Disparities in health outcomes among people with disabilities: A systematic scoping review of the literature

Background: While evidence increasingly points to disparities between people with and without disabilities, less attention is given to disparities within the population of people with disabilities. The present study is a systematic review of peer-reviewed literature for data examining disparities in health outcomes between subgroups of people with disabilities.

Methods: A functional definition of disability was used that included physical, sensory, cognitive, mental health, social, or activity limitations. Disparities in health conditions related to the ten leading causes of death in the U.S. were included. Using systematic scoping review methodology, literature searches were conducted for years 2000 – 2009. Abstracts and then full-text articles were reviewed according to inclusion/exclusion criteria. For articles meeting all criteria, data extraction was performed independently by two reviewers. Inter-coder reliability was monitored regularly.

Results: Search methods yielded 4248 articles for possible inclusion. Twenty-nine articles met all inclusion criteria and were included for data extraction. Preliminary analyses indicate that most articles focused on people with mental health disorders, physical limitations, or cross-disability samples. Health outcomes examined most frequently were diabetes mellitus, accidents and injuries, heart disease, and respiratory disease. Disabling condition category, disability severity, age, and gender were the most examined disparity factors. Further findings will illustrate where health disparities among people with disabilities exist, and areas where additional research is needed.

Conclusions: Existing literature indicates some likely disparity trends. However, additional research is needed to determine which subgroups of people with disabilities experience greatest disparities, and for which health outcomes disparities occur most.