Health Archives - Join NCHPAD Connect

The Great American Smokeout, held on the third Thursday of November every year, encourages smokers across the nation to commit to quitting smoking for at least one day, in the hopes that it will lead to a smoke-free future.

While the focus of this event is on the broader population, it’s important to know how this initiative can be especially impactful for people with disabilities.

Smoking poses unique challenges and risks to individuals with disabilities, making the event a prime opportunity for change, empowerment and improved health outcomes.

Tobacco Prevalence in People with Disabilities

People with disabilities face many barriers to health and wellness access. As a result, people with disabilities often are more susceptible to preventable health problems that decrease their overall health and quality of life. Contributing factors include limited access to health programs and services that meet their needs.

According to the CDC, current cigarette smoking is significantly higher among adults with a disability (19%) compared to adults without a disability (11%). The percentage of adults with disabilities using E-cigarettes is also higher (8%) compared to adults without disabilities (3.9%). Adolescents with disabilities are also consistently more likely to smoke cigarettes compared with their nondisabled peers (Senders et al., 2020) .

Access to tobacco prevention and cessation programs and public information campaigns can significantly improve the health and wellness of people, including those with disabilities. It’s especially important to provide inclusive programs aimed to provide equal access to people who might otherwise be excluded or marginalized. This includes those having physical or intellectual disabilities or belonging to other minority groups.

Strategies for Tobacco Avoidance and Cessation

Quitting smoking is important for many reasons. It improves quality of life, reduces the risk of many smoking-related diseases and can add up to 10 years to life expectancy.

Public health organizations promoting health and wellness must prioritize access to resources, education and programs that will lead people with disabilities to engage in positive healthy behaviors related to a smoke-free life. The graphic below highlights strategies for avoiding – and quitting – tobacco.

Group of older adults sitting in a group exercise class

This is the first blog in a three-part series on exercise and balance, presented with our friends at Allard USA. Please note that if you have severe balance problems or have been losing your balance more often recently, see a healthcare provider before you get started with these exercises.

Balance exercises can not only help you improve your balance but also increase your confidence in exercising and activities of daily living. Including some balance training with your other daily or weekly exercises is also a great way to prevent injury and maintain independence.

What we call our sense of balance is actually a complex combination of multiple body systems working together. Balance is our ability to move and stabilize our center of mass (head to hips) on top of our base of support (hips to feet).

Loss of balance happens when one of those is displaced in relation to the other. When we lose our balance, our visual (gaze stability), vestibular (inner ear fluid) and somatosensory (spatial relationships) systems become flooded with information. In short, you might fall. But you can improve your balance with practice.

“To optimize our ability to improve balance, we must be consistent and deliberate in our practice of balance,” says John Reams, NCHPAD Exercise Physiologist. “Consistency and repetition will improve our ability to stabilize our body position in those moments when we feel out of balance. This is what some people call muscle memory, but it’s really just consistency and repetition.”

A good way to start testing and improving your balance is something called “faces of the clock” weight shifting.

Here’s how it works:

Start from a stable position where you can stay focused and “in the moment.” This can be seated or standing.
Imagine your body is positioned at the center of a clock.
Start by moving your torso and hips toward and away from each number on the clock, then include each of your limbs independently. The goal here is to challenge the distance over which you can shift your weight without losing control.
Try this 10 minutes a day up to 6 days a week.

How do you like to spend time in nature? National Trails Day

June 3 is National Trails Day, the “nationwide movement to give back to trails and build a world where everyone feels welcome and has access to enjoy the great outdoors,” according to the American Hiking Society.

Recently, our friend Dr. Scott Crawford shared how he was able to enjoy some time in nature on a hike – thanks to a wheelchair-accessible trail at the Mississippi Agriculture Museum in Jackson, Miss. The accessible route took him through the woods to enjoy an overlook of Eubanks Creek. “I was there for a meeting, but arrived early to ‘explore,’” said Dr. Crawford. “People with mobility limitations rarely get out in nature, so I try to savor every opportunity I get.”

The outdoors with a raised accessible path in the disatnace

A raised accessible trail outdoors

An outdoor accessible path

A landing outdoors with a tree growing through it

An accessible outdoor landing with a tree growing through it

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Images by Dr. Scott Crawford

Outdoor time in nature is an important aspect of a healthy lifestyle. It’s also one of 11 evidence-based elements of health that our MENTOR program is based on. Each element is part of the acronym MY SCORECARD: Mindfulness, Your spirit, Self-care, Core Values, Outdoor time in nature, Relationship building, Exercise, Contribution to others, Arts and leisure, Rest and relaxation, and Diet. In the MENTOR program, our expert health coaches and instructors combine these elements through personalized instruction and resources to help you reach your health goals – at no cost to you.

Learn more about the MENTOR program here, or reach us at nchpad@uab.edu or 866-866-8896 to sign up.

