The disabled have a narrow margin of health. They are, on average, much more likely than non-disabled persons to experience a broad range of secondary disabilities, and experience disability related acute health problems including decubitus ulcers, urinary tract infections, and respiratory tract infections. It has been shown that persons with disabilities experience higher rates of hospitalisation than the general population, largely from preventable conditions, and experience difficulties in access to primary care, and other services: in particular health promoting services. However, despite the vulnerability of the disabled to these problems, and the wide window of opportunity for health promotion to reduce premature mortality, improve quality of life and lower healthcare costs associated with disability, little research has been conducted to address issues of the funding of health promotion and healthcare for these persons. These issues are of considerable importance, as it is the funding arrangements which largely determine the scope and amount of health promotion received by the disabled, how this is distributed and to whom it is distributed. This paper attempts to redress this imbalance by providing an overview of issues concerning the funding of health promotion for the disabled. Several areas are considered where improvements in funding could be achieved to reduce barriers in access to appropriate healthcare and health promotion for the disabled. From this review it is clear that there is a need to find models of the finance of care that will avert unnecessary rehospitalisation, respond to the new health needs of the disabled as they get older, offer access to timely health promotion and primary care, focus on the outcomes of health promoting activities, lead to shorter stays in hospital, develop community-based rehabilitation, and encourage the role of carers and volunteers. In the end this requires incentives for providers of care to consider the longer-term needs of the disabled, and the most promising means to achieve this restructuring of funding may be through case-management. The uncertainty surrounding the future of the current Australian healthcare system, as with systems worldwide, presents the potential for the disabled to either lose their access to health promotion and care further or to capitalise on these changes to ensure that their situation is improved. Either way it is clear that research is urgently required to address the issues raised in this paper in a timely fashion, to ensure that beneficial changes are capitalised upon and the potential for negative impacts are minimised
