The groundbreaking work of Lisa Iezzoni, M.D., M.Sc., explores the impact of mobility difficulties at both the personal and policy levels and maps out creative solutions to improve the lives of those with trouble walking. Soon to be published in book form with support from a Robert Wood Johnson Foundation Investigator Award in Health Policy Research, Iezzoni’s research should push walking difficulties out of the policy shadows and squarely into the light of public debate.

In view of data showing that assistive technologies and devices such as wheelchairs are unaffordable for more than 60 percent of Americans who need them, Iezzoni’s work takes on even greater urgency. Almost half of those who need assistive technologies pay for them entirely out of their own pockets.

Through interviews with more than 100 people, Iezzoni describes the chronic conditions that cause walking difficulties and gives a personal face to the consequences. She also examines the health care community’s reaction to mobility limitations, shedding light on how they are approached and treated by physicians, as well as how they are viewed by insurers. In particular, she takes a sharp look at how health payment policies hinder long-term therapy to maintain functioning or prevent its decline. These policies may also impede access to mobility aids that restore the personal independence most Americans take for granted.

Iezzoni’s comprehensive prescription for change includes the following ingredients:

• Reshape the way front-line physicians treat patients with walking impairments, giving doctors more training, better assessment tools, and closer ties to rehabilitation resources.
• Prompt private and public purchasers to rethink their benefit designs, using pressure from the collective power of consumers with walking difficulties - particularly the aging Baby Boomers.
• Introduce greater consumer choice to the purchasing of assistive technologies.