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Lloyd M, Temple VA, Foley JT, Yeatman S, Lunsky Y, Huang A, Balogh R. Young adults with intellectual and developmental disabilities who participate in Special Olympics are less likely to be diagnosed with depression. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1699-1708. [PMID: 36544012 DOI: 10.1007/s00127-022-02406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE People with intellectual and developmental disabilities (IDD) experience high rates of depression. Evidence indicates that physical activity, or participation in a sports club, in a supportive social environment has mental and physical health benefits. Adults with IDD, on average, engage in low levels of physical activity. The purpose of this study was to compare the rates of depression among young adult Special Olympics participants with IDD compared to non-participants with IDD. METHODS This was a 20-year retrospective cohort study of young adults (19-29 years) with IDD in the province of Ontario, Canada that compared rates of depression among Special Olympics participants (n = 8710) to non-participants (n = 42,393) using administrative health databases housed at ICES (formerly the Institute for Clinical Evaluative Sciences). Using cox proportional hazard models, the crude hazard ratios were calculated for the association between each independent variable and the dependent variable. RESULTS After controlling for other variables, the hazard rate for depression among Special Olympics participants compared to the hazard rate for depression among non-participants generated an adjusted hazard ratio of 0.51. Over the 20-year follow-up, the participants were 0.51 times as likely to develop depression as non-participants; this represents a 49% reduction in risk among Special Olympics participants. This result was statistically significant and represents a medium effect size. CONCLUSION Future research is needed on how much of this risk reduction is related to a physiological response to physical activity/exercise, and how much is related to the social connectedness of being part of a group participating in Special Olympics.
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Affiliation(s)
- Meghann Lloyd
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St N., Oshawa, ON, L1G 0C5, Canada.
| | - Viviene A Temple
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada
| | - John T Foley
- Department of Physical Education, SUNY Cortland, Cortland, NY, USA
| | - Sharyn Yeatman
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St N., Oshawa, ON, L1G 0C5, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
| | | | - Robert Balogh
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St N., Oshawa, ON, L1G 0C5, Canada
- ICES, Toronto, ON, Canada
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Marquis S, Lunsky Y, McGrail KM, Baumbusch J. Population level administrative data evidence of visits to the emergency department by youth with intellectual/developmental disabilities in BC, Canada. Am J Emerg Med 2023; 69:52-57. [PMID: 37058981 DOI: 10.1016/j.ajem.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION The literature indicates that youth with intellectual/developmental disabilities (IDD) have poor health and that access to health services decreases as they transition from pediatric to adult services. At the same time their use of emergency department services increases. The objective of this study was to compare use of emergency department services by youth with IDD to youth without IDD, with particular emphasis on the transition period from pediatric to adult health care services. METHODS This research used a population level administrative health data base for the province of British Columbia Canada for 2010-2019 to examine the use of emergency departments by youth with IDD (N = 20,591) compared to a population group of youth without IDD (N = 1,293,791). Using the ten years of data, odds ratios for visits to the emergency department were calculated adjusting for sex, income and geographical area within the Province. In addition, difference-in-differences analyses were calculated for age matched subsets of the two cohorts. RESULTS Over the ten year period, 40.60% of youth with IDD visited an emergency department at least once, compared to 29.10% of youth without IDD. Youth with IDD had an odds ratio of visiting an emergency department 1.697 (1.649, 1.747) times that of youth without IDD. However, when odds were adjusted for a diagnosis of either psychotic illness or anxiety/depression, the odds for youth with IDD visiting emergency compared to youth without IDD were reduced to 1.063 (1.031, 1.096). Use of emergency services increased as youth aged. Type of IDD also affected use of emergency services. Youth with Fetal Alcohol Syndrome had the greatest odds of using emergency services compared to youth with other types of IDD. DISCUSSION The findings from this study indicate that youth with IDD have higher odds of using emergency services than youth without IDD although these increased odds appear to be largely driven by mental illness. In addition, use of emergency services increases as the youth age and transition from pediatric to adult health services. Better treatment of mental health issues within this population may reduce their use of emergency services.
