Background There is an increasing interest in the notion of health disparities, inequities and inequalities in Canada and elsewhere. In Canada, individuals with disabilities represent one of six groups identified as particularly vulnerable to health disparities. Method This paper combines the literature related to the concepts of inequity and inequality with the body of knowledge on health disparities faced by individuals with intellectual disabilities. ResultsThe value of distinguishing inequity from inequality, particularly as it relates to the experience of individuals with intellectual disabilities, is highlighted. Conclusions A framework for the study of health inequities based on intellectual impairment is proposed.

The prevalence of intellectual disabilities is often quoted at 1 %. A meta-analysis of articles published between 1980 and 2009 confirmed this prevalence. Changes in diagnostic practices, population characteristics, and exposure to known risk factors in recent years place this estimate in question and make it imperative to examine more recent studies of prevalence and incidence. Twenty relevant articles were obtained from five databases (PubMed, Embase, PsycInfo, Cochrane, and MEDLINE), published between 2010 and 2015. Most studies (n = 17) only reported prevalence estimates, while two provided incidence estimates. Various methodologies were applied, with the majority of studies (n = 16) using administrative data. Heterogeneity in study settings, methodologies, age groups, and case definitions contributed to a range of prevalence estimates (0.05 to 1.55 %). Future research should include reproducible and consistent definitions of intellectual disabilities, provide age-specific estimates, and monitor changes in prevalence over time.

Background While current practices strive to include individuals with intellectual disabilities in community opportunities, stigmatizing attitudes held by the public can be a barrier to achieving true social inclusion. Methods A sample of 625 community members completed the Social Distance Subscale of the Multidimensional Attitude Scale on Mental Retardation. Results Older and less educated participants held attitudes that reflected greater social distance. Participants who had a close family member with an intellectual disability and those who perceived the average level of disability to be 'mild' expressed less social distance. The limited variability in scores leads us to question our overall finding of very favourable attitudes towards social interaction with persons with intellectual disabilities.Conclusions This study demonstrates that although certain demographic variables are still relevant in identifying social distance attitudes, the measurement of this construct requires revision to ensure a valid and sensitive reflection of the public's attitudes.

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Greater amounts of nutritional intake received during the first week in the ICU were associated with longer survival time and faster physical recovery to 3 months but not 6 months post ICU discharge in critically ill patients requiring prolonged mechanical ventilation. Current recommendations to underfeed critically ill patients may cause harm in some long-stay patients.

The large discrepancy in rates of hospitalisation between persons with and without an ID is an indicator of inadequate primary care for this vulnerable population. Decreasing the number of ambulatory care sensitive condition hospitalisations through specialised outpatient programmes for persons with an ID would potentially lead to better health, improved quality of life and cost savings. Future research should include potentially important factors such as disease severity, socio-economic variables and measures of health service organisation in the analysis. International comparisons of ambulatory care sensitive condition hospitalisation rates could point to the benefits and limitations of the health service policy directions adopted by different countries.

Individuals with intellectual and developmental disabilities (IDD) experience high rates of social and health disadvantage. Planning effective services that meet the needs of this vulnerable population requires good population-based data that are collected on a routine, ongoing basis. However, in most jurisdictions, none of the commonly available data (e.g., health or disability benefits administrative data) completely captures the IDD population. To more accurately identify persons with IDD in a population, one solution is to link data across multiple sources. To do this, the authors report on an effort to create a linked database to identify a cohort of adults, aged 18-64, with IDD in Ontario and use these data to examine how the linkage can help study health and healthcare access. The linked dataset was created using four health and one disability income support databases. Standardized differences were used to compare sociodemographic and clinical characteristics of the IDD cohorts identified through the health, disability income support, and linked datasets. Indirect estimation was used to evaluate which IDD subgroups might be over-or underestimated if only a single source of data was available. The linked database identified a cohort of 66,484 adults with IDD (0.78% prevalence). The health and disability income support data each uniquely identified approximately a third of the cohort. Health data were more likely to identify younger adults (18-24 years), those with psychiatric illnesses, and hospitalized individuals. The disability income support data were more likely to identify adults aged 35-54 and those living in lower income neighborhoods. By linking multiple databases, the authors were able to identify a much larger cohort of individuals with IDD than if they had used a single data source. It also enabled the creation of a more accurate sociodemographic and clinical profile of this population as each source captured different segments of it.

The prevalence rate produced by the intermediate algorithm most closely approximated the reported literature rate suggesting the value of imposing a two-physician visit minimum but not restricting the time period covered. While the statistical differences among the algorithms were generally minor, differences in the numbers of individuals in specific population subgroups may be important particularly if they have specific service needs. Health administrative data can be useful for broad-based service planning for individuals with IDD and for population level comparisons around their access and quality of care.