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News from the National Academies
Date: May 20, 1997
Contacts: Dan Quinn, Media Relations Associate
April Sellers, Media Relations Assistant
(202) 334-2138; Internet <>


New Emphasis, Better Coordination Needed to
Elevate Field of Disability and Rehabilitation Research

WASHINGTON -- Federal efforts to improve the lives of people with disabilities are hampered by inadequate research funding and poor coordination among the many programs involved, says a new report from a committee of the Institute of Medicine. A new Agency on Disability and Rehabilitation Research should be created within the Department of Health and Human Services to set priorities, elevate awareness of rehabilitation science and engineering, and fund promising research, the report says.

One in six Americans has some type of disabling condition, and 10 million Americans are unable to attend school, work, or care for themselves. One-quarter of these cases involve impairments such as amputations or spinal cord injuries; the rest are from diseases or disorders such as emphysema or multiple sclerosis. Disabilities cost the nation more than $300 billion each year in medical costs and lost productivity.

"The federal government can improve the lives of millions and reduce overall medical costs by bolstering its commitment to rehabilitation science and engineering," said committee chair Edward Brandt Jr., director, Center for Health Policy, College of Public Health, University of Oklahoma. "To be effective, the government must foster a comprehensive research agenda that unites basic science, health, and engineering in a supportive research environment."

The new Agency on Disability and Rehabilitation Research would set the federal rehabilitation research agenda by coordinating work of the Department of Veterans Affairs, the National Science Foundation, and the National Institutes of Health. It would have the ability to fund interagency research and to enhance support where it identifies a need or an opportunity. Funding for the agency would come from shifting the National Institute on Disability and Rehabilitation Research -- currently in the Department of Education -- to the Department of Health and Human Services. This move would foster a more research-oriented environment, emphasize the importance of disability and rehabilitation as a health issue, and create a more effective mechanism for coordinating the work of researchers in disparate fields, the report says.

At $133 million each year -- or less than $7 annually for each person with a disability -- the current federal research expenditure pales when compared to costs involved. By providing new means of restoring function in people, research could substantially reduce health care costs and help stem the loss of wages and emotional distress that disabilities cause, the report says.

An Emerging Field of Study

Rehabilitation science and engineering seeks to restore physical capabilities in those who have disabilities or make changes that improve their interaction with the surrounding environment. The field melds knowledge from biology, engineering, and the physical, social, and behavioral sciences to better understand how disabling conditions develop, progress, or reverse. Researchers address topics as diverse as sorting out the biological roots of disease and designing more accessible buildings.

Three overarching goals should guide research in the field, the committee said. Researchers should:

> strengthen the science by working to develop ways of measuring and predicting functional limitations, disability, and health outcomes among people with potentially disabling conditions;

> focus on identifying the critical factors in the physical, social, and psychological environments that can promote or inhibit a person's ability to function. Because disability results from the interaction between human limitations and environmental influences, research must consider the entire range of factors, including whether adequate care is available, or whether a social support network is in place.

> develop links between research and practice to ensure that new technology is quickly used to improve the lives of people with disabilities. Although many government agencies have programs to help move ideas, products, and techniques from research to application, there is no well-organized mechanism for distributing research findings in rehabilitation science and engineering to those providing services.

Beyond the federal program, the committee called on the medical education and research community to formally recognize rehabilitation science and engineering as an emerging field of study. As such, it would stimulate ideas and help coordinate multidisciplinary research, while also providing a common knowledge base for individuals working on a rehabilitation team. Recognition of the field would connect the work of basic researchers more closely to the study of human disabilities and rehabilitation.

A committee roster follows. The study was sponsored by the U.S. Department of Health and Human Services. The Institute of Medicine is a private, non-profit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences.

Pre-publication copies of Enabling America: Assessing the Role of Rehabilitation Science and Engineering are available from the National Academy Press at the mailing address in the letterhead; tel. (202) 334-3313 or 1-800-624-6242. The cost of the report is $45.00 (prepaid) plus shipping charges of $4.00 for the first copy and $.50 for each additional copy. Reporters may obtain copies from the Office of News and Public Information at the letterhead address (contacts listed above).

Division of Health Sciences Policy

Committee on Assessing Rehabilitation Science and Engineering
      Edward N. Brandt Jr. (1) (chair)
      Regents Professor and Director, Center for Health Policy
      College of Public Health
      University of Oklahoma Health Sciences Center
      Oklahoma City

      Sharon N. Barnartt
      Professor and Chair, Department of Sociology
      Gallaudet University
      Washington, D.C.

      Carolyn Baum
      Assistant Professor of Occupational Therapy and Neurology,
      and Director, Department of Occupational Therapy
      Washington University School of Medicine
      St. Louis

      Faye Z. Belgrave
      Associate Professor of Psychology and Director of Applied
      Social Program, Department of Psychology
      George Washington University
      Washington, D.C.

      Clifford Brubaker
      Professor and Dean
      School of Health and Rehabilitation Sciences
      University of Pittsburgh

      Diana Cardenas
      University of Washington School of Medicine, and
      Department of Rehabilitation Medicine
      University of Washington Medical Center

      Dudley S. Childress (1)
      Professor of Biomedical Engineering and Orthopedic Surgery,
      and Director, Prosthetics Research Laboratory and
      Rehabilitation Engineering Research Program
      Northwestern University

      Donald L. Custis
      Director, Medical Affairs (retired), and
      Executive Director for Health Policy
      Paralyzed Veterans of America
      Potomac, Md.

      Sue K. Donaldson (1)
      Professor of Physiology
      School of Medicine, and
      Professor and Dean
      School of Nursing
      Johns Hopkins University

      David B. Gray
      Professor of Health Sciences
      Program in Occupational Therapy
      Washington University School of Medicine
      St. Louis

      David Krebs
      Professor and Interim Director
      Graduate Program in Clinical Investigation
      Institute of Health Professions
      Massachusetts General Hospital

      Ellen J. MacKenzie
      Professor, Department of Health Policy and Management;
      Senior Associate Dean for Academic Affairs; and
      Director, Center for Injury Research and Policy
      Johns Hopkins University School of Hygiene and Public Health

      Margaret A. Turk
      Associate Professor, Department of Physical Medicine and
      Rehabilitation and Pediatrics
      State University of New York
      Health Sciences Center at Syracuse

      Glen White
      Assistant Professor, Department of Human Development and
      Family Life
      University of Kansas

      Savio L-Y Woo (1,2)
      Ferguson Professor and Vice Chairman for Research
      Department of Orthopedic Surgery
      School of Medicine
      University of Pittsburgh

      Edward Yelin
      Professor of Medicine and Health Policy
      University of California
      San Francisco

      Wise Young
      Professor, Department of Neurosurgery
      New York University Medical Center
      New York City


      Andrew M. Pope
      Study Director

      (1) Member, Institute of Medicine
      (2) Member, National Academy of Engineering