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Affiliation(s)
- Sandra Marquis
- School of Nursing University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, CAMH, 1025 Queen St West, Toronto, ONT M6J 1H4, Canada.
| | - Kimberlyn M McGrail
- Centre for Health Services and Policy Research, The University of British Columbia, 201-2206 East Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Jennifer Baumbusch
- School of Nursing University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
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Bircan E, Politis MD, Gokun Y, Luo C, Leonard H, Bourke J, Bower C, Nembhard WN. Intellectual disabilities and autism among children with congenital heart defects, Western Australia, 1983-2010. BMC Pediatr 2023; 23:106. [PMID: 36870968 PMCID: PMC9985207 DOI: 10.1186/s12887-023-03924-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Children with congenital heart defects (CHDs) are at higher risk of developing an intellectual disability. However, severity of intellectual disabilities among this group of children are largely unknown. Our objective was to determine the risk of intellectual disability (ID), ID severity, and autism among children with CHDs. METHODS We conducted a retrospective cohort study of singleton live births in Western Australia (n = 20,592) between 1983 and 2010. Children with CHDs were identified from the Western Australian Register for Developmental Anomalies (n = 6563) and infants without CHDs were randomly selected from state birth records (n = 14,029). Children diagnosed with ID before 18 years were identified by linkage to statewide Intellectual Disability Exploring Answers database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from logistic regression models for all CHDs combined and by CHD severity adjusting for potential confounders. RESULTS Of 20,592 children, 466 (7.1%) with CHDs and 187 (1.3%) without CHDs had an ID. Compared to children without CHDs, children with any CHD had 5.26 times (95% CI 4.42, 6.26) the odds of having an ID and 4.76 times (95% CI 3.98, 5.70) the odds of having mild/moderate ID. Children with any CHD had 1.76 times the odds of having autism (95% CI 1.07, 2.88), and 3.27 times the odds of having an unknown cause of ID (95% CI 2.65, 4.05) compared to children without CHD. The risk of having autism (aOR 3.23, 95% CI 1.11, 9.38), and unknown cause of ID (aOR 3.45, 95% CI 2.09, 5.70) was greatest for children with mild CHD. CONCLUSIONS Children with CHDs were more likely to have an ID or autism. Future research should elucidate underlying etiology of ID in children with CHDs.
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Affiliation(s)
- Emine Bircan
- Arkansas Center for Birth Defects Research and Prevention and the Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR, 72205-7199, USA
| | - Maria D Politis
- Arkansas Center for Birth Defects Research and Prevention and the Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR, 72205-7199, USA
| | - Yevgeniya Gokun
- Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Chunqiao Luo
- Data Science Core, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jenny Bourke
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Wendy N Nembhard
- Arkansas Center for Birth Defects Research and Prevention and the Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR, 72205-7199, USA. .,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
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Dinora P, Prohn SM, Bogenschutz M, Broda MD, Lineberry S, West A. An Examination of Support Needs, Supports, and Outcomes for People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:65-78. [PMID: 36706006 DOI: 10.1352/1934-9556-61.1.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
Researchers used a merged dataset to examine if more resources were expended on those with greater support needs and if support needs impacted personal outcomes when controlling for relevant personal and contextual factors. Results indicated that the amount of support a person receives had a direct relationship to their needs. However, we also found that people with the greatest needs had weaker personal outcomes suggesting that distribution of resources based on need may not result in equivalent outcomes. The authors suggest strategies at an individual and systems level to address the outcomes gap for people with the greatest support needs.
