title: The Consequences of the Consequences: The Impact of the Environment on People With Aphasia Over Time.
abstract: Understanding the impact of the environment on the participation of people with aphasia depends on one's perspective. A long-term perspective provides a unique insight into the myriad of ways in which the environment can influence the participation of people living with aphasia over decades. In this article, the authors present the real-life story of "Hank," who has lived with aphasia for more than 15 years. The authors consider how 2 different conceptual frameworks-the International Classification of Functioning, Disability and Health and the Social Determinants of Health-account for Hank's experience. The International Classification of Functioning, Disability and Health is useful to conceptualize the range of factors that influence living with aphasia at a particular point in time. In contrast, the Social Determinants of Health is useful to conceptualize the cumulative impact of living with aphasia on long-term health and well-being. Viewing aphasia as a social condition that impacts social determinants of health has potentially wide ranging implications for service design and delivery and the role of speech-language pathologists.
authors.affiliation: Discipline of Speech Pathology, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: O'Halloran
authors.affiliation: Discipline of Speech Pathology, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Marcella
authors.initials: M
authors.lastname: Carragher
authors.affiliation: Discipline of Speech Pathology, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Abby
authors.initials: A
authors.lastname: Foster
keywords: aphasia; consequences; disability and health; environmental factors; international classification of functioning; social determinants of health