Hatton / Emerson Health Disparities and Intellectual Disabilities

1. Auflage 2015
ISBN: 978-0-12-802484-3
Verlag: Elsevier Science & Techn.
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, Band Volume 48, 284 Seiten

Reihe: International Review of Research in Developmental Disabilities

International Review of Research in Developmental Disabilities is an ongoing scholarly look at research into the causes, effects, classification systems, and syndromes of developmental disabilities. Contributors come from wide-ranging perspectives, including genetics, psychology, education, and other health and behavioral sciences. - Provides the most recent scholarly research in the study of developmental disabilities - A vast range of perspectives is offered, and many topics are covered - An excellent resource for academic researchers

Autoren/Hrsg.

Hatton, Christopher

Emerson, Eric

Leseproben

Chapter One

Introduction

Health Disparities, Health Inequity, and People with Intellectual Disabilities

Chris Hatton* and Eric Emerson*,§,1     *Centre for Disability Research, Lancaster University, Lancaster, Lancashire, UK     §Centre for Disability Research and Policy, University of Sydney, NSW, Australia
1 Corresponding author: e-mail address: [e-mail] 

Abstract

In this chapter, we provide a brief overview of what is known about disparities in the health of people with intellectual disabilities when compared to those in their non-intellectual disabled peers and current approaches to conceptualizing the causes of these differences. We then provide an overview of the six chapters that form the core of this edited volume on the health disparities (and inequities) experienced by people with intellectual disabilities.

Keywords

Developmental disabilities; Health; Health disparities; Health inequity; Health measurement; Intellectual disability

Extensive evidence from high-income countries in Europe, North America, and Australasia indicates that people with intellectual disabilities experience substantially poorer health outcomes than their nonintellectually disabled peers (Anderson et al., 2013; Emerson & Hatton, 2014; Krahn & Fox, 2014; Krahn, Hammond, & Turner, 2006; O'Hara, McCarthy, & Bouras, 2010; Oeseburg, Dijkstra, Groothoff, Reijneveld, & Jansen, 2011; Prasher & Janicki, 2003; Scheepers, Kerr, O'Hara, Bainbridge, & Cooper, 2005; Sutherland, Couch, & Iacono, 2002; Taggart & Cousins, 2014; Van Schrojenstein Lantman-de Valk, 2005). They are more likely to die at an earlier age (e.g., Bittles et al., 2002; Emerson, Glover, Hatton, & Wolstenholme, 2014; Glover & Ayub, 2010; Heslop et al., 2014; Hollins, Attard, van Fraunhofer, McGuigan, & Sedgwick, 1998; McGuigan, Hollins, & Attard, 1995), to have poor rated general health (e.g., Emerson & Hatton, 2007a, 2007c; Emerson, Hatton, Robertson, & Baines, 2014; Haider, Ansari, Vaughan, Matters, & Emerson, 2013; Havercamp & Scott, 2015; Larson, Lakin, Anderson, & Kwak, 2001), and to live with a wide range of complex health conditions such as,

• epilepsy (e.g., Beange, McElduff, & Baker, 1995; Cardoza & Kerr, 2010; Schieve et al., 2012; Straetmans, van Schrojenstein Lantman-de Valk, Schellevis, & Dinant, 2007);

• sensory impairments (e.g., Beange et al., 1995; Nielsen, Skov, & Jensen, 2007; Oeseburg et al., 2011; van Splunder, Stilma, Bernsen, & Evenhuis, 2006);

• respiratory disorders (e.g., Oeseburg et al., 2011; Schieve et al., 2012; Straetmans et al., 2007);

• obesity (e.g., Beange et al., 1995; Melville, Hamilton, Hankey, Miller, & Boyle, 2007);

• diabetes (e.g., Straetmans et al., 2007);

• oral health problems (e.g., Davies, 2012; Morgan et al., 2012);

• disorders of the digestive system (e.g., Böhmer et al., 1999; Davis, 2010; Schieve et al., 2012; Straetmans et al., 2007);

• osteoporosis (e.g., Center, Beange, & McElduff, 1998; Jaffe, Timell, & Gulanski, 2001);

• mental health problems (e.g., Cooper, Smiley, Morrison, Williamson, & Allan, 2007; Einfeld, Ellis, & Emerson, 2011; Emerson, 2011).

