Natasha Altin, MSc. (OT), is a doctoral student in the Social and Behavioural Health Sciences stream at the Dalla Lana School of Public Health. As a health care professional, she passionate about social justice and health equity issues as they relate to marginalized populations. Before starting at the University of Toronto, she had the privilege to work and contribute to projects within the World Health Organization, the Pan American Health Organization, and various grassroots organizations. Her work focused on removing barriers to participation and promoting social inclusion through assistive technology and international human rights monitoring. Natasha’s research interests lie in using variety of theoretical perspectives to understand and respond to the diverse experiences of ageing population and the social systems that often exclude them.
Examining current access to Assistive Technology for older adults in Canada through Human Rights-Based Approach to Health.
Background: As people age, the likelihood of chronic health conditions and associated impairments increases. Assistive technology (e.g. wheelchairs, hearing aids) has been proposed as a strategy to equalize opportunities for older adults with impairments by maximizing functional ability and healthy ageing, enabling civic participation, productive and independent lives. Access to assistive technology (AT) has been identified by the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) as a human rights obligation and a necessary facilitator in the achievement of Sustainable Development Goals. Canada, who has ratified the UNCRPD in 2010, has an obligation to make AT accessible to all.
Objective: The aim of this paper is to determine if current access to AT is equitable and representative of Canada’s obligation to UNCRPD.
Method: This paper draws on the accessibility principle of United Nation’s Human Rights-Based Approach (HRBA) to Health and current literature on AT, to examine access to assistive technology and associated programs.
Results: The HRBA framework illuminates AT access inequities in four overlapping dimensions of accessibility: non-discrimination; economical, physical and information accessibility. Canada does not have a federal legislation that enables universal access to AT. Federal provisions apply to only specific subset of Canadians and are unavailable to the rest of the population with similar needs, who have to rely on highly variable provincial and territorial AT programs, therefore leading to indirect inequities in access. Economic accessibility (affordability) is one of the key barriers to AT access. Most government funded programs do not cover the entire cost of the required AT and services, requiring consumer to pay a portion of the cost. Without appropriate levels of funding, consumers may be forced to go without AT or choose less appropriate but more affordable options, potentially decreasing functionality and safety. Consumers report limited selection of appropriate ATs and AT suppliers. These practices restrict consumers’ choices and can result in consumers making compromises that do not adequately meet their needs. In terms of information accessibility, current AT programs are highly disintegrated resulting in confusion and difficulty navigating.
Conclusions: Current access to AT does not adequately support Canada’s obligation to UNCRPD due to highly variable, complex, restricted and underfunded AT programs. As AT contributes to maintaining the functional ability of older adults with impairments, there is an urgent need to work with policymakers, older adults and AT stakeholders to support development of policies that enhance equitable access to AT.