12. Health issues and disparities of people living with disabilities

From greek.doctor
  • Disability = lack of ability compared to a standard or norm
    • Mental disability (impaired intellectual ability)
    • Physical disability (mobility)
    • Sensory disability (visual/hearing)
  • Physical disability
    • = impaired ability to move or coordinate movements
    • The most frequent disability (10% of USA)
    • Due to musculoskeletal or neurological problems
    • Causes
      • Accidents, injuries
      • Genetic diseases (muscular dystrophies, etc.)
      • Developmental disorders (intrauterine infections or chemical exposure)
        • Thalidomide
      • Osteoporosis
    • Consequences
      • Muscle atrophy
      • Psychological
        • Depression
      • Social
        • Family care is usually needed
        • Impaired career and employment possibilities
    • Prevention
      • Primary
        • Ensure calcium and vitamin D intake (reduces osteoporosis)
        • Weight-bearing exercise (reduces osteoporosis)
        • Enforce road safety
        • Reduce alcohol
        • Disability-friendly buildings, etc.
      • Secondary
        • Screening for musculoskeletal disorders
        • Regular physical examination
  • Mental disability
    • Affects 3% of population
    • Causes
      • Idiopathic
      • Down syndrome
      • Foetal alcohol syndrome
    • Risk factors
      • Poor maternal nutrition
      • Perinatal trauma
      • Neonatal jaundice
      • Postnatal infections or toxins
    • Present for birth or early infancy
    • Limits normal activities of life
    • Diagnosed based on IQ, adaptive skills
      • Mild mental retardation < 70 IQ
      • Severe mental retardation < 35 IQ
    • Down syndrome
      • Most frequent cause of mental disability
      • Characteristic facial features
      • High maternal age is the most important risk factor
      • Frequent health problems (congenital heart disease, cataract, poor immune system, leukaemia)
    • Prevention
      • Pregnancy counselling
      • Prenatal diagnosis
      • Neonatal screening for metabolic disorders
  • Visual disability
    • Causes
      • Idiopathic
      • Cataract
      • Glaucoma
      • Diabetic retinopathy
      • Vitamin A deficiency
      • Infections
    • Consequences
      • More frequent accidents
      • Depression
    • Prevention
      • Primary
        • Ensure vitamin A intake
        • Increase safety of environment
        • Disability-friendly buildings, etc.
      • Secondary
        • Regular physical examination
      • Tertiary
        • Treat underlying cause
  • Hearing disability
    • Affects 10% of developed countries
    • Causes
      • Noise-induced
      • Frequent otitis media in childhood
      • Congenital conditions
    • Prevention
      • Primary
        • Reduce noise pollution
        • Increase safety of environment
        • Disability-friendly buildings, etc.
      • Secondary
        • Screening for hearing loss in infants
      • Tertiary
        • Prevent further hearing loss