Tuesday, February 23, 2010

Healthy People With Disabilities

I've got an Olympics story for you. And no, it's not about how the one ice-dancing team got decked out in faux-aboriginal costumes and skated to music that included the didgeridoo.

It's about Special Olympics and public health.

One benefit of the Special Olympics program that I had not been aware of is the component that offers health screenings to the athletes. In the 1990s, Special Olympics began compiling some alarming statistics based on the results of their screenings in their Healthy Athletes program. They were finding uncorrected errors in vision (up to 85% of the athletes), and major oral health issues (68% of the athletes screened had gingivitis, 33% had at least one obvious dental decay). They ended up referring some athletes directly to the emergency room for acute pain!

Special Olympics commissioned a literature review through the Yale University School of Medicine, which reported in Dec. 2000 that compared to the general population, people with intellectual disabilities -- then called mental retardation -- have:
  • Four times more preventable mortality
  • Less access to primary and specialty health care providers, including physicians and dentists
  • Higher rates of obesity, otitis media, asthma, cardiovascular disease, depression and other mental health conditions.

A Special Hearing on Promoting Health for People with Mental Retardation was held in the spring of 2001 by the U.S. Senate Appropriations Committee, and the Surgeon General called a conference on health disparities that December. Health disparities for people with disabilities, developmental and otherwise, have thus been on the national radar for about a decade now. There's a section in the national Healthy People 2010 goals that recognize the disparities, and the next round (Healthy People 2020) now includes draft goals like:
  • Reduce the proportion of children and adolescents with disabilities who are reported to be sad, unhappy, or depressed.
  • Increase the proportion of people with disabilities who report having access to health and wellness programs.
  • Reduce the proportion of people with disabilities who report unmet need for assistive devices, service animals, technology services, and accessible technologies they need.

One slide in the presentation that struck me in particular involved numbers coming out of Oregon in 2006 on health/behavior risk factors. 27.3% of the people with disabilities in the survey were smokers, as opposed to only 19.3% of people without disabilities. 30.1% of the people with disabilities had obesity issues, compared to only 17.9% of people without disabilities.

Another slide came out of Ohio State University on what health-care providers were likely to talk about when seeing a patient with a disability. Providers were more likely to ask about pain, stress, depression, work and hobbies. They were less likely to discuss smoking, blood pressure, cholesterol, mammograms, colorectal exams, or sexual activity.

The class session was a teleconference, reaching multiple LEND programs across the country. It was inspiring to be a part of a group of up-and-coming professionals who will be working with people with disabilities, discussing how one might incorporate awareness and progress on these issues into one's personal practice but also on a larger (leadership) scale. I hasten to add that we did not manage to solve the world's problems in a single teleconference... but even just having the awareness among the LEND group was an important step. I know that I'd never thought about this on a macro level.

Micro level... keep advocating for your own child, and don't let the basic health stuff get too drowned out by the special needs.

Macro level? Whew. Big issues.


Jess said...

Scary stuff indeed.

I wonder -

What their parents' health profile looks like too.

Anonymous said...

very good micro-level advice! just survived a trip to the dentist. something as simple as brushing/flossing teeth can be a battle in our house, but better to "suffer" a little now than suffer a lot later.

Anonymous said...

I generally fall on the side that parents do as well as they can - allowing that many do not do very well by some standards. But doesn't this statistic also show a failure in the public schools? Why isn't brushing teeth made easy in school?

Looks like it took 20 years to just goal this issue at the national level. (If I read this correctly.) I guess that is consistent with developmental timing for macro social changes (a generation).

I am spurred to post on oral hygiene in my effort to address function this year - thanks, JoyMama!

Break a leg tomorrow when you present at LEND. BRatK

JoyMama said...

Therextras - I perhaps could have worded it better. There's actually a substantial section in Healthy People 2010 on disabilities (written in 2000-ish), and it's up for further expansion in the 2020 goals. See http://www.healthypeople.gov/dOCUMENT/HTML/Volume1/06Disability.htm for the 2010 info.

Thanks for the good wishes! We're bringing cookies for the class -- some GFCF, some not!