Historically, the poorer health of people with intellectual disabilities has been primarily understood as being caused by the biological bases of syndromes or conditions associated with intellectual disability. More recently, these disparities in health status have begun to be conceptualized as examples of health inequity, differences in health status that, being caused by environmental factors beyond the control of individuals concerned, are avoidable, unfair, and unjust (Emerson & Durvasula, 2005; Emerson & Hatton, 2014; Graham, 2005; Krahn et al., 2006; Ouellette-Kuntz, 2005). Evidence that supports an inequity perspective has emerged from disparate sources including investigations by government agencies on the health and healthcare of people with intellectual disabilities (e.g., Disability Rights Commission, 2006; Michael, 2008; NHS Health Scotland, 2004; Parliamentary and Health Service Ombudsman and Local Government Ombudsman, 2009; US Department Health & Human Services, 2002) and research studies that have investigated such issues as

• access to appropriate healthcare and health promotion programs (Alborz, McNally, & Glendinning, 2005; Hayden, Kim, & DePaepe, 2005; Norwood & Slayton, 2013; Osborn et al., 2012; Parish & Saville, 2006) and the quality of management of health conditions among people with intellectual disabilities (Balogh, Brownell, Ouellette-Kuntz, & Colantonio, 2010; Bowley & Kerr, 2000; Janicki et al., 2002; Jensen, Taylor, & Davis, 2013; Lunsky et al., 2014; McDermott et al., 2005);

• lifestyle factors (e.g., lack of exercise and poor nutrition) associated with poorer health among people with intellectual disabilities (Bartlo & Klein, 2011; Robertson, Emerson, Baines, & Hatton, 2014; Robertson et al., 2000);

• exposure to environmental factors (e.g., poverty and violence) associated with poorer health among people with intellectual disabilities (Emerson, 2010, 2013; Emerson & Hatton, 2007b, 2007c, 2007d; Emerson, Hatton et al., 2014);

The aim of this volume of International Review of Research in Developmental Disabilities is to summarize what is known (and what needs to be known) about the impact of this “cascade of disparities” (Krahn et al., 2006) on the health and well-being of people with intellectual disabilities.

In Chapter 2, Emerson and Spencer review the existing knowledge about the determinants of health inequities experienced by children with intellectual disabilities. They argue that the limited evidence that is available indicates that children with intellectual disabilities are at an increased risk of exposure to all of the major categories of social determinants of poorer physical and mental health. They are more likely to live in households characterized by low socioeconomic position and poverty, and to be exposed to recurrent poverty. They are more likely to be exposed to a wide range of material and psychosocial hazards that are detrimental to their health, including inadequate nutrition, poor housing conditions, exposure to environmental toxins, family, peer and community violence, poor parenting and family instability. They are also less likely to have access to the resources necessary to build resilience in the face of adversity. However, the literature in this area is highly variable in its scope and quality. In order to better identify and understand health inequities in this group of children, they suggest three priorities for future research: (1) longitudinal studies using the extensive network of cohort studies in high-income countries to elucidate pathways and mechanisms in the association of low family socioeconomic position with childhood intellectual disability and to strengthen the evidence base on the combined impact of socioeconomic position and intellectual disability on health and well-being across the life course; (2) cross-sectional and longitudinal studies in different country settings to strengthen the evidence base in areas where it is weak; (3) controlled interventions designed to test approaches to reducing discrimination and strengthening resilience at both an individual and societal level.

In Chapter 3, Lauer, Heslop, and Hoghton present a comprehensive review of premature mortality among people with intellectual disabilities, with a particular focus on data from the United States and the United Kingdom. They highlight some of the major challenges to obtaining mortality data concerning people with intellectual disabilities, including reliably identifying people with intellectual disabilities in administrative information systems (see also Chapter 4), and obtaining consistent and valid information on the cause of death. Whilst life expectancy is increasing for people with intellectual disabilities, it is not approaching the life expectancy for the rest of the population, with median age of death at least 20 years younger for people with intellectual disabilities compared to that for the general population. The major causes of death are similar to those for the general population but more diverse among people with intellectual disabilities. Furthermore, much of the excess mortality associated with many causes of death for people with intellectual disabilities is preventable through better access to effective healthcare and support, or amenable through better public health measures to improve healthy lifestyles. The authors conclude with priorities for ensuring better mortality data, and its effective use to drive improvements in healthcare for people with intellectual disabilities.

In Chapter 4, Hatton and colleagues use case studies from the United States, Canada, and England to frame a...