Using a life course health development framework to combat stigma-related health disparities for individuals with intellectual and/or developmental disability (I/DD)

Emily Hotez; Julianna Rava; Shirley Russ; Allysa Ware; Neal Halfon

doi:10.1016/j.cppeds.2023.101433

Using a life course health development framework to combat stigma-related health disparities for individuals with intellectual and/or developmental disability (I/DD)

Curr Probl Pediatr Adolesc Health Care. 2023 May;53(5):101433. doi: 10.1016/j.cppeds.2023.101433. Epub 2023 Oct 21.

Authors

Emily Hotez¹, Julianna Rava², Shirley Russ², Allysa Ware³, Neal Halfon⁴

Affiliations

¹ University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States. Electronic address: ehotez@mednet.ucla.edu.
² University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States.
³ Family Voices, 110 Hartwell Avenue, Lexington, MA, 02421, United States.
⁴ University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States; Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA, United States.

PMID: 37867057
DOI: 10.1016/j.cppeds.2023.101433

Abstract

In the U.S., 1 in 6 children has an intellectual and/or developmental disability (I/DD). This population experiences a multitude of negative health outcomes across the life course, relative to the general population. Stigma-the social devaluation of individuals with certain characteristics, identities, or statuses within interpersonal, educational, healthcare, and policy contexts-is a potentially preventable contributor to health disparities. To date, existing approaches for addressing and preventing stigma are limited to discrete and siloed interventions that often fail to address the lifelong, cumulative impacts of the specific types of stigma experienced by the I/DD population. In the current paper, we describe three elements of Life Course Health Development (LCHD)-a novel translational framework that draws on evidence from biology, sociology, epidemiology, and psychology-that healthcare providers can use to prevent stigma-related health disparities and improve outcomes for individuals with I//DDs. We discuss the utility of targeting prevention to sensitive periods; prioritizing interventions for the most damaging types of stigmas; and leveraging supports from multiple service systems and sectors. By incorporating evidence from life course science into efforts to address stigma-related health disparities, providers can more effectively and strategically prevent and combat stigma-related health disparities for the I/DD population in childhood and across the life course.

Keywords: Disabilities; Life course health development; Life course interventions; Pediatricians; Stigma.

MeSH terms

Child
Developmental Disabilities / therapy
Health Personnel
Humans
Intellectual Disability* / epidemiology
Life Change Events*
Social Stigma