People With Disabilities: Health-Care Disparities

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People With Disabilities: Health-Care Disparities

Introduction

Individuals with developmental disabilities, including intellectual ones, usually experience more health-related issues than people without such disabilities. This phenomenon associated with being at risk of developing more medical problems in comparison to the general population is known as a health disparity (Krahn & Fox, 2014). However, the problem is that people with developmental disabilities also suffer from health-care disparities that refer to differences in the quality of care and medical assistance they receive.

Thus, in many cases, individuals with disabilities are limited in their opportunities to access appropriate health services (Lennox, Diggens, & Ugoni, 2000). These disparities can be researched concerning such a medical issue as obesity in people with developmental disabilities because they are often not assessed and treated appropriately to cope with this problem (Hsieh, Rimmer, & Heller, 2014).

The purpose of this paper is to describe diagnostic and assessment procedures currently used to identify obesity in people with developmental disabilities, determine their limitations, analyze available interventions, discuss changes to address health-care disparities, and describe available local resources.

Currently Used Diagnostic and Assessment Procedures

Developmental disabilities are associated with physical and intellectual disabilities that can affect children before their birth or during their childhood, and these conditions include epilepsy, Down syndrome, cerebral palsy, and autism among others. Those people who have developmental disabilities often suffer from certain medical conditions and diseases, including sensory impairments, obesity, diabetes, and others (Fox, Witten, & Lullo, 2014; Hsieh et al., 2014).

Thus, these individuals are four times more likely to state that their health is poor in comparison to persons without disabilities (Krahn, Walker, & Correa-De-Araujo, 2015). Still, the use of diagnostic and assessment procedures about these people is restricted because of their possible immobility, poverty, limited access to care, unemployment, inappropriate insurance, and other factors (Fox et al., 2014; Krahn & Fox, 2014). It is important to note that these health-care disparities make people with developmental disabilities rather unrecognized, vulnerable, and even discriminated against their access to medical services.

To diagnose overweight and obesity in patients, healthcare providers usually refer to the assessment of an individuals weight and the calculation of the Body Mass Index (BMI). Also, the assessment is conducted concerning a persons height, gender, race, activity, and the percentage of body fat (Fox et al., 2014; MartínezZaragoza, CampilloMartínez, & AtoGarcía, 2016).

Additional assessments for making an appropriate diagnosis and developing an effective treatment plan are usually realized with the help of different devices, including tracking gadgets and different types of sensors, as it is noted by Rimmer, Lai, and Young (2016) in their study. Theoretically, all these techniques can be used to assess the predisposition to obesity and a current health state in individuals with different developmental disabilities (Ptomey et al., 2018). However, the problem is that those people with disabilities who are limited in their mobility or a possibility to visit doctors are usually not diagnosed to have this health issue in time.

Limitations of Applied Diagnostic Procedures

The first limitation to consider according to the literature on diagnosing and treating obesity in people with developmental disabilities is the infrequency and irregularity of such assessments. The problem is that the determination of the early onset of obesity typical of some people with disabilities becomes almost impossible without assessments of a persons body weight and measuring the BMI (Krahn et al., 2015; Ptomey et al., 2018). The other issue is related to older people with developmental disabilities who can lack the necessary care and support from professionals and caregivers (MartínezZaragoza et al., 2016; Rimmer et al., 2016).

As a result, it becomes impossible to regularly assess their health and prevent the development of conditions that are usually provoked by immobility, poor nutrition, the lack of physical activity and exercising, or living in inappropriate environments.

The other risk factor is that, in people with disabilities, the prevalence of obesity is higher than in the general population. These data and associated findings were reported by MartínezZaragoza et al. (2016) and Ptomey et al. (2018) in their studies. As a result, many people with developmental disabilities suffer from overweight and obesity, resulting in the progress of diabetes and cardiovascular diseases among other conditions because of the lack of treatment (Hsieh et al., 2014; Ptomey et al., 2018).

Thus, these individuals need more attention from healthcare providers regarding their issues to respond to the limitations associated with the use of ineffective assessment procedures or approaches. From this point of view, the lack of treatment and positive patient outcomes is a consequence of not assessing people with developmental disabilities and not diagnosing their problem at an early stage because of their limited access to care.