In this week’s edition of MENTOR Spotlight, we caught up with John Reams, our exercise physiologist here at NCHPAD. As exercise physiologist, John designs and leads our weekly exercise programming in the MENTOR program. We chatted with John about his role, his background, and his many hobbies and talents!

How long have you been with NCHPAD?

I’ve worked on MENTOR with NCHPAD for two years.

Tell us about your background & education. What brought you to NCHPAD?

I have a degree in biology and two master’s degrees: one in exercise physiology and one in nutrition sciences.

Before coming to NCHPAD, I worked at the Lakeshore Foundation for 12 years, transitioned to the UAB Center for Exercise Medicine for 5 years, and now I’m in my second year here at NCHPAD.

How long have you worked with people with disabilities?

18 years.

What do you do?

I am an Exercise Physiologist for MENTOR and NCHPAD. I combine my experience in clinical and wellness settings with my depth of education in exercise physiology and nutrition sciences.

What is your favorite thing about NCHPAD or this program?

I love sharing resources associated with the transformative qualities of exercise and nutrition with underserved populations. One of my favorite things about this job is guiding participants toward discovering resources for health-protective behavioral choices.

What hobbies do you have outside of work?

Playing guitar.

What’s your favorite food, favorite thing to cook or favorite recipe?

Donuts…any flavor!

What’s your favorite music, movies or tv shows?

I like to listen to punk, metal and jazz. As far as tv, I am a huge fan of documentaries.

What’s the last book you read? How was it?

Rick Rubin’s The Creative Act. It was really thought provoking.

What inspires you?

Sincerity and authenticity.

What’s your favorite quote?

“Are you simply interested, or are you invested?” – Source unknown

If you could switch careers for a day, what would you choose?

Studio session musician.

What’s one thing (not related to your job) that you could teach someone else how to do?

Build a staircase.

What are pressure sores? How do you spot them? Can you prevent them? What do you do if you get one? Watch as Karneshia Shantel shares what you should know about pressure sores.

What are pressure sores?

Pressure sores are injuries to the skin and tissues beneath the skin that are typically caused by pressure. Pressure sores occur especially over bony areas like heels, elbows, hips and backsides.

If you use a wheelchair, sit or lie down for long periods of time, you’re at a higher risk.

How do you prevent pressure sores?

Conditions like diabetes and vascular disease can put you at a higher risk for pressure sores, and so can unhealthy behaviors like smoking. But a healthy lifestyle and a good diet can help prevent pressure sores.

If you’re malnourished and not maintaining a healthy weight, the loss of fatty cushion around pressure points also increases the risk. And not getting enough protein or vitamins can lead to slower wound healing.

Pressure sores typically develop over time but can progress rapidly. Here are a few things you can do to prevent pressure sores.

Perform pressure reliefs. These exercises allow you to take the weight off areas that are under the most pressure. Do these every two hours while in bed and every thirty minutes while using a wheelchair.
- In bed, roll over on your side. Just be sure to change the position you’re lying in.
- In your wheelchair you can lean back or lift yourself up and float. Be sure to do these for 30-90 seconds.
If you use a wheelchair, make sure it fits. This will cut down on pressure and friction that contributes to pressure sores. Work with a physical or occupational therapist to get a chair that fits and discuss cushion options.
Perform daily skin checks. Use a mirror to check hard to see places or have someone help you.
- Pay attention to the places most likely to develop pressure sores, like heels, ankles, knees, hips, spine, tailbone, elbows, shoulders, shoulder blades, ears and the back of your head.

What happens if you develop a pressure sore?

If you develop a pressure sore, see a doctor right away. Pressure sores can progress into serious medical issues quickly, so it’s important to treat them quickly. Otherwise, you risk the chance of hospitalization or serious illness. Here’s what else you should know:

Pressure sores progress through different stages. This could start with no skin tearing all the way to deep tissue wounds. A doctor will be able to determine which stage the sore is in and treat accordingly.
Keep the wound clean to avoid any infection.
Be especially careful if you experience any kind of incontinence (loss of bladder control).
You may not be able to feel the actual pressure sore.
Be on the lookout for other signs of infection:
- Fever, malaise (feeling unwell), headaches, or redness or swelling around the wound.
- Growth in the size or depth of the wound.Discharge from the wound.
- Any other change in how you may feel.
If found early, infections may be treated with simple antibiotics. But if left untreated, infections from pressure sores can cause serious life-threatening illness.
Your doctor may also prescribe creams and lotions. These lotions protect the wound and encourage new tissue growth. They can also break down the tissue that needs to be cleared for healing.

What happens after I see a doctor?

Once your pressure sore is treated by a doctor, they may refer you to a physical or occupational therapist to explore ways to cut down on pressure. The therapist may look at your chair to see how it fits you. They may also recommend a special mattress or positioning device to reduce the risk of pressure sores while in bed.