From the Department of Pediatrics, University of Cincinnati College of Medicine; Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, OH (CC); Department of Academic Internal Medicine, University of Illinois College of Medicine, Chicago (EEH); Departments of Medical Education, Neurology and Rehabilitation, and Academic Internal Medicine, University of Illinois College of Medicine, Chicago (KLK); Advocate Medical Group Adult Down Syndrome Center, Department of Family Medicine, Advocate Lutheran General Hospital, Park Ridge, IL (BAC).
J Am Board Fam Med. 2022 Mar-Apr;35(2):390-393. doi: 10.3122/jabfm.2022.02.210371.
People with intellectual and developmental disabilities have a higher risk of mortality from COVID-19 than the general population. Providers may assume that this is due to the burden of comorbidities for this population; however, the disparity in mortality persists even when controlling for comorbidities. We review the current policies and practices that may be contributing to this higher level of mortality. We contend that pervasive ableism among medical providers leads to a variation in the medical care options that are provided to people with intellectual disabilities and their families. Due to this bias, poor outcomes for people with intellectual disabilities may become a self-fulfilling prophecy. We make recommendations to address the modifiable factors that are contributing to the higher level of mortality for people with intellectual disabilities who are infected with COVID-19, provide strategies to combat ableism within the medical field, and discuss the unique role of the primary care physician as an advocate.
智障和发育障碍患者死于 COVID-19 的风险比一般人群更高。医疗服务提供者可能认为这是由于该人群合并症的负担所致;然而,即使在控制了合并症后,死亡率的差异仍然存在。我们回顾了可能导致这种更高死亡率的现行政策和做法。我们认为,医疗服务提供者中普遍存在的对能力的偏见导致向智障人士及其家属提供的医疗选择存在差异。由于这种偏见,智障人士的不良预后可能成为一个自我实现的预言。我们提出了一些建议,以解决导致感染 COVID-19 的智障人士死亡率较高的可改变因素,提供在医疗领域内对抗能力偏见的策略,并讨论初级保健医生作为倡导者的独特作用。