Member's NewsNo.52
January 2008
 
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Health Status, Needs and Attitudes Toward People with Intellectual Disability
Stephen Corbin & Heather Driscoll

 

Special Olympics, Inc. is an international, nonprofit organisation dedicated to empowering over 2.5 million individuals with intellectual disability (ID) to become physically fit, productive and respected members of society through sports training and competition. ID is defined by the World Health Organization as “a condition of arrested or incomplete development of the mind, characterised by impairment of skills and overall intelligence in areas such as cognition, language and motor and social abilities.” The overall prevalence of ID worldwide is estimated to be between 1% and 3% (World Health Organization, 2001).
Special Olympics commissioned the Multinational Study of Attitudes toward Individuals with Intellectual Disabilities to document the social acceptance level of individuals with ID worldwide. Conducted in 12 countries with 10 000 respondents, the study focused on how the general population views the capabilities of individuals with ID; the extent to which they should be able to employ those capabilities in inclusive settings; and exactly how far average people believe that persons with ID should be integrated into everyday society. The study is the largest and most comprehensive study ever conducted on this subject, reporting how people across the world view the roles and capabilities of persons with ID in the workplace, the classroom and in daily social life. Survey results showed that the general population lacks an appreciation of the range of capabilities of individuals with ID and therefore have low expectations of what people with ID can achieve. The study also revealed that the world still believes individuals with ID should work and learn in separate settings, apart from people without disabilities. Regarding healthcare, 27% believed that persons with ID receive better health care than the general population, 39% believed they receive the same treatment and 34% believed they receive worse treatment (Siperstein, G., Norris, J., Corbin, S., Shriver, T., 2003). This is much more optimistic than what actual assessments of healthcare access, health status and need demonstrate.


Data collected in 2003 at the Special Olympics World Games Healthy Athletes venue in Dublin, Ireland found that people with ID have a higher prevalence of health problems across disciplines than the general population. Investigators screened more than 3,500 athletes from 145 nations, the largest, most comprehensive survey of the health status of people with ID ever conducted at the time. Health indicators examined included: dental and oral health, foot health, hearing, vision, muscle strength, bone strength, physical fitness and health promotion. Screening results showed:
  • One-third required eyewear, with half of those receiving glasses for the first time
  • 20% of males and 13% of females had below normal bone mineral density
  • Half had one or more foot diseases or conditions
  • 30% were obese, 23% were overweight

Special Olympics Healthy Athletes®
Goal: Help Special Olympics athletes improve their health and fitness and ultimately improve their ability to train and compete in Special Olympics as well as in life
Objectives:
  • improve access to and quality of health care services for Special Olympics athletes
  • make referrals or recommendations for follow up
  • train health care professionals, students and others about the needs of this population
  • collect, analyse and disseminate data on the health status and needs of people with ID
  • advocate for improved health policies and programs.
Healthy Athletes screening disciplines:
  • Special Smiles®
  • Special Olympics-Lions Club Opening Eyes®
  • FUNfitness
  • Healthy Hearing
  • Health Promotion
  • Fit Feet
  • MedFest®
Additional findings from the combined screening results of the 2003, 2005 and 2007 Special Olympics World Games Healthy Athletes, which screened athletes from 159 countries, showed:
  • 42% of athletes had obvious untreated tooth decay
  • 36% of athletes last had an eye exam 3+ years ago
  • 19% of athletes failed a PureTone 2000 hearing test
The data gathered at Healthy Athletes screenings, which collectively constitute the largest and fastest growing health database on people with ID, are important for planning programs, gaining support, improving policies and research (Special Olympics International Healthy Athletes Software).
A survey distributed to more than 2 500 US medical school deans, dental school deans, medical residency directors, dental residency directors, medical students and advocacy and patient care groups reported a general lack of competency to treat individuals with ID. Results showed:
  • 52% of medical school deans, 53% of dental school deans, 56% of students and 32% of medical residency program directors responded that graduates were “not competent”
  • 58% of medical school deans and 50% of dental school deans say clinical training regarding people with ID is not a high priority
  • 81% of medical school students say they are not getting any clinical training regarding people with ID; 66% are not receiving enough classroom instruction.
More encouraging data also from this study showed how 74% of medical school students and 74% of dental school students are indeed interested in treating people with ID, while nearly all administrators said that they would implement a curriculum for this population if given one (Corbin, S., Holder, M., et al., 2005). More than 55 000 health professionals and health professional students have volunteered to screen more than 500 000 athletes at over 2 700 Healthy Athletes events during the past ten years.
At the 2007 Special Olympics World Summer Games in Shanghai, China, leaders across government, health, non-governmental organisations (NGOs), sports, academic and business sectors, representing 60 countries, gathered to make a commitment to people with ID and their families throughout the world. Hosted by Special Olympics International, the 2007 Special Olympics World Summer Games Committee and China Disabled Persons' Federation, the “Commitment to Changing Lives: The Global Policy Summit on the Well-being of People with Intellectual Disabilities,” was the largest policy event ever to cast light on the attitudes towards and needs of people with ID and the challenges they face throughout the world. The event brought together the greatest collection of key global leaders in an effort to educate, inform and activate people around critical issues facing individuals with ID. Using the powerful platform of sport, the Global Policy Summit presented five core areas: a global snapshot highlighting key research findings on the attitudes toward, status of and prospects for people with ID; an in-depth analysis of the progress that China has made and plans to strengthen outreach to this population as a World Games legacy; model corporate, NGO and intergovernmental inclusion and collaboration policies and practices that support and engage people with ID; discussion of model laws and policies currently in place and future policy implementation; and, the role of sport in advancing peace, fitness and health for people with ID. The Summit incorporated more than 30 scientific presentations about people with ID from around the world, while furthering opportunities for this community. The Special Olympics movement was strengthened as UNICEF, the US Centres for Disease Control and Prevention (CDC) and Lions Clubs International Foundation announced official “Commitments to Action” and encouraged other attendees to follow their lead. The Fédération Internationale de Football Association (FIFA) also pledged its commitment to Special Olympics.
Over the last ten years, Special Olympics has made great strides in identifying the health care needs of people with ID. Moving forward, it is critical to make health a presence in the athletes’ lives on a daily and continuous basis and empower them for healthy living. There must be a greater commitment to integrating health promotion programs throughout Special Olympics by providing athletes with the information, encouragement and facilities they need to sustain physical fitness, healthy lifestyle choices and, ultimately, better sports performance. To accomplish this, improving athlete, coach and care giver health literacy, defined in Healthy People 2010 as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions,” (US Department of Health and Human Services, 2001) is imperative. Creating partnerships outside of Special Olympics is also important for educating the community on both the abilities and specific health care needs of people with ID, establishing relationships with health care professionals for follow up after events and continued research. Misperceptions are the biggest barrier to inclusion, and while the world has tried to rectify the wrongs of discrimination for many other minority groups, people with ID stand alone as the silent and forgotten minority, which has had serious ramifications on their health status. Special Olympics aims to identify and highlight the health disparities facing people with ID and promote a more realistic image of this population throughout the world so that they are more readily accepted in schools, the workplace, the health care communities and daily life.

References
1. World Health Organization. (2001). Mental and Neurological Disorders. Fact Sheet:
The World Health Report. Retrieved December 17, 2007 from http://www.who.int/whr/2001/media_centre/en/whr01_fact_sheet1_en.pdf
2. Siperstein G., Norrins, J., Corbin, S. and Shriver, T. (2003). Multinational study of attitudes toward individuals with intellectual disabilities. Washington, D.C., Special Olympics International: 12 pp.
3. Special Olympics International Healthy Athletes Software (HAS), HEALTHone Global. Data collected at the 2003, 2005 and 2007 World Games in Dublin, Nagano, and Shanghai.
4. Corbin, S., Holder, M., et al. (2005). Changing attitudes, changing the world: the health and health care of people with intellectual disabilities. Washington, D.C., Special Olympics International: 6 pp.
5. US Department of Health and Human Services. Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2010. Retrieved January 22, 2001, from the World Wide Web: http://www.health.gov/healthypeople/


Contact
Dr. Stephen Corbin
Senior Vice President, Constituent Services and Support
Dean, Special Olympics University
Special Olympics, Inc.
1133 19th Street, NW
Washington, DC 20036
P: 202-824-0283
Email: scorbin@specialolympics.org

Heather Driscoll
Senior Manager, Health Promotion
Special Olympics, Inc.
1133 19th Street, NW
Washington, DC 20036
P: 202-715-1149
Email: hdriscoll@specialolympics.org




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