Health promotion for people with intellectual disabilities

Recent evidence shows that people with ID are more likely to die 20 years younger, and more likely to experience coronary heart disease, respiratory problems and gastrointestinal cancers compared to their non-disabled peers. They are also more likely to experience a range of secondary health conditions. Many of these conditions can be prevented and/or managed moreappropriately; thereby improving the persons’ quality of life, increasing longevity, and reducing care costs.The UN Convention on the Rights of Persons with Disabilities (2006)highlights the universal impetus towards ‘the highest attainable standards ofhealth without discrimination and promotes population-based public healthprogrammes’. However, people with ID in particular continue to be excludedfrom such public health programmes.Despite many exemplars of evidence-base practices in health promotion in thenon-disabled population such robust evidence is lacking for the ID population.The aim of this key-note presentation is to identify the main barriers to healthpromotion and healthcare, and the innovative ways of overcoming them.Responding appropriately to the health inequalities faced by people with IDdemands action on five strands. These five strands are inter-related butunderpinned by the goals of changing attitudes, improving knowledge andunderstanding and developing new skills of all involved with this population.The first strand should focus upon supporting the person with ID to accesstheir family doctor/practice nurse to receive an annual health check. After thisscreening a health-action-plan can be developed to promote the person’s wellbeing.Family doctor practices will need to have a system in place in order to identify people with ID and a designated link person will be required to support these healthcare professionals to communicate with this population.A second strand should focus upon greater co-operation between people withID, their family carers, ID support staff and healthcare personnel to worktogether to promote the health of this population. It is each person’sresponsibility to identify the risk and protective factors of this population’shealth in order to empower the person with ID to make healthier lifestylechoices throughout the lifespan. Health promotion involves developing anenvironment that best supports good health outcomes for this population, andas such is not the sole responsibility of any one professional group. Hence thiswill require the education of the person with ID, family carers, ID support staffand healthcare personnel.A third strand is that people with ID should be supported to access publiclyfunded population-based public health programmes: for this to take placereasonable adjustments are required. Trials of new health promotion initiativesto improve health should be required to include marginalized populations.However, most of these programmes have neither recognised nor addressed thespecific challenges posed by this population’s cognitive deficits, low levels ofliteracy skills, communication difficulties, learning styles and mobility. Thus apromising approach is for existing programmes to be adapted and evaluated byID personnel. This has the added benefit of providing comparative benchmarksfor the health gains that can be expected within an ID population.A fourth strand should focus upon people with ID who may be unable toaccess mainstream public health programmes, therefore more tailored andspecially delivered health programmes are required that will address thebarriers to healthcare that this population face. Although some exemplars ofthese types of programmes exist, there is a greater need for a more robustmethodology and evidence-base to identify if such interventions work and theircost-effectiveness.Lastly, as publicly funded health programmes place a strong emphasis onindividuals to self-monitor and self-manage their own chronic health conditions,people with ID should be included in these initiatives. This then requires trainedpersonnel in primary healthcare and ID services, and evidence-basedprogrammes using a range of effective health promotion strategies (i.e. userfriendly material, one-to-one and/or group education sessions, flexibility,repetition, use of kinesthetic learning, role-play). Furthermore, future healthpromotion programmes cannot ignore the added value that digital technologycan have in facilitating the self-monitoring and self-management of a range ofchronic health conditions by using commercially available portable, accessibledevices.