Ableism, Human Rights, and the COVID-19 Pandemic: Healthcare-Related Barriers Experienced by Deaf People in Aotearoa New Zealand

Abstract

The COVID-19 pandemic significantly affected global healthcare access and exacerbated pre-pandemic structural barriers. Literature on disabled people’s experiences accessing healthcare is limited, with even less framing healthcare access as a human rights issue. This study documents and critically analyses Deaf people’s healthcare access experiences in Aotearoa New Zealand during the COVID-19 pandemic. Eleven self-identified Deaf individuals participated in semi-structured videoconferencing interviews. Discourse analysis was applied to participant narratives with discourses juxtaposed against a human rights analysis. Barriers influencing healthcare access included: (1) the inability of healthcare providers to communicate appropriately, including a rigid adherence to face mask use; (2) cultural insensitivity and limited awareness of Deaf people’s unique needs; and (3) the impact of ableist assumptions and healthcare delaying care. Barriers to healthcare access represent consecutive breaches of rights guaranteed under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Such breaches delay appropriate healthcare access and risk creating future compounding effects. Action is required to address identified breaches: (1) The CRPD should also underpin all health policy and practice development, inclusive of pandemic and disaster management responsiveness. (2) Health professionals and support staff should be trained, and demonstrate competency, in Deaf cultural awareness and sensitivity.

Mental Health Client Experiences of Telehealth in Aotearoa New Zealand During the COVID-19 Pandemic: Lessons and Implications

“…Effective communication is core to truly embedding person-centered care into practice [ 38 ]. Our findings concerning hearing impairment mirror those of earlier research into Deaf people’s experiences of health care access over the pandemic in New Zealand [ 39 ]. While research into telehealth has largely suggested the equivalence of this delivery method, telehealth could allow some clients to be underserved, specifically, those who are less proficient at verbalizing their distress; this could also affect a client’s willingness to use telehealth.…”

Systems Are Overstretched from the COVID-19 Pandemic: An Interpretive Description of Disabled People’s Access to Healthcare and Disability Support in New Zealand

“…Our findings affirm that disabled New Zealanders' access to healthcare and disability support services were negatively impacted by the pandemic, consistent with extant literature [8,11,13,[21][22][23]. Our study has revealed that, while policy decisions generally negatively impacted the healthcare and disability support of disabled individuals, some policies resulted in positive outcomes for disabled people.…”

“…However, the ongoing restrictions also significantly disrupted healthcare and support services, resulting in challenges for disabled people. For example, staff shortages were exacerbated by infection control measures, staff illness, and mandatory self-isolation periods, resulting in in-home support services being scaled back, disrupted, or even suspended, and many community services, such as day programmes and respite care were also negatively impacted [11][12][13].…”

“…"Through COVID, for two years, it would stress me out going there [GP practice] because of the mask situation and there were just too many rules to follow." (P42) Pandemic-related healthcare challenges were so significant for the Deaf community and vision-impaired participants that the findings have been analysed in two separate articles (see Roguski et al [13] and Good et al [11], respectively). Deaf participants raised a myriad of issues around accessing healthcare, which led many to opt out of accessing it except in emergency situations.…”

Warming the whare for trans people and whānau in perinatal care

“…Crucially, takatāpui who are gender diverse, and trans people and whānau who are also part of other underserved communities may navigate intersecting and compounding barriers to accessing healthcare. These barriers include the impacts of colonisation and racism (Espiner et al, 2021) and ableism (Roguski et al, 2022), alongside hetero-and cisnormativity in health systems (Pihama, 2020).…”