Box 3.2Health inequalities experienced by people with disabilities

The Disability Rights Commission in the United Kingdom formally investigated premature deaths among people with learning disabilities or mental health problems and local reports of unequal access to health care between 2004 and 2006.

People with long-term mental health problems – such as severe depression, bipolar disorder, or schizophrenia – and learning disabilities, such as autism:

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Had more chronic health conditions than the general population. They were more likely to be obese and have heart disease, high blood pressure, respiratory disease, diabetes, strokes, or breast cancer. People with schizophrenia were nearly twice as likely to have bowel cancer. Although the recording of people with learning disability in primary care settings was poor, higher rates of respiratory disease and obesity in this population were indicated.

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Developed chronic health conditions at a younger age than other people. For example, 31% of people with schizophrenia were diagnosed with heart disease under the age of 55, compared with 18% of others with heart disease.

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Died sooner following diagnosis. Five years following a diagnosis of heart disease (adjusting for age), 22% of people with schizophrenia and 15% of people with bipolar disorder had died, compared with 8% of people without serious mental health problems. The pattern was similar for stroke and chronic obstructive pulmonary disorder.

Social deprivation was a major contributor to these health inequalities, and people with mental health problems and learning disabilities were at a high risk of poverty. The lack of health promotion, service access, and equal treatment were also cited as significant barriers. Disabled people identified fear and mistrust, limited access to general practice lists, difficulty negotiating appointment systems, inaccessible information, poor communication, and diagnostic overshadowing. Service providers identified issues such as fear, ignorance, and inadequate training.

Responses to the study were positive. Prominent health care professionals endorsed the findings. The British Medical Association established training for medical students, and nongovernmental organizations ran campaigns on health inequalities. The British government introduced incentives to encourage people with learning disabilities to undergo health checks and strengthened guidance for mental health-care workers. The Health Care Commission in association with RADAR – a disability NGO – undertook further work to explore disabling factors in health care and to produce guidelines on good practice and criteria for future health care inspections.

Source (15).