Ouellette-Kuntz Hélène, Garcin Nathalie, Lewis M E Suzanne, Minnes Patricia, Martin Carol, Holden Jeanette J A
Department of Community Health & Epidemiology, Queen's University & Ongwanada.
Can J Public Health. 2005 Mar-Apr;96 Suppl 2(Suppl 2):S8-22. doi: 10.1007/BF03403699.
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.
智力残疾(ID)是指在18岁之前出现的状况,会导致智力功能以及概念、社交和实践适应技能受到显著限制。智力残疾影响着1%至3%的人口。智力残疾者更有可能患有身体残疾、心理健康问题、听力障碍、视力障碍和沟通障碍。这些并存的残疾,再加上智力功能和适应行为方面的限制,使得这一群体的加拿大人特别容易受到健康差距的影响。这篇综述文章的目的是探讨智力残疾者面临健康脆弱性的潜在促成因素,揭示该人群健康差距的程度和性质,并研究解决此类差异的举措。该综述表明,在一些关键健康指标上,智力残疾者的情况比一般人群更糟。导致脆弱性的因素众多且复杂。它们包括社会看待智力残疾的方式、智力残疾的病因、损害健康的行为、接触不健康环境、与健康相关的流动性以及获得基本医疗和其他基本服务的机会不足。对于智力残疾者来说,在获得医疗服务方面存在重要差距,这些差距很难与歧视性价值观和做法区分开来。美国、英格兰和苏格兰的政策制定者最近已开始着手解决这些问题。建议制定明确的卫生政策和战略愿景,以解决加拿大智力残疾者面临的健康差距问题。