Interventions Used to Address Health-Care Disparities and Associated Challenges

While referring to the example of obesity as a medical issue and the problem of health-care disparities related to people with disabilities, it is also important to discuss currently implemented interventions to address the issue. According to MartínezZaragoza et al. (2016), interventions for people with obesity usually include changes in a diet, programs for increasing physical activity, as well as exercising and walking, and counseling.

Changes in a diet are most frequently applied for individuals with overweight and obesity, and they are based on restricting calories taken per day, increasing the consumption of fruits and vegetables, and reducing the number of taken sugars and saturated fat (Ptomey et al., 2018). If effectively-developed dietary plans are supported by appropriate programs for increasing physical activity, patients usually achieve high results in decreasing their weight and improving the state of their cardiovascular system among other outcomes (Fox et al., 2014). It is important to note that these standard interventions are also proposed for people with developmental disabilities.

The development of technologies has also affected the choice of interventions and their type for addressing a variety of health issues, including obesity, cardiovascular diseases, diabetes, and respiratory diseases among other ones. Thus, Rimmer et al. (2016) studied the effectiveness of using hardware and software technologies, as well as different types of devices, for improving exercising and found that people with disabilities can effectively use trackers, sensors, and other gadgets to improve the quality of their life.

Still, one should note that, for many people with disabilities, these devices are not available because of the problem of a health-care disparity and the lack of financial support for these individuals. However, the use of these technologies can become a part of a unique multi-component program or an intervention developed for patients with the obesity problem.

Thus, a range of effective interventions cannot be applied for people with developmental disabilities in many cases even though they are often proposed by researchers and experts. Challenges are associated with health and health-care inequalities related to people with disabilities. Thus, these persons physical activity and mobility are often affected because of their disability, and they are unable to perform recommended exercises (Hsieh et al., 2014; Krahn et al., 2015; Ptomey et al., 2018).

Secondly, to follow dietary and exercising plans, these people usually need the support of caregivers and healthcare professionals (MartínezZaragoza et al., 2016; Ptomey et al., 2018). This aspect negatively affects the success of following any interventions, not only those which are specially developed for decreasing weight. Finally, even if people with disabilities are informed about what diets to follow and what programs to use, they are often limited in resources to improve their nutrition and living conditions (Ptomey et al., 2018). As a result, this aspect prevents them from addressing a medical issue and illustrates a disparity.

Modifications and Suggestions to Improve the Delivery of Services

The recent research on health-care disparities that are related to people with developmental disabilities associated with such a medical issue as obesity indicates that traditional interventions applied to the general population can be ineffective for this specific population. To address the needs of individuals with disabilities, it is necessary to suggest cooperating with social workers and caregivers. People with specific needs should receive additional support, guidance, education, and assistance depending on their disability (Krahn et al., 2015).

Thus, people with Down syndrome and autism usually cannot keep to a healthy diet or follow fitness plans without the help of their caregivers. If these individuals need certain treatment plans, in many cases, they cannot use them independently. Persons with spinal cord injury or limited mobility also require specific plans because of the impossibility to increase their physical activity using traditional interventions proposed for persons without disabilities (Krahn & Fox, 2014). Only those people with specific needs who can care for themselves independently can follow interventions for individuals with obesity without modifications. Other persons require assistance, guidance, and monitoring performed by specialists and their caregivers.

The problem is that, if people with disabilities are deprived of a possibility to receive the assistance of specialists, this inequality in access to health care leads to their impossibility to cope with obesity. Therefore, important modifications to the proposed interventions include the necessity of assigning responsible healthcare providers, nurses, and social workers for educating patients, supporting them, and monitoring their progress and success.

The ability for self-regulation and self-monitoring is limited in many individuals with developmental disabilities, and this aspect needs to be taken into account (Krahn & Fox, 2014). To improve the delivery of services for this group of patients, it is also possible to apply telehealth and telemedicine technologies for assisting people with disabilities in following their treatment plans (Rimmer et al., 2016). As a result, the problem of access to services and consultation becomes effectively addressed for those individuals whose mobility and resources are limited.

