in older adults suffering from conditions like stroke, multiple sclerosis, and spinal cord injuries include issues such as pain, fatigue, bladder and bowel dysfunction, sleep disturbances, spasticity, depression, and a higher risk of falls. Lifestyle choices such as physical inactivity or smoking can exacerbate health difficulties that many older adults experience, including high blood pressure, heart disease, frailty, pressure ulcers and/or arthritis. Emphasizing health promotion by tackling prevalent risk factors can aid in maintaining functionality and lessen the effects of these widespread health issues.
Gains
Short-term gains achieved during rehabilitation can rapidly decline after discharge [1]. With time, older individuals with disabilities may drop below the minimum requirement for self-sufficiency, heightening the chances of encountering more health complications. About forty-seven percent of disabled adults lead a sedentary lifestyle, in contrast to twenty-six percent of their healthy peer group. A lack of physical activity among disabled individuals leads to deterioration in health, resulting in a recurring cycle of physical decline. The period right after rehabilitation is crucial for maximizing physical activity and engaging in other health-promoting practices to uphold both health and independence. The aim of post-rehabilitation exercise, paired with a balanced lifestyle, is to retain the immediate benefits from rehabilitation and foster ongoing functional improvements.
Health Promotion
The importance of health promotion has never been greater in tackling public health challenges [2]. The health landscape is at a unique intersection as the global community faces a ‘triple burden of diseases,’ which includes the ongoing issues of infectious diseases, the rise of new and resurfacing illnesses, and the unprecedented increase in noncommunicable chronic conditions. Factors that support advancement in modern society, such as trade globalization, urban development, easy international travel, and cutting-edge technologies, serve as a double edged sword. While they can lead to positive health impacts, they also elevate the risk of poor health due to the encouragement of inactive lifestyles and unhealthy eating habits. A significant prevalence of tobacco consumption, coupled with poor dietary choices and reduced physical activity, contributes to increased biological risk factors, resulting in a rise in noncommunicable diseases (NCD). The detrimental effects of global climate change, a lack of physical activity, the growing incidence of natural disasters, economic downturns, security threats, and more intensify the obstacles faced by public health today.Health, according to the definition provided by the World Health Organization (WHO), refers to a complete state of physical, social, and mental well-being, rather than merely the lack of illness or disability. The right to achieve the highest possible level of health is recognized as a basic human right for every individual. In recent decades, there has been growing acknowledgment that solely relying on biomedical solutions does not ensure improved health outcomes. Health is significantly shaped by elements beyond the health care sector, particularly by social, economic, and political influences. These factors play a crucial role in defining the environments where individuals are born, reside, work, and age, along with the systems established to address health demands, leading to disparities in health both among and within nations. Therefore, reaching the highest attainable health standard requires a broad and integrated strategy that goes beyond traditional medical care, involving communities, health professionals, and various stakeholders. This comprehensive strategy should enable both individuals and communities to take charge of their health, encourage public health leadership, foster collaboration across sectors to create effective health policies, and build enduring health systems within society. These factors exemplify the core of “health promotion,” which focuses on empowering individuals to manage their health and its influencing factors, ultimately enhancing their health. This includes actions at personal, organizational, social, and political levels to encourage adaptations (such as lifestyle changes and environmental modifications) that support health improvement or protection.
Approach
Health promotion initiatives can target significant health issues affecting a large segment of the population and advocate for various interventions [2]. An approach centered around specific issues will be most effective when paired with context-based strategies. These context based strategies can be applied in schools, workplaces, markets, residential neighborhoods, and other settings to tackle key health challenges by considering various intricate health determinants like behaviors, cultural values, and practices prevalent in the environments where individuals live and work. Context-based strategies also promote the incorporation of health promotion efforts into existing social activities while being mindful of local circumstances.
The total population affected by any health condition can be categorized into four segments: a) individuals who are healthy, b) those with risk factors, c) individuals exhibiting symptoms, and d) those diagnosed with a disease or disorder. Each of these four segments requires targeted interventions to address the comprehensive health needs of the entire population. In summary, it involves primordial prevention for the healthy segment, as well as treatment and rehabilitation for those with diseases. Primordial prevention aims to create and sustain conditions that reduce health risks. This includes actions and strategies designed to prevent the occurrence and development of environmental, economic, social, and behavioral factors, as well as cultural norms that are known to elevate the likelihood of disease occurrence.
