Invisible populations: parallels between the health of people with intellectual disability and people of a refugee background
Claire E. Brolan A D , Robert S. Ware A B , Nicholas G. Lennox B , Miriam Taylor Gomez B , Margaret Kay C and Peter S. Hill AA The University of Queensland, School of Population Health, Herston, Qld 4006, Australia.
B The University of Queensland, Queensland Centre for Intellectual and Developmental Disabilities, School of Medicine, South Brisbane, Qld 4101, Australia.
C The University of Queensland, Discipline of General Practice, School of Medicine, RBWH Complex, Herston, Qld 4029, Australia.
D Corresponding author. Email: c.brolan@uq.edu.au
Australian Journal of Primary Health 17(3) 210-213 https://doi.org/10.1071/PY10022
Submitted: 3 June 2010 Accepted: 8 November 2010 Published: 5 September 2011
Abstract
When considering the delivery of primary health care in the community, some populations remain virtually invisible. While people with intellectual disability might seem to share few characteristics with refugees and humanitarian entrants, there are a number of difficulties that both groups share when accessing and receiving primary health care. Commonalities include communication barriers, difficulties accessing past medical records and the complexity of health needs that confront the practitioner providing health care. These issues and additional systemic barriers that prevent the delivery of optimal health care to both groups are explored. Integrated multidisciplinary care is often required for the delivery of best practice care; however, such care can be difficult for each group to access. In May 2010, the specific Medicare Health Assessment Item numbers for both of these groups were incorporated into a group of more generic Item numbers. This has resulted in a lost opportunity to enhance the evidence surrounding health care delivery to these vulnerable populations. This paper recognises the importance of health policy in leading affirmative action to ensure these populations become visible in the implementation of the National Primary Health Care Strategy.
References
Australian Institute of Health & Welfare (2008) Disability in Australia: intellectual disability. Bulletin 67, November. Commonwealth Government of Australia, Canberra.Beange H, Lennox N, Parmenter T (1999) Health targets for people with intellectual disability. Journal of Intellectual & Developmental Disability 24, 283–297.
| Health targets for people with intellectual disability.Crossref | GoogleScholarGoogle Scholar |
Bronson Dussan K, Galbraith EM, Grzybowski M, Motyka Vautaw B, Murray L, Eagle KA (2009) Effects of a refugee elective on medical student perceptions. BMC Medical Education 9, 15
| Effects of a refugee elective on medical student perceptions.Crossref | GoogleScholarGoogle Scholar |
Cooper S, Melville C, Morrison J (2004) People with intellectual disabilities. BMJ (Clinical Research Ed.) 329, 414–415.
| People with intellectual disabilities.Crossref | GoogleScholarGoogle Scholar |
Cooper S-A, Morrison J, Melville C, Finlayson J, Allan L, Martin G, Robinson N (2006) Improving the health of people with intellectual disabilities: outcomes of a health screening programme after 1 year. Journal of Intellectual Disability Research 50, 667–677.
| Improving the health of people with intellectual disabilities: outcomes of a health screening programme after 1 year.Crossref | GoogleScholarGoogle Scholar |
Davidson N, Skull S, Burgner D, Kelly P, Raman S, Silove D, Steel Z, Vora R, Smith M (2004) An issue of access: delivering equitable health care for newly arrived refugee children in Australia. Journal of Paediatrics and Child Health 40, 569–575.
| An issue of access: delivering equitable health care for newly arrived refugee children in Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2cvlvFelsg%3D%3D&md5=09df78b83de9bd82258db6f8ba1beccdCAS |
Davidson N, Skull S, Calache H, Chesters D, Chalmers J (2007) Equitable access to dental care for an at-risk group: a review of services for Australian refugees. Australian and New Zealand Journal of Public Health 31, 73–80.
| Equitable access to dental care for an at-risk group: a review of services for Australian refugees.Crossref | GoogleScholarGoogle Scholar |
Department of Health and Ageing (2010a) Australian Government. Medicare Benefits Schedule Note A24 2010. Available at http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=A24&qt=noteID&criteria=701 [Verified 6 October 2010]
Department of Health and Ageing (2010b) Medicare Benefits Schedule (MBS) health assessment for refugees and other humanitarian entrants. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_refugees [Verified 22 October 2010]
Department of Health and Ageing (2010c) Building a 21st Century primary health care system: Australia’s first national primary health care strategy. Available at http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/550436A8DA6839ECCA25771B00220E23/$File/6552%20NPHC%201205.pdf [Verified 3 November 2010]
Department of Immigration and Citizenship (2009) Fact Sheet 60 – Australia’s refugee and humanitarian program. Australian Government, Canberra. Available at http://www.immi.gov.au/media/fact-sheets/60refugee.htm [Verified 6 January 2010]
Department of Immigration and Citizenship (2010) Australian Government. Free services: free interpreting services. Department of Immigration and Citizenship, Canberra. Available at http://www.immi.gov.au/living-in-australia/help-with-english/help_with_translation/free-services.htm [Verified 6 January 2010]
Evans C (2009) A strengthened commitment to our international obligations. Minister for Immigration and Citizenship, Canberra. Available at http://www.minister.immi.gov.au/media/media-releases/2009/ce09020.htm [Verified 29 November 2009]
Ferguson L (MP) Interpreting services extended for pharmacies – press release from the Parliamentary Secretary for Multicultural Affairs and Settlement Services, 8 December 2008.
