University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States.
University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States.
Curr Probl Pediatr Adolesc Health Care. 2023 May;53(5):101433. doi: 10.1016/j.cppeds.2023.101433. Epub 2023 Oct 21.
In the U.S., 1 in 6 children has an intellectual and/or developmental disability (I/DD). This population experiences a multitude of negative health outcomes across the life course, relative to the general population. Stigma-the social devaluation of individuals with certain characteristics, identities, or statuses within interpersonal, educational, healthcare, and policy contexts-is a potentially preventable contributor to health disparities. To date, existing approaches for addressing and preventing stigma are limited to discrete and siloed interventions that often fail to address the lifelong, cumulative impacts of the specific types of stigma experienced by the I/DD population. In the current paper, we describe three elements of Life Course Health Development (LCHD)-a novel translational framework that draws on evidence from biology, sociology, epidemiology, and psychology-that healthcare providers can use to prevent stigma-related health disparities and improve outcomes for individuals with I//DDs. We discuss the utility of targeting prevention to sensitive periods; prioritizing interventions for the most damaging types of stigmas; and leveraging supports from multiple service systems and sectors. By incorporating evidence from life course science into efforts to address stigma-related health disparities, providers can more effectively and strategically prevent and combat stigma-related health disparities for the I/DD population in childhood and across the life course.
在美国,每 6 名儿童中就有 1 名患有智力和/或发育障碍(I/DD)。与一般人群相比,这一人群在整个生命过程中经历了许多负面的健康结果。污名化——在人际、教育、医疗保健和政策环境中,对具有某些特征、身份或地位的个人的社会贬低——是导致健康差距的一个潜在可预防因素。迄今为止,解决和预防污名化的现有方法仅限于离散和孤立的干预措施,这些措施往往未能解决 I/DD 人群所经历的特定类型污名化的终身、累积影响。在当前的论文中,我们描述了三个生命历程健康发展(LCHD)的要素——一个新的转化框架,该框架借鉴了生物学、社会学、流行病学和心理学的证据——医疗保健提供者可以用来预防与污名相关的健康差距,并改善 I/DD 患者的结局。我们讨论了将预防措施针对敏感时期的实用性;优先考虑针对最具破坏性的污名类型的干预措施;并利用多个服务系统和部门的支持。通过将生命历程科学的证据纳入解决与污名相关的健康差距的努力中,提供者可以更有效地、有策略地预防和应对 I/DD 人群在儿童时期和整个生命过程中的与污名相关的健康差距。