Uncovering health care inequalities among adults with intellectual and developmental disabilities.
Ward RL, Nichols AD, Freedman RI. Department of Sociology, Anthropology, Social Work, and Criminal Justice, SUNY Fredonia, NY 14063, USA. rolanda.ward@gmail.com Health Soc Work. 2010 Nov;35(4):280-90.
Even as attention is drawn to the increasing number of individuals who experience health inequalities in the United States, little is known about the health inequalities experienced by individuals with intellectual and developmental disabilities. Current disability research mainly focuses on physical disabilities. This article discusses the health disparities experienced by individuals with intellectual and developmental disabilities.The authors conducted focus groups with parents/guardians, self-advocates, and community support professionals and key informant interviews with health care professionals to assess the needs of this less frequently documented population. Results from this study indicate that individuals with intellectual and developmental disabilities face health care disparities and inequities in four areas: access, knowledge, communication, and quality.
Disparities in service utilization and expenditures for individuals with developmental disabilities.
Harrington C, Kang T. Department of Social and Behavioral Science, University of California, San Francisco, CA 94118, USA. charlene.harrington@ucsf.edu Disabil Health J. 2008 Oct;1(4):184-95.
BACKGROUND: The factors that affect access to services for individuals with developmental disabilities (DD) have not received much attention.
METHODS: This study examined service utilization and expenditures provided by regional centers to individuals with DD living at home and in residential settings in California in 2004–2005. Logistic regressions of secondary data were used to predict the receipt of services, and ordinary least squares regressions were used to examine the predictors of service expenditures.
RESULTS: Of the 175,595 individuals assessed with DD, 21% did not receive any purchased services from regional centers in 2004–2005. Controlling for client needs, individuals aged 3–21 years were less likely than other age groups to receive services. All racial and ethnic minority groups were less likely to receive any services than were whites. The supply of intermediate care facilities for habilitation and residential care reduced the likelihood of receiving regional center services. Of those who received services, younger individuals and all racial and ethnic minority groups had significantly lower expenditures. Provider supply, area population characteristics, and regional centers also predicted variation in service use and expenditures.
CONCLUSION: The disparities by age, race/ethnicity, and geographic area require further study, and specific approaches are needed to ensure equity in access to services.
Health services, health promotion, and health literacy: Report from the State of the Science in Aging with Developmental Disabilities Conference.
BACKGROUND: This study examined the types of services and expenditures for 8 service categories provided by regional centers to 138,336 individuals with developmental disabilities living at home and in the community in California in 2004-2005.
METHODS: Logistic regressions of secondary data were used to predict the types of services received, and ordinary least squares regressions were used to predict types of service expenditures.
RESULTS: Higher client needs generally were associated with higher odds of receiving services and with expenditures, although the types of services varied by client need. Controlling for client needs and other factors, males were more likely to receive out-of-home services. Individuals aged 3-21 years were generally less likely to receive many services but were more likely to receive in-home and out-of-home respite services than were those over age 62. All racial and ethnic minority groups were less likely to receive support and out-of-home services than were whites and had lower expenditures, although these varied by the types of services. The supply of nursing homes, community care facilities, area population characteristics, and regional centers also predicted variations in service use and expenditure patterns.
CONCLUSION: Studies of the underlying reasons for the variations are needed to ensure equity in access to all types of services and expenditures.
Photovoice with vulnerable populations: addressing disparities in health promotion among people with intellectual disabilities.
Jurkowski JM, Paul-Ward A. Department of Health Policy, Management, and Behavior, University at Albany, SUNY, School of Public Health, USA. Erratum in Health Promot Pract. 2008 Jan;9(1):104. Health Promot Pract. 2007 Oct;8(4):358-65. Epub 2007 Jul 24.
Eliminating health disparities is a national priority. People with intellectual disabilities (PWID) are a vulnerable group that experiences health disparities. However, their health disparities have largely been overlooked. Photovoice is an effective method for engaging PWID in health promotion planning and research. This article discusses the importance of including PWID as a priority group, presents a Photovoice project among Latinos with ID, and concludes with recommendations for employing Photovoice with PWID. The Photovoice project was a part of a larger pilot study that aimed to enable the voices of Latinos with ID and guide the development of health promotion programs at a community agency. The findings were presented in reports and at a town hall meeting during which attendees responded and developed actions steps for improving health promotion for PWID. Each Photovoice participant received a scrapbook of their photographs as a keepsake of their experiences participating in the project [corrected]