Health care and intellectual disability

Abstract

Introduction: Although the presence of intellectual disability (ID) per se is not usually regarded as a health problem, the biopsychosocial implications of cognitive impairment contribute to the vulnerability of people with ID in any healthcare system (Wallace and Beange, 2008). The evidence for differences in health determinants, morbidity and mortality profiles and in the ability to access quality health care as compared to the general population is well established. This disparity cannot be explained by social deprivation or biological variations alone (Mencap, 2007; Stoddart et al., 2005). People with ID are more likely to have significant health needs that may go unrecognised and untreated because of communication difficulties, diagnostic overshadowing, discrimination or indifference (Cumella and Martin, 2004; Disability Rights Commission, 2006; Health Care Commission, 2007; Michael, 2008). There is concern that public health measures aimed at reducing mortality in the general population will not address the main healthcare issues for people with ID and indeed may preferentially widen the inequality that already exists (Cooper et al., 2004; NHS Health Scotland, 2004). Therefore, understanding the specific health needs of people with ID, including the impact of gender (O'Hara J, 2008a), ethnicity (McCarthy et al., 2008) and physical and mental co-morbidities and how they determine care pathways is urgently needed. Health indicators are being developed across nations in the hope of improving knowledge about people with ID worldwide (Scholte, 2008; Walsh, 2008; Walsh et al., 2003).