Leslie Heller
Healthcare encounters involving patients with disabilities are shaped not only by symptoms and clinical information but also by assumptions regarding credibility, competence, and social identity. Drawing on concepts of intersectionality, diagnostic overshadowing, and patient credibility, this commentary examines how ableism, intersectionality, and diagnostic overshadowing interact to shape diagnostic reasoning, preventive care, and health equity. These intersecting mechanisms may contribute to delayed diagnosis, missed diagnosis, reduced access to preventive services, and preventable morbidity and mortality. Disability-related inequities may also affect participation in preventive screening, opportunities for early detection, and other core goals of preventive medicine. Recognizing disability as a critical component of health equity and preventive medicine may help healthcare systems improve preventive service delivery, diagnostic accuracy, patient safety, and population health outcomes. Structural safeguards, disability-informed education, and healthcare system reforms are needed to reduce preventable harms associated with disability-related bias.