The Intersectionality of Ethnicity/race and Intellectual and Developmental Disabilities: Impact on Health Profiles, Service Access and Mortality

Abstract

The coronavirus pandemic continues to be a serious global problem with very significant consequences for individual health, wellbeing and economic stability. As we learn more about the disease and its prognosis, several facts have emerged about onset, spread and fatality rates. One of the most striking findings is that of people from Black Asian and Minority Ethnic (BAME) groups bearing more severe forms of the illness and consequently dying at higher rates than their white counterparts. This disparity has been seen in many countries as reports about the characteristics of those infected and hospitalized are being published (Patel et al., 2020). Particular concerns have been raised about what might be driving this increased susceptibility to the virus including the role of widely suspected structural inequalities. A group of people who are exceedingly vulnerable, usually underserved and often stigmatized and discriminated against are those with intellectual and developmental disabilities. Those who are at the intersection of BAME and intellectual and developmental disabilities are likely to fare less well. There has been some research in people with intellectual and developmental disabilities from BAME groups but only a small proportion examines health status. Robertson et al. (2019) found 23 studies reporting on health status and service use in people with intellectual and developmental disabilities living in the UK. BAME status was associated with 4fold increase in abnormal blood glucose levels; a diagnosis of psychosis; lower likelihood to have his/her mental ill-health recognized by a family carer. South Asian families in particular were less likely to access specialist intellectual disability services for a mental health problem and reported increased social care needs. Analysis of US-based databases such as the Adult Consumer Survey of the National Indicators Project (Bershadsky et al., 2014) indicated that ethnicity (White non-Hispanic, Black non-Hispanic, Hispanic) was an important variable in accessing 6 public health preventive programs although the differences dissipated when person characteristics were accounted for. Another study