The care of individuals with mental retardation: lessons from the New Zealand experience

Ment. Retard. Dev. Disabil. Res. Rev.

Hammond

Turner

2006

626

539

People with ID represent approximately 2% of the population and, as a group, experience poorer health than the general population. This article presents recent conceptualizations that begin to disentangle health from disability, summarizes the literature from 1999 to 2005 in terms of the cascade of disparities, reviews intervention issues and promising practices, and provides recommendations for future action and research. The reconceptualization of health and disability examines health disparity in terms of the determinants of health (genetic, social circumstances, environment, individual behaviors, health care access) and types of health conditions (associated, comorbid, secondary). The literature is summarized in terms of a cascade of disparities experienced by people with ID, including a higher prevalence of adverse conditions, inadequate attention to care needs, inadequate focus on health promotion, and inadequate access to quality health care services. Promising practices are reviewed from the perspective of persons with ID, providers of care and services, and policies that influence systems of care. Recommendations across multiple countries and organizations are synthesized as guidelines to direct future action. They call for promoting principles of early identification, inclusion, and self-determination of people with ID; reducing the occurrence and impact of associated, comorbid, and secondary conditions; empowering caregivers and family members; promoting healthy behaviors in people with ID; and ensuring equitable access to quality health care by people with ID. Their broadscale implementations would begin to reduce the health disparity experienced by people with ID.

Section: Studies Using Surveysmentioning

confidence: 96%

Section: Residential Effectsmentioning

confidence: 99%

Section: Clinician Practicesmentioning

confidence: 99%

See 1 more Smart Citation

A cascade of disparities: Health and health care access for people with intellectual disabilities

Ment. Retard. Dev. Disabil. Res. Rev.

Hammond

Turner

2006

626

539

“…; Beange ; Kerr et al . ; Hand ; Lennox et al . ; van Schrojenstein Lantman‐de Valk ), but only recently has it been cast within the framework of health disparities and inequities.…”

Section: What Do We Know About Health Disparities Of People With Intementioning

confidence: 99%

Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?

Research Intellect Disabil

Fox

2013

230

184

Background Recent attention to health of people with intellectual disabilities has used a health disparities framework. Building on historical context, the paper summarizes what is known about health disparities from reports and research and provide direction on what to do to reduce these disparities among adults with intellectual disabilities. Methods The present authors examined literature from 2002 to 2011 on health disparities and people with disabilities looking for broad themes on documenting disparities and on research approaches and methods. Results Multiple countries published reports on health of people with intellectual disabilities. Researchers summarized existing research within a health disparities framework. A number of promising methodologies are identified such as health services research, health indicators, enhanced surveillance and mixed-methods. Conclusions Strategies to reduce health disparities include use of data to educate decision makers, attention to social determinants and a life-course model and emphasis on leveraging inclusion in mainstream services where possible.

“…HP 2010 objectives that are related to this principle are 6.2, 6.3, and 6.5 that assess feelings of depression and emotional supports. This goal relates directly to the concern that decentralization of health care following de-institutionalization has transferred responsibility to community providers with inadequate knowledge and little experience caring for the unique needs of persons with IDD [Hand, 1999;McGilloway and Donnelly, 1999;Nottestad and Linaker, 1999;Lewis et al, 2002;Lennox et al, 2003;Cornwell, 2004].…”

Section: Durable Medical Equipmentmentioning

confidence: 99%

Translating policy principles into practice to improve health care access for adults with intellectual disabilities: A research review of the past decade

Ment. Retard. Dev. Disabil. Res. Rev.

Drum

2007

This article extracts principles from two Surgeon General reports, Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation (2002) and Call to Action to Improve the Health and Wellness of Persons with Disabilities (2005), and combines them with the Objectives from Chapter 6 of Healthy People 2010 to create a policy framework. This framework is used to review literature from the past decade on access to health care and health promotion for persons with intellectual and developmental disabilities (IDD). Review of the literature indicates an emerging evidence base for health promotion programs for persons with IDD. Research in health care and health promotion access requires improvements in surveillance and measurement of quality of life, as well as increased participation of persons with IDD and their families in its implementation. While international guidelines for primary health care have been developed for people with IDD, US guidelines are specialty focused and address specific conditions. Despite its recognized importance, there is surprisingly little information on training programs for health care providers to improve care of persons with IDD. Financing of health care continues to threaten access to comprehensive care for persons with IDD, particularly regarding coordination of care and availability of providers who accept Medicaid patients. Community-based sources of health care have been slow to emerge, and there is clear need for assumption of responsibility for providing care to persons with IDD. Future US policy should include consideration of environmental factors in health care access.