Health inequalities in people with intellectual disability

McMahon, Martin and Hatton, Chris and Preston, Nancy and Hardy, Claire (2022) Health inequalities in people with intellectual disability. PhD thesis, Lancaster University.

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Abstract

Abstract Background: The opportunity for people with intellectual disability to live a long and healthy life is impacted by the conditions into which they are born, grow up and live. This research provides insight into health and non-medical factors that influence health, in a comparative population of people with and without intellectual disability. Aim: To examine the health, objective and subjective socioeconomic status of adults with and without intellectual disability in Jersey. It explores the prevalence of health problems, polypharmacy and drug-drug interactions and the relationships with objective and subjective socioeconomic status on the health of people with an intellectual disability. Methods: An administrative population of 217 adults with, and a random stratified sample of 2,350 adults without, intellectual disability participated in this study. Proxy respondents were used where people did not have capacity to consent. The prevalence, patterns and relationships with health problems, polypharmacy, drug-drug interactions and socioeconomic status are described. Associations of these characteristics were analysed using univariate and multivariate analysis. Findings: People with intellectual disability have poorer health than the general population which starts earlier in life. They are especially vulnerable to the negative effects of taking multiple medications. Adults with intellectual disability also occupy lower socioeconomic status and report lower levels of subjective socioeconomic status and poorer self-rated health than the general population. Higher subjective socioeconomic status and younger age were significant predictors of better self-rated health reported by the proxy intellectual disability group only, while being employed was associated with better health for all populations. Conclusion: Significant efforts are needed to reduce the non-medical factors that influence the health inequalities experienced by adults with intellectual disability. This study underlines the poorer health and adverse impact that multiple medications may have. Equally, it highlights the atypical and lower socioeconomic position that adults with an intellectual disability experience. Further research in larger prospective comparative studies is needed to understand the relationship between subjective socioeconomic status and health in adults with intellectual disability.