Health promotion and intellectual disability: listening to men

Abstract

Taking responsibility for your own health has been a central tenet of public health policy internationally for a number of decades. Governments in the UK and internationally continue to promote a plethora of health promotion strategies, encouraging individuals and communities to adopt healthy lifestyle choices. Although it is widely recognised that men are not as proactive in seeking out medical help or taking on health promotion advice as women, limited gender-sensitive research exists in the field of intellectual disability. Despite many health promotion policy and practice strategies targeted at this population, little research exists exploring whether men with intellectual disability acknowledge health promotion advice. The study aimed to explore how men with mild-to-moderate intellectual disability understood and perceived their health and what health promotion messages they acted upon. The study was based on a participatory approach which enabled 11 men with intellectual disability to contribute as steering group members and as participants through one-to-one interviews. Data were collected between September 2011 and July 2012. Thematic analysis was undertaken. The participants demonstrated a capacity to understand their own health. This was inclusive of a concern about associating being obese with being unhealthy. The participants reported good relationships with their general practitioners (GPs) and felt valued, in particular when the GP was prepared to offer specific intellectual disability and health promotion advice. More gendered research inclusive of the views of this male population is required and the study reiterates the importance of promoting the health of men and women with intellectual disability.

Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review

“…There may be transferable evidence from studies involving children and younger people from this population and other cognitive disability populations (for example, patients with dementia, cerebral palsy, stroke, or acquired brain injury). The use of convenience samples 23 , 56 and self-selection 20 may also bias the results. Some studies were limited to urban areas as opposed to rural areas, which may pose different healthcare barriers.…”

Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review

“…Fourteen studies reported in 16 publications, published from 2003 to 2017, were included in this group (Table 12). Of these, three dealt with general practice, 44,45,48 three dealt with a range of primary care services, 36,37,49 three dealt with carers working at residential or supported living homes [33][34][35]43 and two dealt with formal and informal carers of people with ID in residential or family homes. 38,39 The other three studies dealt with audiology services, 42 cervical and cancer screening 40 and sexual health.…”

“…There were 16 papers reporting 14 different studies in this cluster. Among these studies, health needs were identified by the person with ID, 34,36,38,41,44 family carers, 49,114 paid carers 33,35,39,40,42,48,73,114,115 and health professionals. 37,45,48 Identifying health need depends on some knowledge of potential risks to health.…”

“…37,45,48 Identifying health need depends on some knowledge of potential risks to health. Ten papers reporting eight studies looked at carers' awareness and knowledge of risks and potential health needs relating to cardiovascular disease, 48 hearing, 42 cancer, 40 men's health, 36 older people 35 and pain. 33,34,37-39 Table 16 provides the key findings of the studies in the identifying needs cluster.…”

“…Similarly, a study that interviewed men who had mild to moderate ID to explore the factors affecting their health and their capacity to act on health promotion messages found that a good relationship with a GP was important to ensure ongoing access to GP services and that people particularly valued the GP talking to them directly and then talking to the carer if there was a need to clarify information. 36…”