Emerson Eric, Hatton Chris, Baines Susannah, Robertson Janet
Centre for Disability Research, Lancaster University, Lancaster, UK.
Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia.
Int J Equity Health. 2016 Jan 20;15:11. doi: 10.1186/s12939-016-0296-x.
Adults with intellectual disability have poorer health than their non-disabled peers. However, little is known about the health of the 'hidden majority' of adults with primarily mild intellectual disability who do not use intellectual disability services. The aims of the present study were: to estimate the physical health status of a population-based sample of British adults with and without mild intellectual disability while controlling for any potentially confounding effects resulting from between-group differences in gender, age, socio-economic disadvantage and neighborhood social capital.
Secondary analysis of data from Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. We identified 299 participants aged 16-49 (1.2 % of the unweighted age-restricted sample) as having intellectual disability, and 22,927 as not having intellectual disability. Multivariate logistic regression was used to investigate between group differences adjusting for potential confounding personal characteristics (e.g., gender).
Unadjusted comparisons indicated that British adults with intellectual disability have markedly poorer health than their non-disabled peers on the majority of indicators investigated including self-rated health, multiple morbidity, arthritis, cancer, diabetes, obesity, measured grip strength, measured lung function and polypharmacy. Adjusting for between-group differences in age and gender had a marginal impact on these estimates. Further adjusting for between-group differences in socio-economic disadvantage and neighborhood quality had a more marked impact on estimates with the number of statistically significant differences reducing from 13 to 8 and statistically significant attenuation of odds on three indicators (self-rated health, SF-12 physical component and multiple morbidity).
The 'hidden majority' of adults with primarily mild intellectual disability who do not use intellectual disability services have significantly poorer health than their non-disabled peers. This may, in part, reflect their increased risk of exposure to well established 'social determinants' of poorer health.
与无智力残疾的同龄人相比,成年智力残疾者的健康状况更差。然而,对于那些主要为轻度智力残疾且不使用智力残疾服务的“隐藏多数”成年人的健康状况,我们知之甚少。本研究的目的是:在控制因性别、年龄、社会经济劣势和邻里社会资本的组间差异所产生的任何潜在混杂效应的同时,估计以人群为基础的英国有和没有轻度智力残疾的成年人的身体健康状况。
对“理解社会”项目的数据进行二次分析,该项目是一项关注英国公民生活经历的新的纵向研究。我们确定了299名年龄在16 - 49岁之间的参与者(占未加权年龄限制样本的1.2%)患有智力残疾,22927名参与者没有智力残疾。使用多变量逻辑回归来研究调整潜在混杂个人特征(如性别)后的组间差异。
未经调整的比较表明,在大多数调查指标上,包括自评健康、多种疾病、关节炎、癌症、糖尿病、肥胖、测量的握力、测量的肺功能和多重用药情况,英国有智力残疾的成年人的健康状况明显比无智力残疾的同龄人差。调整年龄和性别组间差异对这些估计值有轻微影响。进一步调整社会经济劣势和邻里质量的组间差异对估计值有更显著影响,具有统计学显著差异的数量从13个减少到8个,并且三个指标(自评健康、SF - 12身体成分和多种疾病)的优势比有统计学显著减弱。
那些主要为轻度智力残疾且不使用智力残疾服务的“隐藏多数”成年人的健康状况明显比无智力残疾的同龄人差。这可能部分反映了他们接触健康状况较差的既定“社会决定因素”的风险增加。