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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2005 Mar 1;96(Suppl 2):S8–S22. doi: 10.1007/BF03403699

Addressing Health Disparities Through Promoting Equity for Individuals with Intellectual Disability

Hélène Ouellette-Kuntz 11,✉, Patricia Minnes 41, Nathalie Garcin 21, Carol Martin 51, M E Suzanne Lewis 31, Jeanette J A Holden 61
PMCID: PMC6976115  PMID: 16078552

Abstract

Intellectual disabilities (ID) are conditions originating before the age of 18 that result in significant limitations in intellectual functioning and conceptual, social and practical adaptive skills. IDs affect 1 to 3% of the population. Persons with ID are more likely to have physical disabilities, mental health problems, hearing impairments, vision impairments and communication disorders. These co-existing disabilities, combined with the limitations in intellectual functioning and in adaptive behaviours, make this group of Canadians particularly vulnerable to health disparities. The purpose of this synthesis article is to explore potential contributory factors to health vulnerabilities faced by persons with ID, reveal the extent and nature of health disparities in this population, and examine initiatives to address such differences. The review indicates that persons with ID fare worse than the general population on a number of key health indicators. The factors leading to vulnerability are numerous and complex. They include the way society has viewed ID, the etiology of ID, health damaging behaviours, exposure to unhealthy environments, health-related mobility and inadequate access to essential health and other basic services. For persons with ID there are important disparities in access to care that are difficult to disentangle from discriminatory values and practice. Policy-makers in the United States, England and Scotland have recently begun to address these issues. It is recommended that a clear vision for health policy and strategies be created to address health disparities faced by persons with ID in Canada.

MeSH terms: Health, health care access, policy, disabled persons, mental retardation Hélène Ouellette-Kuntz

Footnotes

Acknowledgments, Sources of Support and Disclaimer: The original paper that forms the basis of this manuscript was commissioned by the Canadian Institutes of Health Research for the International Think Tank on Reducing Health Disparities and Promoting Equity for Vulnerable Populations held in Ottawa, Canada (September 21–23, 2003). The authors first prepared a draft paper for discussion at the Think Tank. The paper was then revised and finalized by incorporating many of the comments and suggestions made during the Think Tank discussions. While individuals with other disabilities (physical, sensory, mental/emotional) also face significant health disparities, the authors and the Think Tank Disability Discussion Group deemed it desirable to retain the original focus of the paper on intellectual disabilities (ID). Many parallels can be drawn from the focus on ID to other disability groups. However, the issues faced by Canadians with ID, including a history of institutionalization, the lifelong nature of the disability, the effects of cognitive and other deficits through the developmental years and the multiple medical disorders seen across syndromes associated with ID present distinct and extensive vulnerabilities in this population.

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