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Affiliation(s)
- Parthenia Dinora
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Seb M Prohn
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Michael D Broda
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Sarah Lineberry
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Angela West
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
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Lunsky Y, Lai MC, Balogh R, Chung H, Durbin A, Jachyra P, Tint A, Weiss J, Lin E. Premature mortality in a population-based cohort of autistic adults in Canada. Autism Res 2022; 15:1550-1559. [PMID: 35633154 DOI: 10.1002/aur.2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/28/2022] [Indexed: 11/08/2022]
Abstract
Research from different countries suggests that autistic adults are more likely to die prematurely than non-autistic adults, but these studies do not always investigate male and female individuals separately and do not consider whether this pattern is unique to autistic people or is also an issue for people with other developmental disabilities. We examined premature mortality in autistic males and females (assigned at birth) in a population-based cohort, compared to males and females with and without other developmental disabilities. Using linked administrative health and social services population data from Ontario, Canada, age-matched males and females aged 19-65 years were followed between 2010 and 2016, and causes of death were determined. Over the 6-year observation period, 330 of 42,607 persons (0.77%) in the group without developmental disabilities had died compared to 259 of 10,646 persons (2.43%) in the autism group and 419 of 10,615 persons (3.95%) in the other developmental disabilities group. Autistic males and females were more likely to die than non-autistic males (adjusted risk ratio, RR 3.13, 95%CI 2.58-3.79) and non-autistic females (adjusted RR 3.12, 95%CI 2.35-4.13) without developmental disabilities, but were less likely to die than adults with other developmental disabilities (males: adjusted RR 0.66, 95%CI 0.55-0.79; females: adjusted RR 0.55, 95%CI 0.43-0.71). Most common causes of death varied depending on a person's sex and diagnosis. Given the greater likelihood of premature mortality in adults with developmental disabilities including autism, greater attention and resources directed toward their health and social care are needed, tailored to their sex and diagnosis-informed needs. LAY SUMMARY: This study looked at how many autistic men and women died over 6 years (2010-2016), along with how they died, and compared this to adults who did not have autism living in Ontario, Canada. It found that autistic men and women were more than three times as likely to die as people of the same age who did not have a developmental disability. However, adults with other developmental disabilities besides autism were even more likely to die than autistic adults. This means that we have to pay more attention and invest in better social and health care for autistic people, along with people who have other types of developmental disabilities.
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Affiliation(s)
- Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Robert Balogh
- ICES, Toronto, Ontario, Canada.,Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Anna Durbin
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Unity Health, Toronto, Ontario, Canada
| | - Patrick Jachyra
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Ami Tint
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Jonathan Weiss
- Department of Psychology, Faculty of Health Sciences, York University, Toronto, Ontario, Canada
| | - Elizabeth Lin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
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Cooper SA, Henderson A, Kinnear D, Mackay D, Fleming M, Smith GS, Hughes-McCormack LA, Rydzewska E, Dunn K, Pell JP, Melville C. Cohort profile: Scotland's record-linkage e-cohorts of people with intellectual disabilities, and autistic people (SCIDA). BMJ Open 2022; 12:e057230. [PMID: 35568493 PMCID: PMC9109103 DOI: 10.1136/bmjopen-2021-057230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE To investigate health, mortality and healthcare inequalities experienced by people with intellectual disabilities, and autistic people, and their determinants; an important step towards identifying and implementing solutions to reduce inequalities. This paper describes the cohorts, record-linkages and variables that will be used. PARTICIPANTS Scotland's Census, 2011 was used to identify Scotland's citizens with intellectual disabilities, and autistic citizens, and representative general population samples with neither. Using Scotland's community health index, the Census data (demography, household, employment, long-term conditions) were linked with routinely collected health, death and healthcare data: Scotland's register of deaths, Scottish morbidity data 06 (SMR06: cancer incidence, mortality, treatments), Prescribing Information System (identifying asthma/chronic obstructive pulmonary disease; angina/congestive heart failure/hypertension; peptic ulcer/reflux; constipation; diabetes; thyroid disorder; depression; bipolar disorders; anxiety/sleep; psychosis; attention deficit hyperactivity disorder; epilepsy; glaucoma), SMR01 (general/acute hospital admissions and causes, ambulatory care sensitive admissions), SMR04 (mental health admissions and causes), Scottish Care Information-Diabetes Collaboration (diabetic care quality, diabetic outcomes), national bowel screening programme and cervical screening. FINDINGS TO DATE Of the whole population, 0.5% had intellectual disabilities, and 0.6% were autistic. Linkage was successful for >92%. The resultant e-cohorts include: (1) 22 538 people with intellectual disabilities (12 837 men and 9701 women), 4509 of whom are children <16 years, (2) 27 741 autistic people (21 390 men and 6351 women), 15 387 of whom are children <16 years and (3) representative general population samples with neither condition. Very good general health was reported for only 3389 (15.0%) people with intellectual disabilities, 10 510 (38.0%) autistic people, compared with 52.4% general population. Mental health conditions were reported for 4755 (21.1%) people with intellectual disabilities, 3998 (14.4%) autistic people, compared with 4.2% general population. FUTURE PLANS Analyses will determine the extent of premature mortality, causes of death, and avoidable deaths, profile of health conditions and cancers, healthcare quality and screening and determinants of mortality and healthcare.
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Affiliation(s)
- Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Angela Henderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Deborah Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daniel Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Michael Fleming
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Gillian S Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Ewelina Rydzewska
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kirsty Dunn
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Craig Melville
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Matheson FI, Dastoori P, Whittingham L, Calzavara A, Keown LA, Durbin A, Kouyoumdjian FG, Lin E, Volpe T, Lunsky Y. Intellectual/developmental disabilities among people incarcerated in federal correctional facilities in Ontario, Canada: Examining prevalence, health and correctional characteristics. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:900-909. [PMID: 35338547 DOI: 10.1111/jar.12995] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/22/2021] [Accepted: 02/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is little research with people who experience intellectual/developmental disabilities and imprisonment. METHODS The study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n = 9278) and two non-incarcerated groups (n = 10,086,802). RESULTS The prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non-incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post-incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non-incarcerated groups. CONCLUSIONS People with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post-incarceration.
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Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, Centre for Criminology & Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada
| | - Parisa Dastoori
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lisa Whittingham
- Department of Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | | | - Leslie A Keown
- Research Branch, Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Anna Durbin
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Fiona G Kouyoumdjian
- ICES, Toronto, Ontario, Canada.,Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Lin
- ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yona Lunsky
- ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Lloyd M, Dobranowski K, Cheng SY, Temple VA, Foley JT, Lunsky Y, Lin E, Balogh R. Matching Special Olympics Registration Data with Administrative Health Databases: Feasibility and Health Status Differences in Children and Youth with IDD. Disabil Health J 2022; 15:101319. [DOI: 10.1016/j.dhjo.2022.101319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/26/2022]
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Leonard H, Montgomery A, Wolff B, Strumpher E, Masi A, Woolfenden S, Williams K, Eapen V, Finlay-Jones A, Whitehouse A, Symons M, Licari M, Varcin K, Alvares G, Evans K, Downs J, Glasson E. A systematic review of the biological, social, and environmental determinants of intellectual disability in children and adolescents. Front Psychiatry 2022; 13:926681. [PMID: 36090348 PMCID: PMC9453821 DOI: 10.3389/fpsyt.2022.926681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
AIM This systematic review aimed to identify the most important social, environmental, biological, and/or genetic risk factors for intellectual disability (ID). METHODS Eligible were published prospective or retrospective comparative studies investigating risk factors for ID in children 4-18 years. Exclusions were single group studies with no comparator without ID and a sample size <100. Electronic databases (Medline, Cochrane Library, EMBASE, PsycInfo, Campbell Collaboration, and CINAHL) were searched for eligible publications from 1980 to 2020. Joanna Briggs Institute critical appraisal instruments, appropriate for study type, were used to assess study quality and risk of bias. Descriptive characteristics and individual study results were presented followed by the synthesis for individual risk factors, also assessed using GRADE. RESULTS Fifty-eight individual eligible studies were grouped into six exposure topics: sociodemographic; antenatal and perinatal; maternal physical health; maternal mental health; environmental; genetic or biological studies. There were few eligible genetic studies. For half the topics, the certainty of evidence (GRADE) was moderate or high. CONCLUSION Multiple studies have examined individual potential determinants of ID, but few have investigated holistically to identify those populations most at risk. Our review would indicate that there are vulnerable groups where risk factors we identified, such as low socioeconomic status, minority ethnicity, teenage motherhood, maternal mental illness, and alcohol abuse, may cluster, highlighting a target for preventive strategies. At-risk populations need to be identified and monitored so that interventions can be implemented when appropriate, at preconception, during pregnancy, or after birth. This could reduce the likelihood of ID and provide optimal opportunities for vulnerable infants. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=120032], identifier [CRD42019120032].
