title: The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe.
abstract: BACKGROUND
  Despite progress in the process of deinstitutionalisation, very little is known about the health conditions of people with intellectual disability (PWID) who live in large institutions and PWID living in small residential services, family homes or independent living within the community. Furthermore, there are no international comparison studies at European level of the health status and health risk factors of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses with no formal support.
  
  
  METHODS
  A total of 1269 persons with ID and/or their proxy respondents were recruited and face-to-face interviewed in 14 EU countries with the P15, a multinational assessment battery for collecting data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, availability of formal support and stage of deinstitutionalisation.
  
  
  RESULTS
  Obesity and sedentary lifestyle along with a number of illnesses such as epilepsy, mental disorders, allergies or constipation were highly prevalent among PWID. A significantly higher presence of myocardial infarctions, chronic bronchitis, osteoporosis and gastric or duodenal ulcers was found among participants in countries considered to be at the early stage of deinstitutionalisation. Regardless of deinstitutionalisation stage, important deficits in variables related to such medical health promotion measures as vaccinations, cancer screenings and medical checks were found in family homes and independent living arrangements. Age, number of people living in the same home or number of places in residential services, presence of affective symptoms and obesity require further attention as they seem to be related to an increase in the number of illnesses suffered by PWID.
  
  
  CONCLUSIONS
  Particular illnesses were found to be highly prevalent in PWID. There were important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation. PWID are in need of tailored primary health programs that guarantee their access to quality health and health promotion and the preventative health actions of vaccination programs, systematic health checks, specific screenings and nutritional controls. Extensive national health surveys and epidemiological studies of PWID in the EC member states are urgently needed in order to reduce increased morbidity rates among this population.
authors: UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundación Villablanca, Grup Pere Mata, Reus, Spain Department of Psychiatry, University of Cádiz, Spain. rmarleal@gmail.com
authors: R
authors: R
authors: Martínez-Leal
authors: L
authors: L
authors: Salvador-Carulla
authors: C
authors: C
authors: Linehan
authors: P
authors: P
authors: Walsh
authors: G
authors: G
authors: Weber
authors: G
authors: G
authors: Van Hove
authors: T
authors: T
authors: Määttä
authors: B
authors: B
authors: Azema
authors: M
authors: M
authors: Haveman
authors: S
authors: S
authors: Buono
authors: A
authors: A
authors: Germanavicius
authors: H
authors: H
authors: van Schrojenstein Lantman-de Valk
authors: J
authors: J
authors: Tossebro
authors: A
authors: A
authors: Carmen-Câra
authors: D
authors: D
authors: Moravec Berger
authors: J
authors: J
authors: Perry
authors: M
authors: M
authors: Kerr
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003688:Deinstitutionalization / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006304:Health Status; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data*; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult