eric emerson learning disabilities public health observatory
TRANSCRIPT
Eric Emerson
Learning Disabilities Public Health Observatory
Three questions◦ Who are ‘people with intellectual disability’?◦ What do we know about international variation in
the health inequalities faced by people with intellectual disability?
◦ Why do these health inequalities exist? Future directions
The ‘hidden majority’
Little known◦ Poor health◦ High rates of
poverty & social exclusion
◦ Invisible to intellectual disability services (and policy)
Administrative Prevalence of Intellectual Disability in England
Mortality Morbidity
◦ Impairments◦ Physical health◦ Mental health
Health states & behaviours◦ Obesity◦ Inactivity◦ Smoking, drug use & sexual health?
Variation in need◦ incidence of intellectual disability (nearly all
preventable)◦ prevalence?◦ health status?
Variation in expenditure, policies and health care systems ◦ in general◦ for people with intellectual disabilities?
Syndrome-specific biological vulnerability◦ Down’s syndrome:
congenital heart defects, hearing loss, early onset dementia
Impact of intellectual disability ◦ Vulnerability to poorer
physical and mental health
◦ Self-identification of ‘ill health’
◦ Communication of health needs
◦ Understanding health promotion
Overt and institutional discrimination in health care systems
Social Determinants of Health: Social position and inequality are related to ...◦ Mortality◦ Morbidity
Impairments Physical health Mental health
◦ Health behaviours Obesity Inactivity Smoking, drug use & sexual health
People with intellectual disability are more likely than others to be exposed from infancy onwards to a wide range of material and psychosocial hazards◦ Poverty◦ Low social status◦ Low control◦ Victimisation & abuse
The poorer health of people with intellectual disability is (in part) due to their experience of deprivation and disadvantage (rather than their intellectual disability per se)
High rates of mental health problems among children with intellectual disability
Over 50% of children in the UK who have intellectual disability and a mental health problem are currently living in poverty
33%-50% of this increased risk is possibly due to increased exposure to poverty
Adversity Index
Prevalence of Diagnosable Mental Health Disorders
Better understanding of the health (and the determinants of health) of the ‘hidden majority’ of adults with intellectual disability
Better understanding of international variation in need and capacity
Combat discrimination in health care systems (and more generally)
Address the wider social determinants of health◦ Change the odds of exposure to adversity◦ Beat the odds when exposed (build resilience)
A public health approach to the health inequalities faced by people with intellectual disabilities
Improve daily living conditions
Tackle the inequitable distribution of power, money, and resources
Measure and understand the problem and assess the impact of action