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Affiliation(s)
- Helen Leonard
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Alicia Montgomery
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Brittany Wolff
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Elissa Strumpher
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Anne Masi
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Susan Woolfenden
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Valsamma Eapen
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Amy Finlay-Jones
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Martyn Symons
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Melissa Licari
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Kandice Varcin
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Gail Alvares
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Kiah Evans
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Jenny Downs
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Emma Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
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10
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Rosencrans M, Tassé MJ, Kim M, Krahn GL, Bonardi A, Rabidoux P, Bourne ML, Havercamp SM. Invisible populations: Who is missing from research in intellectual disability? RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104117. [PMID: 34736107 DOI: 10.1016/j.ridd.2021.104117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
It is estimated that approximately 41% of adults with intellectual and developmental disability (IDD) are served through the developmental disabilities (DD) system in the US. The remaining 59% include individuals who meet diagnostic criteria but are not actively receiving paid services or may not be known to the DD system. Scholars have referred to this group as the "hidden majority." Very little is known about the health and well-being of these adults. It remains to be seen if the hidden majority is comparably susceptible to mental health difficulties, given how little is known about this population by DD systems. The purpose of this manuscript is to highlight where one may identify individuals belonging to this hidden population and how researchers might effectively recruit from this group so as to ensure more representative samples of all people with IDD.
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Affiliation(s)
| | - Marc J Tassé
- The Ohio State University Nisonger Center, United States
| | - Minje Kim
- The Ohio State University Nisonger Center, United States
| | | | | | - Paula Rabidoux
- The Ohio State University Nisonger Center, United States
| | - Mary Lou Bourne
- National Association of State Directors of Developmental Disabilities Services, United States
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11
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Fortune N, Madden RH, Clifton S. Health and Access to Health Services for People with Disability in Australia: Data and Data Gaps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11705. [PMID: 34770219 PMCID: PMC8583158 DOI: 10.3390/ijerph182111705] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/17/2022]
Abstract
The right of people with disability to enjoyment of the highest attainable standard of health without discrimination on the basis of disability is enshrined in the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Among its obligations as a signatory to the CRPD, Australia is required to collect appropriate information, including statistical and research data, to inform development and implementation of policies to give effect to the Convention. In this commentary, we first describe how the International Classification of Functioning, Disability and Health (ICF) conceptual model of disability can be operationalised in statistical data collections, with a focus on how this is achieved in key Australian data sources such that people with disability can be identified as a population group. We then review existing statistical data on health and health service use for people with disability in Australia, highlighting data gaps and limitations. Finally, we outline priorities and considerations for improving data on health and access to health services for people with disability. As well as conceptual, practical, and ethical considerations, a key principle that must guide future disability data development is that people with disability and their representative organisations must be involved and participate fully in the development of disability data and statistics, and in their use.
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Affiliation(s)
- Nicola Fortune
- Centre for Disability Research and Policy, The University of Sydney, Susan Wakil Health Building, Western Ave., Camperdown, NSW 2050, Australia; (R.H.M.); (S.C.)
