McLean Kiley J, Koenig Jamie, Wolpe Samara, Song Wei, Bishop Lauren
A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104-3734, United States.
Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, WI 53706, United States.
Health Aff Sch. 2025 Apr 22;3(4):qxae158. doi: 10.1093/haschl/qxae158. eCollection 2025 Apr.
This study assesses changes in self-reported health and healthcare status among adults with intellectual and developmental disabilities (I/DD) over the past 20 years, utilizing data from the National Health Interview Survey. We conducted a cross-sectional analysis of 601 464 adults 18 and older, categorized by disability status: no functional limitations, developmental disabilities, intellectual disabilities, and other functional limitations. We aimed to identify trends in health status, healthcare access, affordability, and utilization from 1999 to 2018, comparing outcomes across disability groups. Results indicate adults with intellectual disabilities reported poorer health compared to those without functional limitations, particularly in the most recent period (2014-2018). Adults with developmental disabilities exhibited increased odds of poor health during 2009-2013 compared to 1999-2003, but no significant differences occurred between other periods. Additionally, poverty rates for adults with I/DD were higher, with a substantial proportion of adults with intellectual disabilities living in poverty compared to those without functional limitations, indicating persistent disparities without significant trend improvements. Despite advancements in healthcare access and affordability, self-reported health outcomes for adults with I/DD have not improved, highlighting the need for policies to enhance care quality. Future research should focus on effective healthcare practices and provider training to address these persistent disparities.
本研究利用美国国家健康访谈调查的数据，评估了过去20年中成年智力和发育障碍（I/DD）患者自我报告的健康状况和医疗保健状况的变化。我们对601464名18岁及以上的成年人进行了横断面分析，根据残疾状况进行分类：无功能限制、发育障碍、智力障碍和其他功能限制。我们旨在确定1999年至2018年期间健康状况、医疗保健可及性、可负担性和利用率的趋势，比较不同残疾群体的结果。结果表明，与无功能限制的成年人相比，智力障碍成年人报告的健康状况较差，尤其是在最近时期（2014 - 2018年）。与1999 - 2003年相比，发育障碍成年人在2009 - 2013年期间健康状况不佳的几率增加，但其他时期之间没有显著差异。此外，I/DD成年人的贫困率更高，与无功能限制的成年人相比，有相当比例的智力障碍成年人生活在贫困中，这表明存在持续的差距且没有明显的趋势改善。尽管在医疗保健可及性和可负担性方面取得了进展，但I/DD成年人自我报告的健康结果并未改善，这凸显了制定政策以提高护理质量的必要性。未来的研究应侧重于有效的医疗保健实践和提供者培训，以解决这些持续存在的差距。
