Cited by 775Down syndrome and intellectual disability researchDisability Rights and RepresentationFamily and Disability Support Research

A cascade of disparities: Health and health care access for people with intellectual disabilities

Krahn, Gloria L., Hammond, Laura, Turner, Anne·2006·Mental Retardation and Developmental Disabilities Research Reviews

Abstract

People with ID represent approximately 2% of the population and, as a group, experience poorer health than the general population. This article presents recent conceptualizations that begin to disentangle health from disability, summarizes the literature from 1999 to 2005 in terms of the cascade of disparities, reviews intervention issues and promising practices, and provides recommendations for future action and research. The reconceptualization of health and disability examines health disparity in terms of the determinants of health (genetic, social circumstances, environment, individual behaviors, health care access) and types of health conditions (associated, comorbid, secondary). The literature is summarized in terms of a cascade of disparities experienced by people with ID, including a higher prevalence of adverse conditions, inadequate attention to care needs, inadequate focus on health promotion, and inadequate access to quality health care services. Promising practices are reviewed from the perspective of persons with ID, providers of care and services, and policies that influence systems of care. Recommendations across multiple countries and organizations are synthesized as guidelines to direct future action. They call for promoting principles of early identification, inclusion, and self‐determination of people with ID; reducing the occurrence and impact of associated, comorbid, and secondary conditions; empowering caregivers and family members; promoting healthy behaviors in people with ID; and ensuring equitable access to quality health care by people with ID. Their broadscale implementations would begin to reduce the health disparity experienced by people with ID. MRDD Research Reviews 2006;12:70–82. © 2006 Wiley‐Liss, Inc.

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Registry

Crossref · 10.1002/mrdd.20098

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Authors
Krahn, G. L., Hammond, L., & Turner, A.
Affiliations
Oregon Health & Science University (US)
Corresponding author
Krahn, Gloria L.
Venue
Mental Retardation and Developmental Disabilities Research Reviews
Publisher
Wiley
Published
2006-01
Volume
12
Issue
1
Pages
70-82
ISSN
  • 1080-4013 (ISSN-L)
  • 1098-2779
OpenAlex
W2044631678
Cited by
775
References
110
Citations by year
2026: 27 · 2025: 38 · 2024: 51 · 2023: 45 · 2022: 43 · 2021: 44 · 2020: 50 · 2019: 48 · 2018: 54 · 2017: 58 · 2016: 44 · 2015: 49 · 2014: 45 · 2013: 49 · 2012: 43
FWCI
9.99
Type
journal article
Language
en
Open access
closed
Locations
  • Mental Retardation and Developmental Disabilities Research Reviews (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Münchner Zentrum für Gesundheitswissenschaften
  • National Institute on Disability and Rehabilitation Research
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
  • Social Sciences › Safety Research › Disability Rights and Representation
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Keywords
intellectual disability, health disparities, health care access, health promotion, comorbidities, secondary conditions, associated conditions, health determinants, health equity, caregiver empowerment, family involvement, self-determination, early detection, inclusion, health policy, quality of care
MeSH terms
Cross-Cultural Comparison, Health Services Accessibility, Health Services Needs and Demand, Health Status, Humans, Intellectual Disability, Reference Values, Social Justice

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