Physical activity
Exercise physiologists, fitness coaches, and trained support staff can assist in addressing challenges when moving from exercise prescribed by healthcare to exercise within the community [1]. An effective shift can be achieved through the application of the following approaches aimed at enhancing chances for older individuals with disabilities to remain active: (1) recognizing and educating community healthcare providers; (2) enhancing accessibility within the community; (3) ensuring the availability of safe, cost effective, and accessible equipment and facilities; and (4) providing forms of physical activity that encourage social engagement and can be sustained throughout life.
Seniors with disabilities face challenges in joining the same exercise programs and leisure activities as their counterparts. Programs that integrate physical activity into daily routines may lead to better compliance and be as beneficial as formally organized exercise regimens. Those with cognitive challenges are likely to gain from having an exercise partner who is cognitively sound, receiving step-by-step guidance, engaging in high repetitions, participating in familiar activities, using memory prompts, and engaging in enjoyable and personalized exercises.Consistent physical activity can lower a person’s chances of developing various chronic conditions, including obesity, some cancers, and diabetes, as well as reducing the risk of health issues such as heart attacks or high blood pressure [3]. Regular exercise can combat and lower obesity by enhancing lean muscle tissue and energy output while decreasing fat accumulation. Being active is essential for maintaining weight loss. The American College of Sports Medicine has indicated that consistent physical activity, which includes appropriate aerobic and strength training, is beneficial for individuals with type 2 diabetes as it reduces glucose levels and boosts insulin sensitivity. Research on intensive behavior changes that include physical activity and dietary adjustments has revealed significant health improvements for those at risk of type 2 diabetes and has substantially lowered diabetes incidence. Activities aimed at enhancing endurance can not only prevent hypertension but also reduce blood pressure in both hypertensive and nonhypertensive adults.
Numerous other advantages are linked to an active lifestyle. To begin with, engaging in physical activity strengthens muscles and bones. Exercises that involve bearing weight promote normal skeletal growth in children and teens and assist young adults in attaining and sustaining their maximum bone density. Furthermore, physical activity offers several mental health benefits, including lower levels of anxiety and stress, along with an uplifted mood. Moreover, it may serve as a protective factor against future depression development. In populations affected by depression, two meta-analyses found average effect sizes ranging from -.72 to -1.1 for alleviating depressive symptoms compared to groups that did not receive treatment.
Injury
Injury is now recognized as a health concern that can be best comprehended and managed by employing strategies similar to those used for other illnesses [4]. The occurrence of injury stems from the interplay between individuals (factors related to the host), energy (elements of the agent and vehicle), and the surroundings (environmental elements). This epidemiological perspective on injury serves as the basis for implementing health promotion tactics aimed at reducing injury rates.
It is possible to manage injury by diminishing the frequency of potentially harmful incidents and by lessening the severity of injuries when they do happen. Within the realm of public health, injury is described as “unintentional or intentional harm to the body caused by sudden exposure to thermal, mechanical, electrical, or chemical energy, or due to the lack of critical elements such as heat or oxygen.” For instance, when considering a sports injury, harm to the individual (the affected person) occurs through a swift transfer of kinetic energy. This energy exchange can be altered in various ways, such as enhancing the individual’s resilience to it (by boosting tolerance for injuries) or by disconnecting the individual from the energy transfer (for example, by using protective gear between the person and the energy source). Despite being a public health issue, addressing injury necessitates the involvement of experts from numerous fields, including nursing, health education, teaching, administration in hospitals and care facilities, psychology, social work, law enforcement, product design, transportation planning, criminology, playground design, sports medicine, coaching, and workplace safety. To achieve success, collaboration is essential in injury prevention methodologies.
Chronic disease management
Historically, services for these patients were developed around the interests and specialties of individual practitioners [5]. Surveys concerning the number and role of community neurorehabilitation teams have been conducted to assist the British Society for Rehabilitation Medicine in establishing standards for community based rehabilitation. These findings reveal that service availability is inconsistent and of highly variable quality and quantity regarding the interventions provided. This situation presents both a challenge and a chance to either redesign existing services or create new ones that cater to the needs of individuals currently overlooked.
Chronic disease management presents another opportunity and is featured on public health agendas both globally and locally. Effective chronic disease management necessitates a significant shift from a reactive approach to one that emphasizes proactive health promotion. This involves health and social care professionals reassessing the existing service delivery systems and developing protocols to facilitate the application of best practice guidelines while creating pathways for managing care episodes. Certain neurological disorders persist throughout a person’s life, requiring a transition from
services focused on children and education to those oriented towards adults. This shift poses challenges for maintaining continuous service provision while also providing a genuine chance to integrate services across these arbitrary organizational divides. The National Service Framework and Chronic Disease Management Agenda both depend on the successful amalgamation of health and social care, which offers further possibilities for collaborative efforts.
