Online Program

Utility of mortality surveillance in adults with intellectual and developmental disabilities

Sunday, November 3, 2013

Emily Lauer, MPH, Center for Developmental Disabilities Evaluation and Research, E. K. Shriver Center, University of Massachusetts Medical School, Waltham, MA
Alexandra Bonardi, OTR/L, MHA, CDDER/EK Shriver Center, UMass Medical School, Boston, MA
The review of individual and aggregate mortality data for adults with intellectual disabilities can provide useful estimates of support service quality and underlying morbidity. Over the past decade, annual mortality statistics in select state intellectual and developmental disability service systems demonstrate mortality patterns with both similarities to and differences from patterns in the general population. Collectively, adults with intellectual disability tend to have a lower life expectancy at birth (58.7-62.0 years) compared with U.S. residents (77.9 years). Without adjusting for age, causes of death is 2009 suggest a lower burden of cancer (RR=0.67), and an increased burden of kidney disease (RR=2.0), septicemia (RR=3.6), Alzheimer's disease (RR=3.9), influenza and pneumonia (RR=6.4) and aspiration pneumonia (RR=21.1) in adults with intellectual disability receiving state services. Risk of death is similar to the general population for unintentional injuries (RR=1.4) and heart disease (RR=1.1). Similarly, the mortality rates for this subpopulation meet certain applicable Healthy People 2020 objectives, and fall short of other cause-specific target rates. While some causes of premature mortality in this population may be associated with the cause of the adult's intellectual disability and challenging to mitigate, others may have modifiable determinants either unique to this population or similar to the general population. Mortality surveillance and case review can be highly useful and fairly efficient strategies in resource-limited settings for effective targeting of health and service improvement strategies. Examples of recent effective interventions on both individual and policy levels to reduce morbidity and mortality based upon these findings will be presented.

Learning Areas:

Biostatistics, economics
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe findings from recent instances of mortality in adults with developmental and intellectual disabilities and discuss the use of these findings for systems improvement.

Keyword(s): Disability, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been an investigator on multiple federally funded grants focused on health surveillance for this population. Additionally, I have lent expertise to numerous state departments and service providers to design mortality surveillance systems and analyze mortality data for adults with developmental and intellectual disabilities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.