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Health Inequalities and Social Care . This morning. What do we know about: The scale and nature of the health inequalities experienced by people with learning disabilities? The causes of the health inequalities experienced by people with learning disabilities? - PowerPoint PPT Presentation
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Health Inequalities and Social Care
This morningo What do we know about:
o The scale and nature of the health inequalities experienced by people with learning disabilities?
o The causes of the health inequalities experienced by people with learning disabilities?
o What works in resolving the health inequalities experienced by people with learning disabilities?
o How can social care help in reducing health inequalities?
The Scale & Nature of the Issueo Consistent evidence from research of:
o Shorter life expectancyo All-cause mortality 3 times higher for people with
moderate to severe learning disabilitiesoMortality particularly high for young adults, women,
and people with Down’s syndromeo More sensory & physical impairments
o 8-200 times more likely to have a visual impairmento 40% with hearing impairmento 14 times more likely to have musculo-skeletal
impairment
The Scale & Nature of the Issueo Consistent evidence from research of
o Poorer physical healtho Children and adults more likely to report poor
general physical healthoHealth checks identify high levels of unmet health
needso Respiratory disease leading cause of death (46%-
52%)o Coronary heart disease a common cause of death
(14%-20%), and likely to be increasingo Currently lower rates of cancer, but proportion of
gastro-intestinal cancer higher and pattern/scale of cancer changing with increased longevity
The Scale & Nature of the Issueo Consistent evidence from research of
o Poorer physical healthoRates of epilepsy at least 20 times higheroOne third have unhealthy teeth and gumsoAround 8% reported with dysphagiao Increased rates of diabetesoPossible higher rates of osteoporosisoHigher rates of injuries and fallsoMore likely to have poor diet and low levels of
exerciseoMore likely to be obese or underweight
The Scale & Nature of the Issueo Consistent evidence from research of
o Poorer mental healtho Psychiatric disorders 4.5 times higher for children
with learning disabilitieso Rates of psychosis, anxiety, depression likely to
be higher for adults with learning disabilitiesoHigher rates of dementia and more likely early
onset (especially for people with Down’s syndrome)
o Challenging behaviouro 10%-15% show some form of challenging
behaviour
The Causes of Poorer Health 1
o Causes related to the nature of learning disability o Syndrome-specific risks (e.g.,
hypothyroidism in Down syndrome, overeating in Prader-Willi syndrome)
oCommunication difficulties resulting in the failure to (or delay in) identifying illness and/or accessing health care
What Does (or Should) Work?
Cause Potential Solution(s)
Syndrome-specific risks •Document and disseminate knowledge •Targeted screening programmes & medical intervention
Communication difficulties
•Help families and child care workers identify signs of ill-health•Routine health checks
Health Checkso Robust evidence that
health checks are effective in identifying unknown illness
o DES Feb 2009o Poor uptake (49% in
2010/11)o Unknown impact on
health status
The Causes of Poorer Health 2
o Poverty and material disadvantageo Poverty causes
poorer healtho Poverty is a cause of
(especially mild) learning disability
o Learning disability may increase the risk of poverty
What Does (or Should) Work?
Cause Potential Solution(s)
Poverty •Targeted family support (e.g., welfare benefits, enabling parents to work)•Build the resilience of children and adults with learning disabilities (and their families)
The Causes of Poorer Health 3
o Discrimination o People with learning
disability face discrimination (systemic and at times overt) in health care systems
o People with learning disability face discrimination in their daily lives
What Does (or Should) Work?
Cause Potential Solution(s)
Discrimination in health care systems
•Ensuring compliance with relevant UN Conventions•‘Reasonable adjustments’ (e.g., more accessible information, longer appointment times)
Discrimination in everyday life
•Anti-bullying strategies•Building more inclusive communities
How Can Social Care Help?o Awareness of health issues and working with
health serviceso Awareness of health needs amongst people with
learning disabilities using (and not using) learning disability services
o Supporting healthy lifestyles (exercise, diet, employment, friendships and relationships)
o Demanding and supporting health checks and follow-up screening/interventions from health services
o Working with health services and families to ensure effective health care (‘reasonable adjustments’)
How Can Social Care Help?o Assessing risks and impact of general social
care policy and practice on people with learning disabilities and doing something about it, e.g.:o Anti-discriminationo Poverty reduction and neighbourhood improvemento Leisureo Transporto Education and other services for children
o Ensuring public health (to be located in local authorities) is responsive to the health needs of people with learning disabilities
http://www.improvinghealthandlives.org.uk/