- Centre of Research Excellence in Disability and Health, University of Melbourne, 207 Bouverie Str., Carlton, VIC 3053, Australia
| | - Rosamond H. Madden
- Centre for Disability Research and Policy, The University of Sydney, Susan Wakil Health Building, Western Ave., Camperdown, NSW 2050, Australia; (R.H.M.); (S.C.)
| | - Shane Clifton
- Centre for Disability Research and Policy, The University of Sydney, Susan Wakil Health Building, Western Ave., Camperdown, NSW 2050, Australia; (R.H.M.); (S.C.)
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12
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Migliore A, Butterworth J, Nye-Lengerman K. Rethinking Management Information Systems for Scaling up Employment Outcomes. JOURNAL OF DISABILITY POLICY STUDIES 2021. [DOI: 10.1177/10442073211043518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People with intellectual disability, autism, and other developmental disabilities have successfully demonstrated their ability to work in the general labor market. Yet, their employment rate remains substantially lower compared with the general population without disabilities. Scaling up the employment outcomes of this population requires improving the effectiveness and efficiency of employment support systems. To this end, this article recommends supporting employment providers rethink how they use their management information systems (MIS): from primary tools that automate billing and compliance, to tools that track metrics for continuous quality improvement. As federal and state funding policies are the main factors shaping how MIS are currently used, this article recommends that federal and state policy guidelines be issued that enable employment providers to leverage their MIS to improve effectiveness and efficiency, and thus scale up employment outcomes of job seekers.
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13
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Liao P, Vajdic C, Trollor J, Reppermund S. Prevalence and incidence of physical health conditions in people with intellectual disability - a systematic review. PLoS One 2021; 16:e0256294. [PMID: 34428249 PMCID: PMC8384165 DOI: 10.1371/journal.pone.0256294] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/03/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To synthesize evidence on the prevalence and incidence of physical health conditions in people with intellectual disability (ID). METHODS We searched Medline, PsycInfo, and Embase for eligible studies and extracted the prevalence, incidence, and risk of physical health conditions in people with ID. RESULTS Of 131 eligible studies, we synthesized results from 77 moderate- to high-quality studies, which was mainly limited to high-income countries. The highest prevalence estimates were observed for epilepsy, ear and eye disorders, cerebral palsy, obesity, osteoporosis, congenital heart defects, and thyroid disorders. Some conditions were more common in people with a genetic syndrome. Compared with the general population, many health conditions occur more frequently among people with ID, including asthma and diabetes, while some conditions such as non-congenital circulatory diseases and solid cancers occur at the same or lower rate. The latter associations may reflect under-detection. CONCLUSIONS People with ID have a health profile more complex than previously known. There is a pressing need for targeted, evidence-informed population health initiatives including preventative programs for this population.
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Affiliation(s)
- Peiwen Liao
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Claire Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Simone Reppermund
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
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14
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Trofimovs J, Dowse L, Srasuebkul P, Trollor JN. Using linked administrative data to determine the prevalence of intellectual disability in adult prison in New South Wales, Australia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:589-600. [PMID: 33821542 DOI: 10.1111/jir.12836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Studies of the representation of people with intellectual disability (ID) in custody report widely inconsistent findings that reflect variation in how ID is defined and the methods employed for identification. Using linked administrative data may be of utility in studies of the representation of people with ID in custody. However, this approach requires an understanding of the purpose of and factors influencing identification in disparate administrative datasets. METHODS This study uses linked administrative data encompassing disability, health and corrections data for the year 2014 to estimate the prevalence of ID in adult custody and explore how ID representation within administrative data impacts prevalence estimates and what patterns of identification reveal about support service access for this group. RESULTS This study finds that 4.3% of the New South Wales adult custody population had an identified ID. Prisoners with ID were younger, more likely to have had a previous custodial episode and more likely to be Indigenous than the general prison population. Identification of ID across linked administrative datasets is uneven, which, if used in isolation, would result in variation in prevalence estimates according to source data. CONCLUSIONS The utilisation of linkage data from a broad range of health and support services including custody offers a comprehensive identification methodology. Inconsistency in the identification of ID across datasets indicates a potential disjuncture between prisoners with ID and support services, which may have relevance for efforts to reduce reincarceration of those in this population.
