TABLE 1.

Systematic Review Results for Disparities Between Women With and Without Disabilities

Study	Topic	Disability	Outcomes
Blustein & Weiss, 1998	Preventive  screenings	ADL limitations	WWD significantly less likely to have had a  mammogram (21.3% vs. 32.1%) during 2-year  period.
Caban et al., 2002	Cancer; health  services use	Physical/mobility	No significant difference between WWD and  nondisabled women in stage at diagnosis or  type of breast cancer treatment received.
Cerhan & Chiu, 1998	Cancer	Mobility/physical  functioning	WWD at decreased risk for breast cancer  compared to inactive nondisabled women  (RR D 0.4; 95% CI, 0.2–0.9).
Chan et al., 1999	Preventive  screenings	ADL limitations	WWD aged 45+ less likely than nondisabled  women to have past-year mammogram  (13.2% vs. 43.6%). WWD <71 less likely to  have Pap test in past year (23.0% vs. 41.2%),  more likely to have past-year flu vaccine  (67.4% vs. 57.3%), and as likely to have  lifetime pneumonia vaccine (32.0% vs. 32.9%).
Diab & Johnston, 2004	Preventive  screenings	ADL limitations	WWD aged 50+ less likely than nondisabled  women to have received a mammogram (p <  .05) in 1998 data; no differences in 2000 data.  In both years, WWD aged 50+ less likely to  have received clinical breast exam (p < .05)  and all WWD aged 18+ less likely to have  received Pap test (p < .05).
Eden et al., 1995	Health services use	Physical	WWD visited physician (74% vs. 53.8%,  p < .001), physiotherapist (25.2% vs. 12%,  p < .001), and alternative caregiver (9.8% vs.  3%, p < .01) more often than controls. No  differences for visits with district nurse or  inpatient care. Prescription drug use higher  among WWD than controls (p < .001).
Emerson, 2005	Health promotion	Intellectual disability	WWD more likely to be inactive than  nondisabled women (p < .001).
Graciani et al., 2004	Chronic disease;  cancer; mental  health/substance  use	ADL, IADL, mobility  and agility  limitations	WWD had greater chronic disease than  nondisabled women: hypertension (43.3% vs.  20.2%), ischemic heart disease (5.7% vs. 1.7%),  and diabetes (16.9% vs. 9.6%). WWD more  likely to have prevalent cancer than  nondisabled women (2.5% vs. 1.3%). WWD  had greater depression (15.4% vs. 8.2%).
Havercamp et al., 2004	Preventive  screenings	Intellectual disability;  other disabilities	Women with intellectual disability more likely to  never have had Pap test (RR, 5.3; 95% CI, 2.9–  9.5) or mammogram (age 40+) (RR, 2.1; 95%  CI, 1.4–3.0) than nondisabled women. Women  with other disabilities did not significantly  differ from nondisabled women.
Hermon et al., 2001	Chronic disease;  cancer	Intellectual disability	Mortality for WWD significantly elevated for  diabetes (SMR = 1,125), epilepsy (SMR =  3,995), heart/circulatory diseases (SMR = 457),  and all causes combined (SMR = 805).  Leukemia mortality for WWD significantly  elevated (SMR = 1,626).
Iezzoni et al., 2000	Preventive  screenings	Physical/mobility	In adjusted analyses, WWD significantly less  likely to have received Pap test (OR, 0.6; 95%  CI, 0.4–0.9) or mammogram (age 50+) (OR,  0.7; 95% CI, 0.5–0.9).
Jones & Bell, 2004	Chronic disease;  mental health/  substance use	Functional limitations  including  communication  limitations	WWD more likely to have hypertension (41.8%  vs. 12.1%) and diabetes (15.3% vs. 1.8%) than  nondisabled women. WWD more likely to be  current smokers (52.6% vs. 47.0%) and heavy  smokers (7.0% vs. 2.1%) but less likely to be  current drinkers (4.1% vs. 61.2) or heavy  drinkers (>7/week) (3.6% vs. 3.9%) than  nondisabled women.
Kapell et al., 1998	Chronic disease	Intellectual disability	For women with Down syndrome, SMR  significantly lower than expected for  hypertension (0.2; 95% CI, 0.1–0.6) and  significantly higher for thyroid disorders (10.1;  95% CI, 6.6–14.8) and nonischemic heart  problems (6.4; 95% CI, 4.1–9.6). For females  with other intellectual disability, SMR  significantly higher for heart problems (1.9;  95% CI, 1.2–3.0) compared to NHIS.