The conjunction of healthcare and social services creates a chance to establish support for individuals whose requirements do not neatly align with current service frameworks. For instance, individuals who have suffered traumatic brain injuries may not display any physical or mental handicaps, nor exhibit language or sensory challenges, yet they may still find it impossible to live independently without daily assistance and oversight. Evaluating these unseen challenges and formulating effective rehabilitation strategies for these individuals is exactly where an advanced practitioner can provide significant impact.
Palliative care
The aim of palliative care is to secure the highest possible quality of existence for both patients and their families [6]. In the rehabilitation process for patients with terminal conditions, balancing optimal functioning with comfort becomes a significant concern. For individuals with severe illnesses, symptoms such as exhaustion, discomfort, and overall weakness are often reported, while other alarming issues include increasing frailty, reliance on caregivers, worries about unmanaged discomfort and solitude, and a loss of independence. Patients and their partners often place a high value on physical capability, the duration spent lying down, and their ability to engage in desired activities when considering overall life quality. Consequently, therapists should closely collaborate with each patient to identify their functional objectives and deliver treatments aimed at preserving strength and functionality for as long as feasible. As disabilities may escalate and diseases progress, interventions and objectives should concentrate on reducing or eliminating issues while providing care and assistance. Objectives related to palliative care should be consistently updated and refined, considering the disease phase; the patient’s health condition, cognitive abilities, and prognosis; as well as the intended discharge location. Common goals for therapy generally involve managing pain, preventing contractures and pressure ulcers, averting unnecessary decline from inactivity, and conserving energy. A balance should be achieved between increasing rest to ease fatigue and encouraging mobility. It is crucial to train caregivers in the proper use of adaptive tools, such as patient lifts, to assist in effective patient care during this crucial stage.
Rehabilitation
Geriatric rehabilitation focuses on restoring or enhancing the remaining functional abilities through diagnostic evaluations and therapy for elderly individuals facing disabling conditions [7]. Its primary emphasis is on improving function and overall well-being rather than solely addressing illnesses, with the aim of maintaining functional independence and enhancing the quality of life for seniors.
In theory, the concepts of geriatric rehabilitation align closely with those of general rehabilitation. Nevertheless, the individuals undergoing geriatric rehabilitation present age-related features, such as multiple health issues and frailty across several systems, which leads to specific needs needing careful consideration, such as therapy modalities and their intensity levels. Traditionally, geriatric rehabilitation was defined with a focus on older adults suffering from disabilities caused by certain health concerns like stroke or arthritis; this approach is now viewed as a component of a wider health strategy aimed at enhancing the functioning of elderly individuals.
Geriatric rehabilitation can be undertaken in various environments based on the rehabilitation requirements, which include acute hospitals, intermediate care settings, rehabilitation facilities, and community-oriented locations. Typically, those who receive geriatric rehabilitation have previously experienced a significant decline in function, either acutely or subacutely. The effectiveness of rehabilitation is mainly influenced by the degree of preexisting disability and the intensity of the current disabling condition.
Chronological age itself should not solely dictate an individual’s participation or potential to benefit from rehabilitation services. Considering the aforementioned factors, tailored goals are established and achieved through the collaboration of a multidisciplinary team of professionals.
The objective of physical rehabilitation is to restore movement and functionality impacted by injuries, illnesses, or disabilities [8]. Therapies aimed at gait rehabilitation emphasize the restoration, compensation, enhancement, or retraining of the lost locomotor abilities as well as cognitive functions of the person. Generally, rehabilitation efforts seek to enhance walking capabilities through (1) promoting voluntary muscle engagement in the legs, (2) improving strength and coordination in the muscles, (3) reestablishing walking speed and endurance, often coupled with cardiovascular conditioning, and (4) maximizing the range of motion in the lower limbs. In this context, physical rehabilitation encompasses various techniques and strategies, from traditional gait training to robotic and machine-assisted therapies. These methods focus on weight support, propulsion of body mass, along with balance and postural stability during movement.
Conclusion
The concept of health promotion involves enhancing health and creating opportunities for good health prior to the emergence of health issues or threats. Health promotion is described as a process that empowers individuals to enhance their health and take charge of their well-being. The aim of health promotion is to help individuals and communities gain control over the determinants of health. This health-focused perspective highlights the positive capacities and potentials of individuals and communities alike. Effective health promotion necessitates the active engagement of all significant social sectors, including health policymakers and the citizens, who are entitled to health as a fundamental human right.
References