Review ArticleHealth outcome disparities among subgroups of people with disabilities: A scoping review
Section snippets
Study rationale
Approximately 19% of the US population has a disability.3 Prevalence of disability increases with age such that most people will experience some type of disability during their lifetime.3, 4 A growing body of research has found that people with disabilities experience lower health status and an excess burden of disease relative to the general US population.5, 6, 7 These studies and others have examined the health disparities experienced by people with disabilities compared to other demographic
Objectives
The purpose of this study was to conduct a scoping review of literature to describe recent research activity that has examined health outcome disparities within populations of people with disabilities. Scoping reviews use broad key questions and aim to describe the extent, range, and nature of research activity in a specific subject area as a means of mapping the landscape of the field.9 Our review sought to explicate what disability research has occurred and where gaps currently exist. We
Protocol
Scoping reviews use systematic review methods for identifying potentially relevant evidence and assessing it for inclusion. This scoping review used guidelines described by international leaders in systematic review methodology. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement informed the steps and flow of the review.10 The Cochrane Collaboration Handbook informed the development of key questions and criteria for included studies.11 Reporting of
Results
Our search methods retrieved 4248 unique references for review. At the abstract review stage, 239 articles were selected for full-text review. During full text review, we identified 29 articles for inclusion in the present analysis (see Fig. 1).
Summary of the literature landscape
While most variables we assessed have not been well studied, our review reveals concentrations of research on some health outcomes (diabetes, heart disease, cancer, respiratory disease, and accidents/injuries) and disparity factors of interest (disability type, disability severity, age, gender, race, income, and education). In other words, studies are clustered in a few areas, leaving a significant lack of research in other areas. With regard to intersections of variables, a few emerging areas
Conclusions
There are many significant gaps in research on health disparities among people with disabilities. Most of the disparity factors and health outcome intersections examined in this scoping review are typified by little to no data. More research is needed to understand which groups are most at risk and what factors are associated with health disparities between subgroups of people with disabilities. Future research should use rigorous methods and clear and consistent definitions of terms. Building
Acknowledgments
We thank Dolores Judkins of OHSU libraries for her guidance and consultation on our electronic search strategies. We also thank Colleen Kidney and Erin Stack for their assistance in reviewing abstracts and articles for inclusion.
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Funding: This work was supported by grant #H133A080031 from National Institute on Disability and Rehabilitation Research/DOE. However, the contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.
Conflicts of interest: The authors report no conflicts of interest.