Community Resources for People With Developmental Disabilities

In Florida, there are many agencies, organizations, and centers that provide assistance and support of different types for people with developmental disabilities. In the context of the proposed programs, some interventions can help individuals with specific needs to address the issues of a health-care disparity and possible overweight and obesity. Firstly, it is possible to receive the assessment, treatment plans, and assistance of local healthcare providers and social workers in the context of Floridas Disability and Health Program (DHP).

The program is oriented toward increasing the availability of services and resources for people who have developmental and intellectual disabilities to improve their inclusion in social life and improve their living conditions. Secondly, people with needs can receive assistance from the members of Floridas Voice on Developmental Disabilities (FVDD), a non-profit organization that unites families with individuals having disabilities. Thirdly, it is possible to contact the representatives of the Florida Independent Living Council and Florida Alliance for Assistive Services and Technology working to increase peoples access to assistive devices and other technologies.

Also, the necessary guidance and education on interventions to overcome obesity can be received from the professionals of the Family Care Council of Florida. Furthermore, some organizations represent and protect the rights and interests of populations with specific disabilities, including autism, Down syndrome, epilepsy, and many others. Individuals with certain needs and their families can consult the professionals who work in these centers and hospitals to receive the necessary education on how to cope with the obesity issue when having this or that disability and certain limitations associated with it.

Reflection

The work with those people who have developmental disabilities is associated with a range of challenges because of certain health disparities, as well as health-care ones. Thus, having researched the recent literature in the field, I found that many individuals with disabilities are deprived of opportunities to access high-quality care because of their limited mobility, affected cognitive skills, restricted financial resources, the absence of appropriate care and support from caregivers, and social workers, and possible poverty.

This inequality leads to these peoples inability to cope with many medical conditions, including overweight and obesity. I should state that if healthcare providers pay more attention to the needs of people with disabilities, they will be able to prevent the development of many conditions, including those related to changes in weight, diabetes, and heart diseases.

Thus, in current and future practice, it is important to focus on communicating more with people having developmental disabilities and the members of their families, as well as their caregivers. The research has indicated that appropriate assessments allow for detecting problems with weight typical of people with disabilities at the early stages. From this perspective, communication should include the preliminary assessment of a persons physical state and vital signs, as well as answering questions on access to nutrition, daily diets, and physical activity. A specialist should also provide persons with disabilities and their families with required education and guidance.

Moreover, it is also helpful to provide a list of local community resources for these people if they need more support, monitoring their treatment plans, or if they lack resources. Thus, the collected information supports the idea that individuals with disabilities are vulnerable, and they need more assistance in coping with different health-related issues because of certain health-care inequalities observed in society. These aspects make me concentrate on these peoples needs and contribute to providing them with the required care and assistance.

References

Fox, M. H., Witten, M. H., & Lullo, C. (2014). Reducing obesity among people with disabilities. Journal of Disability Policy Studies, 25(3), 175-185.

Hsieh, K., Rimmer, J. H., & Heller, T. (2014). Obesity and associated factors in adults with intellectual disabilities. Journal of Intellectual Disability Research, 58(9), 851-863.

Krahn, G. L., & Fox, M. H. (2014). Health disparities of adults with intellectual disabilities: What do we know? What do we do? Journal of Applied Research in Intellectual Disabilities, 27(5), 431-446.

Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an unrecognized health disparity population. American Journal of Public Health, 105(S2), S198-S206.

Lennox, N. G., Diggens, J., & Ugoni, A. (2000). Health care for people with an intellectual disability: General practitioners attitudes, and provision of care. Journal of Intellectual and Developmental Disability, 25(2), 127-133.

MartínezZaragoza, F., CampilloMartínez, J. M., & AtoGarcía, M. (2016). Effects on physical health of a multicomponent programme for overweight and obesity for adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 29(3), 250-265.

Ptomey, L. T., Saunders, R. R., Saunders, M., Washburn, R. A., Mayo, M. S., Sullivan, D. K.,& Danon, J. C. (2018). Weight management in adults with intellectual and developmental disabilities: A randomized controlled trial of two dietary approaches. Journal of Applied Research in Intellectual Disabilities, 31, 82-96.

Rimmer, J. H., Lai, B., & Young, H. J. (2016). Bending the arc of exercise and recreation technology toward people with disabilities. Archives of Physical Medicine and Rehabilitation, 97(9), S247-S251.

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