National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities

doi:10.1016/j.dhjo.2014.11.002

Disability and Health Journal

Volume 8, Issue 2, April 2015, Pages 165-172

https://doi.org/10.1016/j.dhjo.2014.11.002 Get rights and content

Abstract

Background

People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability.

Objectives

The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability.

Methods

This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey.

Results

Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns.

Conclusions

Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed.

Section snippets

Behavior risk factor surveillance system (BRFSS)

The Behavior Risk Factor Surveillance System (BRFSS) generated the surveillance data for the Disability and No Disability groups in this study. BRFSS is a telephone survey directed by the Centers of Disease Control and Prevention to track health conditions and risk behavior. All 50 states participate in this survey with over 350,000 interviews conducted yearly. For this study, the 2010 data for all states and territories is reported. In 2010, the BRFSS had two questions used to screen for

Results

Data are presented for the No Disability (n = 312,144), Disability (n = 132,812), and IDD (n = 20,395) groups on all measures. The No Disability and Disability group were weighted, and the prevalence of disability reported by the BRFSS for this survey year was 22%. Demographic information is presented in Table 1. The Disability group was slightly older than the other two groups. The percentage of men in the IDD sample was significantly larger than in the other samples. This preponderance of

Discussion

These findings indicate that people with disability, including IDD, are more likely to have health risks compared to people without disability. Most striking were the differences between the groups in the areas of physical activity and emotional support. Both Disability groups reported less exercise compared to the No Disability group and almost 50% of the IDD sample reported no physical activity whatsoever in the past month. People with disability were much more likely to smoke cigarettes

Limitations

This study was limited by the survey methodology, which prevented us from confirming disability status, exploring the nature or severity of disability, or checking the accuracy of the information reported. The NCI data for the IDD group was limited to adults receiving state DD services; these findings may not generalize to the many adults in the community who may have an intellectual or developmental disability but do not receive services. The BRFSS identifies people with disability using two

Conclusions

The use of large scale nationally representative survey data gives a unique look into the health access and health behaviors of Americans with disability. This study demonstrated the gaps in health care access at a national level, particularly for people with IDD, and shed light on the areas where intervention and reform are most needed. Similarly, this study provides valuable knowledge of the health risks of people with disability and IDD and can help direct practice and policy. Studies such

Acknowledgments

The authors would like to express our gratitude to Brian S. Armour, PhD, Economist, and Alissa Cyrus Stevens, MPH, CPH, Health Scientist, National Center on Birth Defects and Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia for help with BRFSS data.

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: Source of support and disclaimer: This work was supported in part by the Centers for Disease Control and Prevention Cooperative Agreement Number 5U59DD000931-02. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

: Disclosure: We have no financial disclosures or conflicts of interest to disclose.

View full text

Research PaperNational health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities

Abstract

Background

Objectives

Methods

Results

Conclusions

Section snippets

Behavior risk factor surveillance system (BRFSS)

Results

Discussion

Limitations

Conclusions

Acknowledgments

Arch Phys Med Rehabil

Am J Prev Med

Disabil Health J

Seizure

Arch Phys Med Rehabil

Womens Health Issues

Disabil Health J

Lancet

Am J Prev Med

Disabil Health J

Disabil Health J

Prev Med

Defining equity in health

J Epidemiol Community Health

The concepts and principles of equity and health

Int J Health Serv

Obesity and disability – a short review

Obes Rev

Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina

Public Health Rep

The health of adults with disability in family practice-1990-2003

A descriptive study of secondary conditions reported by a population of adults with physical disabilities served by three independent living centers in a rural state

J Rehabil

Disability as a public health issue: findings and reflections from the Massachusetts Survey of secondary conditions

Milbank Q

Assessing secondary conditions among adults with developmental disabilities: a preliminary study

Ment Retard

Prevalence of secondary conditions among people with disabilities

Am J Public Health

America's neglected health minority: working-age persons with disabilities

Milbank Q

A profile of state-level differences in the oral health of people with and without disabilities, in the U.S., in 2004

Public Health Rep

General practitioners' perception of their role in care for people with intellectual disability

J Intellect Disabil Res

Managing the care of patients with mental retardation: a survey of physicians

Ment Retard

Commentary: defining disability in health care education

Acad Med

Teaching medical students about disability: the use of standardized patients

Acad Med

Desired educational outcomes of disability-related training for the generalist physician: knowledge, attitudes, and skills

Acad Med

Women's health

Understanding health disparities and inequities faced by individuals with intellectual disabilities

J Appl Res Int Dis

Body weight status among adults with intellectual disability in the community

Ment Retard

Body mass index in adults with intellectual disability: distribution, associations and service implications: a population-based prevalence study

J Intellect Disabil Res

Mental ill-health in adults with intellectual disabilities: prevalence and associated factors

Br J Psychiatry

The quality of health care for adults with developmental disabilities

Public Health Rep

Research Paper
National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities