Is it just me…?

Editor in Chief, Robert Chamberlain looks at the disturbing research findings highlighting the health inequalities facing people with learning disabilities.

Data recently published by NHS Digital to compare differences in treatment, health status, and outcomes of people with learning disabilities compared with the rest of the population makes worrying reading. The research contrasted data from people registered with their GP as having a learning disability with a control group not recorded by their GP as having a learning disability. The information was gathered for 2014-15 and 2015-16 involving over half of GP practices in England. The dataset included 146,005 people with a learning disability and 32,491,016 people without, representing just over 56% of GP registered patients.

Key findings

The main findings really highlight the stark differences between the health and life expectancy of people with a learning disability when compared to those without.

Regarding life expectancy, on average, females with learning disabilities had around an 18-year shorter life expectancy than the general population. Males with learning disabilities also had a shorter life expectancy, at around 14 years.

When it comes to health screening, eligible people with learning disabilities don’t have the same access as those without. Fewer than one in three eligible females with a learning disability received cervical cancer screening. This has not changed from 2014-15. Whereas, over three in four eligible females without a learning disability received the test.

Breast cancer screening for eligible female patients decreased in all age groups in both patients with and without a learning disability. Females aged 65 to 69 with a learning disability saw the largest decrease, from just under 55% in 2014-15 to around 52% in 2015-16.

However, there has been some improvement with three in four eligible patients with a learning disability receiving colorectal cancer screening. This is an increase from just over two in three in 2014-15.

According to the data, only 46% patients known to their GP as having a learning disability received their annual health check, this figure is up from 43% in 2014-15.

Finally, the data shows that obesity is twice as common in people aged 18-35 with learning disabilities and being underweight is twice as common in people aged over 64 with learning disabilities when compared with patients without learning disabilities.

Is it just me?

As with all research of this nature, the question now is how can the issues highlighted be addressed to ensure greater equality? I guess the starting point must be to ask how this situation is currently occurring.

What action could be taken to increase the level of awareness about the importance of health checks amongst people with learning disabilities? Is there sufficient support to help with GP visits and follow-up treatment? Who could and should provide this support?

For those living in a care setting, one would hope that the care professionals consider such health checks as a duty of care. Is this the case? When considering the growth in numbers of those supported in the community or still living with parents, I do wonder if enough is being done to ensure GP services are being accessed. Is this a grey area for support workers though? Obviously, an individual cannot be frog-marched to their doctor under duress, but are they supported to understand the importance of health checks and the possible implications of ignoring them? What obligations do providers have?

To take just one example from the findings, if fewer than a third of people with learning disabilities are screened for cervical cancer (compared to three quarters of those without a learning disability) something is seriously amiss.

I feel that there needs to be a structured awareness campaign, specifically aimed at improving the statistics. A campaign not only targeted at those with a learning disability, but also those who support them in any setting. Everyone should have an equal right to look after his or her health and I’m sure that this data demonstrates a lack of understanding across our population.

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