Korten et al., 1998	Health services use	ADL, hearing/visual  limitations	ADL and visual impairment significantly  associated with more GP visits, β(SE):  ADL = 0.063 (0.017); visual impairment =  0.061 (0.026).
Mandelblatt et al., 2001	Health services use	Functional limitations	WWD less likely to receive BCS with  radiotherapy (more likely to receive BCS alone  or mastectomy) and less likely to receive  chemotherapy.
Moore & Li, 1998	Mental health/  substance use	Various	Illicit drug use higher among WWD than the  general population. Greatest difference for  crack use (>3x higher than general  population).
Morgan et al., 2003	Chronic disease	Intellectual disability	WWD more likely to have epilepsy (age  standardized RR, 22.4; 95% CI, 18.64–26.92).
Nosek & Howland, 1997	Preventive  screenings	Physical	WWD less likely to receive regular pelvic exams  (67.1% vs. 72.8%) (significant for women with  severe disabilities). No difference for  mammograms.
Nosek & Gill, 1998	Preventive  screenings	Functional limitations	WWD were as likely to have ever had a Pap test  but less likely to have had a recent Pap test  (1–2 FLs: 64.8%; ≥3 FLs: 60.6%; none: 76.1%).  WWD aged 65+ with ≥3 FLs were less likely  to have had a mammogram ever (64.7% vs.  73.3%) or in last 2 years (42.5% vs. 56.5%)  than nondisabled women.
Patja et al., 2001	Cancer	Intellectual disability	No difference in overall rates of cancer
Rimmer et al., 1994	Mental health/  substance use	Intellectual disability	WWD less likely to smoke (0% in 16+ bed  facility, 6.7% in group homes, 2.1% in natural  family) than Framingham women (27%).
Roetzheim & Chirikos, 2002	Cancer	Various	WWD less likely to have cancer diagnosed at  early stage (OR, 0.77; 95% CI, 0.61–0.97). No  differences in breast cancer–specific mortality  rates.
Schootman & Fuortes, 1999	Preventive  screenings	ADL and IADL  limitations	Women with severe limitations were less likely  to have had a Pap test (65.5%) compared to  women with some limitations (72.8%) and  women with no limitations (78.9%). No  differences on mammograms.
Schootman & Jeffe, 2003	Preventive  screenings	ADL and IADL  limitations	WWD were significantly less likely to have had a  mammogram in the past year than  nondisabled women (p < .001).
Schultz-Pedersen et al., 2001	Cancer	Intellectual disability	Cancer incidence in WWD significantly lower  than general population (SIR, 0.15; 95% CI,  0.0–0.9).
Stronks et al., 1997	Chronic disease	Various	WWD significantly more likely than employed  women to have one or more chronic  conditions (OR, 5.29; 95% CI, 4.02–6.97).
Sullivan et al., 2003	Cancer	Intellectual disability	WWD had lower incidence of breast cancer  (SIR, 0.44; 95% CI, 0.27–0.68).
Sullivan et al., 2004	Cancer	Intellectual disability	Overall cancer risk in WWD not significantly  different from general population. Higher  incidence of colorectal cancer (SIR, 3.10;  95% CI, 1.42–5.88), leukemia (SIR, 4.64;  95% CI, 2.40–8.11), and uterine cancer  (SIR, 2.98; 95% CI, 1.29–5.87) in WWD.
Tomiak et al., 1998	Health services use	Various	WWD had more hospital separations (OR, 3.8),  hospital separated days (OR, 4.5), physician  services (OR, 1.7), physician costs (OR, 1.9),  and nursing home entry (OR, 3.7) than  nondisabled women.
Wyrwich & Wolinsky, 2000	Health services use	ADL limitations	Among inactive women, there were no  differences between those with disabilities and  those without.

Note. ADL = activities of daily living; BCS = breast conservation surgery; CI = confidence interval; FL = functional limitations; IADL = instrumental activities of daily living; NHIS = National Health Interview Survey; OR = odds ratio; RR = relative risk; SIR = standardized incidence ratio; SMR = standardized mortality ratio; WWD = women with disabilities.