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This study examines the health outcomes in adults with developmental disabilities (DD) and compares those with and without mental health problems. The research reveals the prevalence of health conditions and highlights the challenges in healthcare access for this population. The study also explores the impact of mental health on physical health and the need for health promotion and disease prevention initiatives.
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How Do Health Outcomes Compare in Adults with DD with and without Mental Health Problems? Susan M. Havercamp, Ph.D. University of North Carolina North Carolina Office on Disability and Health Karen Luken, TRS/CTRS North Carolina Office on Disability and Health AAMR 2004
Health & DD • DD health is invisible to public health and ignored by DD service delivery • Research suggests prevalence of health conditions is the same or higher • Limitations in function due to problems with communication, physical fitness, and weight • Healthcare access can be a challenge, especially in the community
Health & Mental Health • Mental Health problems may look like physical illness and vice versa • Poor physical health may worsen mental health problems (esp. anxiety and depression) • Physical health problems may go undetected in persons with mental illness
National Core Indicators is a Quality Management protocol for the DD service delivery system Coordinated nationally by Human Services Research Institute (HSRI) Standard instrument, interviewer training, and methodology Three sources of information: self-report, proxy (informant), and case manager (file) Health Indicators
DD Sample Selection • Stratified random selection of individuals meeting inclusion criteria • Adults (age 18+) who receive services from the state division on developmental disabilities • Invited to participate in interview (informed consent obtained by case manager)
Health Indicator Items • Many Items adapted from the BRFSS • BRFSS methodology under-represents DD • Special considerations in interviewing persons with DD • Cloak of competence • Acquiescence • Memory impairment
Physical Health is compared across two groups • Adults with Developmental Disabilities without co-occurring Mental Health Problems (n=675; 70.8%) And • Adults with Developmental Disabilities and Mental Health Problems (n=341; 29.2%)
Health Indicators Content • Health Risk Behaviors • Overall Health Status & Health Conditions • Healthcare Access
Health Risk Behaviors * p<.05 *** p<.001
Chronic Health Conditions * p<.05 *** p<.001
Health Service Utilization * p<.05
Health Indicators Conclusions • Adults with dual diagnosis are more likely to smoke cigarettes and be overweight or obese compared to adults with developmental disabilities without mental health problems. • Both groups (MH and noMH) suffer extreme life stress and inadequate social support • Adults with dual diagnosis were more likely to have diabetes and high blood pressure • The MH group had surprisingly better access to healthcare services
Adults with developmental disabilities, and especially those with co-occurring mental health problems, are in need of health promotion and disease prevention initiatives
For more information… Contact: Susan M. Havercamp, Ph.D. University of North Carolina CB# 7255 Chapel Hill, NC 27599-7255 Tel. (919) 966-6312 E-mail: susan.havercamp@cdl.unc.edu OR Visit the HSRI website: www.hsri.org/manage/core.html