We identified trends in the receipt of preventive health care by adults with intellectual and developmental disabilities by type of residential setting.
Methods.
We used data from the 2008–2009 collection round of the National Core Indicators (NCI) program. Participating states drew random samples of adults receiving developmental disabilities services. The study was observational, with both self-report and report by proxy. Once the random samples were drawn in each state, data were collected using the NCI Adult Consumer Survey. Trained interviewers administered the survey in person.
Results.
The likelihood of a person receiving preventive care procedures was related to age, level of intellectual disability, mobility, health status, and state. Type of living arrangement also affected whether a person received these health services, even after controlling for state, level of disability, and other personal characteristics. In general, people living with parents or relatives were consistently the least likely to receive preventive health exams and procedures.
Conclusion.
With growing numbers of adults being served in the family home, educational and policy-based efforts to ensure access to preventive care are increasingly critical.
References
1.
Office of the Surgeon General (US); National Institute of Child Health and Human Development (US); Centers for Disease Control and Prevention (US). Closing the gap: A national blueprint for improving the health of individuals with mental retardation. Report of the Surgeon General's Conference on Health Disparities and Mental Retardation. Washington: Department of Health and Human Services (US); 2002.
2.
Office of the Surgeon General, Department of Health and Human Services (US). Surgeon General's call to action to improve the health and wellness of persons with disabilities. Washington: HHS; 2005 Also available from: URL: http://www.surgeongeneral.gov/library/calls/disabilities/index.html [cited 2011 Aug 22].
Centers for Disease Control and Prevention (US), National Center on Birth Defects and Developmental Disabilities. Disability and health: Funded state programs [cited 2011 Aug 22]. Available from: URL: http://www.cdc.gov/ncbddd/disabilityandhealth/programs.html
5.
HaydenMFKimSH. Health status, health care utilization patterns, and health care outcomes of persons with intellectual disabilities: A review of the literature. Policy Res Brief2002; 13:1–18.
6.
TraciMASeekinsTSzalda-PetreeARaveslootC.Assessing secondary conditions among adults with developmental disabilities: A preliminary study. Ment Retard2002; 40:119–31.
7.
VoelkerR. Improved care for neglected population must be “rule rather than exception”. JAMA2002; 288:299–301.
8.
CampbellMLSheetsDStrongPS. Secondary health conditions among middle-aged individuals with chronic physical disabilities: Implications for unmet needs for services. Assist Technol1999; 11:105–22.
9.
ReichardAStolzleH.Diabetes among adults with cognitive limitation compared to individuals with no cognitive disabilities. Intellect Dev Disabil2011; 49:141–54.
10.
Rehabilitation Research and Training Center on Disability Statistics and Demographics (StatsRRTC). 2004 disability status reports. Ithaca (NY): Cornell University; 2005.
11.
SmithJP. Healthy bodies and thick wallets: The dual relation between health and economic status. J Econ Perspect1999; 13:145–66.
12.
LakinKCLarsonSSalmiPWebsterA.Residential services for persons with developmental disabilities: Status and trends through 2009. Research and Training Center on Community Living: National Residential Information Systems Project [cited 2011 Aug 22]. Available from: URL: http://rtc.umn.edu/risp09
13.
LakinKCStancliffeRJ. Residential supports for persons with intellectual and developmental disabilities. Ment Retard Dev Disabil Res Rev2007; 13:151–9.
14.
HoweJHornerRHNewtonJS. Comparison of supported living and traditional residential services in the state of Oregon. Ment Retard1998; 36:1–11.
15.
StancliffeRJKeaneS.Outcomes and costs of community living: A matched comparison of group homes and semi-independent living. J Intellect Dev Disabil2000; 25:281–305.
16.
LakinKCDoljanacRByunSStancliffeRTaubSChiriG.Choice-making among Medicaid HCBS and ICF/MR recipients in six states. Am J Ment Retard2008; 113:325–42.
17.
StancliffeRJLakinKCTaubSChiriGByunSY. Satisfaction and sense of well-being among Medicaid ICF/MR and HCBS recipients in six states. Intellect Dev Disabil2009; 47:63–83.
18.
HewittALarsonS.The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising practices. Ment Retard Dev Disabil Res Rev2007; 13:178–87.
19.
LewisMALewisCELeakeBKingBHLindemannR.The quality of health care for adults with developmental disabilities. Public Health Rep2002; 117:174–84.
20.
BershadskyJKaneRL. Place of residence affects routine dental care in the intellectually and developmentally disabled adult population on Medicaid. Health Serv Res2010; 45(5 Pt 1):1376–89.
21.
GordonRMSeltzerMMKraussMW. The aftermath of parental death: Changes in the context and quality of life. In: SchalockRL, editor. Quality of life. Vol 2: application to persons with disabilities. Washington: American Association on Mental Retardation; 1997. p. 25–42.
22.
KrahnGLHammondLTurnerA.A cascade of disparities: Health and health care access for people with intellectual disabilities. Ment Retard Dev Disabil Res Rev2006; 12:70–82.
23.
RimmerJHBraddockDMarksB.Health characteristics and behaviors of adults with mental retardation residing in three living arrangements. Res Dev Disabil1995; 16:489–99.
24.
RoushSEFresher-SamwaysKStolgitisJRabbitatJCardinalE.Self- and caregiver-reported experiences of young adults with developmental disabilities. J Soc Work Disabil Rehabil2007; 6:53–73.
25.
FreedmanRIChasslerD.Physical and behavioral health of adults with mental retardation across residential settings. Public Health Rep2004; 119:401–8.
26.
EmersonE. Health status and health risks of the “hidden majority” of adults with intellectual disability. Intellect Dev Disabil2011; 49:155–65.
27.
LarsonSALakinKCAndersonLKwakNLeeJHAndersonD.Prevalence of mental retardation and development disabilities: Estimates from the 1994/1995 National Health Interview Survey Disability Supplements. Am J Ment Retard2001; 106:231–52.
28.
Human Services Research Institute; National Association of State Directors of Developmental Disabilities Services. National Core Indicators [cited 2012 May 1]. Available from: URL: http://www.nationalcoreindicators.org
29.
IBM/SPSS Inc. SPSS®: Version 18. Chicago: IBM/SPSS Inc.; 2009.
30.
LarsonSAndersonLDoljanacR.Access to health care. In: NehringW, editor. Health promotion for persons with intellectual and developmental disabilities: Disabilities: The state of scientific evidence. Washington: American Association on Mental Retardation; 2005. p. 129–84.
31.
Patient Protection and Affordable Care Act. Pub. L. No. 111-148 (March 2010).