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Affiliation(s)
- J Trofimovs
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - L Dowse
- School of Social Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - P Srasuebkul
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - J N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), UNSW Sydney, Sydney, New South Wales, Australia
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15
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Wong K, Glasson EJ, Jacoby P, Srasuebkul P, Forbes D, Ravikumara M, Wilson A, Bourke J, Trollor J, Leonard H, Nagarajan L, Downs J. Survival of children and adolescents with intellectual disability following gastrostomy insertion. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:497-511. [PMID: 32319159 DOI: 10.1111/jir.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Positive health outcomes have been observed following gastrostomy insertion in children with intellectual disability, which is being increasingly used at younger ages to improve nutritional intake. This study investigated the effect of gastrostomy insertion on survival of children with severe intellectual disability. METHODS We used linked disability and health data of children and adolescents who were born in Western Australia between 1983 and 2009 to compare survival of individuals with severe intellectual disability by exposure to gastrostomy status. For those born in 2000-2009, we employed propensity score matching to adjust for confounding by indication. Effect of gastrostomy insertion on survival was compared by pertinent health and sociodemographic risk factors. RESULTS Compared with children born in the 1980s-1990s, probability of survival following first gastrostomy insertion for those born in 2000-2009 was higher (2 years: 94% vs. 83%). Mortality risk was higher in cases than that in their matched controls (hazard ratio 2.9, 95% confidence interval 1.1, 7.3). The relative risk of mortality (gastrostomy vs. non-gastrostomy) may have differed by sex, birthweight and time at first gastrostomy insertion. Respiratory conditions were a common immediate or underlying cause of death among all children, particularly among those undergoing gastrostomy insertion. CONCLUSIONS Whilst gastrostomy insertion was associated with lower survival rates than children without gastrostomy, survival improved with time, and gastrostomy afforded some protection for the more vulnerable groups, and earlier use appears beneficial to survival. Specific clinical data that may be used to prioritise the need for gastrostomy insertion may be responsible for the survival differences observed.
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Affiliation(s)
- K Wong
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - E J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - P Jacoby
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - P Srasuebkul
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - D Forbes
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - M Ravikumara
- Department of Gastroenterology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - A Wilson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- School of Paediatrics, The University of Western Australia, Perth, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - J Bourke
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - J Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - H Leonard
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - L Nagarajan
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Children's Neuroscience Service, Department of Neurology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - J Downs
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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16
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Whittingham L, Durbin A, Lin E, Matheson FI, Volpe T, Dastoori P, Calzavara A, Lunsky Y, Kouyoumdjian F. The prevalence and health status of people with developmental disabilities in provincial prisons in Ontario, Canada: A retrospective cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1368-1379. [PMID: 32529696 DOI: 10.1111/jar.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/15/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on the prevalence of developmental disabilities in people who experience imprisonment and on their characteristics are lacking. METHODS The present authors identified adults with developmental disabilities who were released from Ontario provincial prisons in 2010 and a general population comparator group using administrative data. The present authors examined demographic characteristics, morbidity and healthcare use. RESULTS The prevalence of developmental disabilities was 2.2% in the prison group (N = 52,302) and 0.7% in the general population (N = 10,466,847). The prevalence of psychotic illness, substance-related disorder and self-harm was higher among people in the prison group with developmental disabilities. People with developmental disabilities were more likely to have emergency department visits and hospitalizations in prison and in the year after release. CONCLUSIONS People with developmental disabilities are overrepresented in provincial prisons and have a high burden of disease. Strategies are indicated to prevent incarceration and to improve health.
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Affiliation(s)
- Lisa Whittingham
- Department of Child and Youth Studies, Brock University, Saint Catharines, ON, Canada
| | - Anna Durbin
- ICES, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Lin
- ICES, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Flora I Matheson
- ICES, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Parisa Dastoori
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Yona Lunsky
- ICES, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fiona Kouyoumdjian
- ICES, Toronto, ON, Canada.,Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Strobel NA, Bourke J, Leonard H, Richardson A, Edmond KM, McAullay D. Assessing the quality, efficiency and usefulness of the Western Australian population-based Intellectual Disability Exploring Answers (IDEA) surveillance system: a surveillance system evaluation. BMJ Open 2019; 9:e026003. [PMID: 31630096 PMCID: PMC6803127 DOI: 10.1136/bmjopen-2018-026003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Our overall aim was to evaluate the Western Australian Intellectual Disability Exploring Answers (IDEA) surveillance system. The primary objective was to evaluate the attributes of the system. The secondary objective was to provide recommendations to data custodians and stakeholders to strengthen the system. METHOD The IDEA system was evaluated using process observation, interviews and secondary data analysis of system attributes: usefulness, simplicity, data quality, acceptability, representativeness, timeliness and stability. 2001 US Centers for Disease Control and Prevention guidelines were used. RESULTS We found that the IDEA system was useful, simple, flexible, acceptable, representative, timely and stable. We compared individuals from the IDEA system (n=10 593) with those with cerebral palsy and intellectual disability (ID) (n=582) from another surveillance system. Of the 582 with cerebral palsy and ID, 501 (86.1%) were in the IDEA system and 81 (13.9%) were not. In total, 0.7% of cases (81/10674) with ID were not identified in the IDEA system. There were little differences in cases that were not identified in the IDEA system between Indigenous status, sex and place of residence. CONCLUSIONS The strengths of the IDEA system include having a high data quality resource contributing to national and international data on ID, strong government support and a dedicated management team. Output from studies linking to IDEA data have had major contributions to the international literature about ID. However, limited resources have prevented it from realising its full potential in relation to translational activities. The IDEA system is a valuable resource to address the needs of people living with ID.
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Affiliation(s)
- Natalie A Strobel
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
- NCEPH, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jenny Bourke
- Telethon Kids Institute, West Perth, Western Australia, Australia
| | - Helen Leonard
- Telethon Kids Institute, West Perth, Western Australia, Australia
| | - Alice Richardson
- NCEPH, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Karen M Edmond
- Department Of Women & Children's Health, King's College London, London, UK
| | - Daniel McAullay
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
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18
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Krahn GL, Havercamp SM. From Invisible to Visible to Valued: Improving Population Health of People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:476-481. [PMID: 31568739 DOI: 10.1352/1934-9556-57.5.476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Gloria L Krahn
- Gloria L. Krahn, Oregon State University, College of Public Health and Human Sciences, Corvallis; and Susan M. Havercamp, The Ohio State University Nisonger Center
| | - Susan M Havercamp
- Gloria L. Krahn, Oregon State University, College of Public Health and Human Sciences, Corvallis; and Susan M. Havercamp, The Ohio State University Nisonger Center
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19
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Krahn GL. A Call for Better Data on Prevalence and Health Surveillance of People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:357-375. [PMID: 31568742 DOI: 10.1352/1934-9556-57.5.357] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The U.S. approach to the health of people with intellectual and developmental disabilities (IDD) is fraught with paradox. The health of this population has been of longstanding concern, yet we understand their health less well than many other groups. The U.S. spends much more per person on the well-being of people with IDD compared to the general population, yet the outcomes of those expenditures are disappointing and include significant preventable health disparities. Even as expectations for people with IDD have changed to include better health and greater participation in their communities, eligibility for services that support these outcomes is rooted in expectations of dependence and poverty. This article is a call for better data that considers a series of questions to provide context for understanding the need and directions for better health surveillance of people with IDD.
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Affiliation(s)
- Gloria L Krahn
- Gloria L. Krahn, Oregon State University, College of Public Health and Human Sciences, Corvallis
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