Graham H (2005) Intellectual disabilities and socioeconomic inequalities in health: an overview of research. Journal of Applied Research in Intellectual Disabilities 18, 101–111.
| Intellectual disabilities and socioeconomic inequalities in health: an overview of research.Crossref | GoogleScholarGoogle Scholar |
Huang Y-T, Phillips C (2009) Telephone interpreters in general practice: bridging the barriers to their use. Australian Family Physician 38, 443–446.
Johnson DR, Ziersch AM, Burgess T (2008) I don’t think general practice should be the front line: experiences of general practitioners working with refugees in South Australia. Australia and New Zealand Health Policy 5, 20
| I don’t think general practice should be the front line: experiences of general practitioners working with refugees in South Australia.Crossref | GoogleScholarGoogle Scholar |
Kay M, Fowler C (2006) Health assessment record for Australian refugees. In: ‘2006 general practice and primary health care research conference: program & abstracts’. Primary Health Care Research and Information Service, Australia. Available at www.phcris.org.au/conference/browse.php?id=2294 [Verified 9 April 2011]
Lennox N, Diggens J, Ugoni A (1997) The general practice care of people with an intellectual disability: barriers and solutions. Journal of Intellectual Disability Research 41, 380–390.
| The general practice care of people with an intellectual disability: barriers and solutions.Crossref | GoogleScholarGoogle Scholar |
Lennox N, Taylor M, Rey-Conde T, Bain C, Boyle FM, Purdie DM (2004) Ask for it: development of a health advocacy intervention for adults with intellectual disability and their general practitioners. Health Promotion International 19, 167–175.
| Ask for it: development of a health advocacy intervention for adults with intellectual disability and their general practitioners.Crossref | GoogleScholarGoogle Scholar |
Lennox N, Bain C, Rey-Conde T, Purdie D, Bush R, Pandeya N (2007) Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial. International Journal of Epidemiology 36, 139–146.
| Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial.Crossref | GoogleScholarGoogle Scholar |
Lennox N, Bain C, Rey-Conde T, Taylor M, Boyle FM, Purdie DM, Ware RS (2010) Cluster randomized-controlled trial of interventions to improve health for adults with intellectual disability who live in private dwellings. Journal of Applied Research in Intellectual Disabilities 23, 303–311.
| Cluster randomized-controlled trial of interventions to improve health for adults with intellectual disability who live in private dwellings.Crossref | GoogleScholarGoogle Scholar |
Lennox N, Ware R, Bain C, Taylor Gomez M, Cooper S-A (2011) Effects of health screening for adults with intellectual disability: a pooled analysis. British Journal of General Practice 61, 193–196.
| Effects of health screening for adults with intellectual disability: a pooled analysis.Crossref | GoogleScholarGoogle Scholar |
National Health and Hospitals Reform Commission (2009) A healthier future for all Australians – Final Report. (Australian Government, Canberra) Available at http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report [Verified 12 April 2011]
Phillips C (2010) Using interpreters. A guide for GPs. Australian Family Physician 39, 188–197.
Royal Australian College of General Practitioners (2007a) Curriculum for Australian general practice: multicultural health. Available at http://www.racgp.org.au/scriptcontent/curriculum/pdf/multiculturalhealth.pdf [Verified 3 November 2010]
Royal Australian College of General Practitioners (2007b) Curriculum for Australian general practice: disability. Available at http://www.racgp.org.au/scriptcontent/curriculum/pdf/disability.pdf [Verified 3 November 2010]
Shakespeare T, Iezonni LI, Groce NE (2009) The art of medicine: disability and the training of health professionals. Lancet 374, 1815–1816.
| The art of medicine: disability and the training of health professionals.Crossref | GoogleScholarGoogle Scholar |
Sheikh-Mohammed M, MacIntyre CR, Wood NJ, Leask J, Isaacs D (2006) Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. The Medical Journal of Australia 185, 594–597.
Skull SA, Ngeow JYY, Hogg G, Biggs BA (2008) Incomplete immunity and missed vaccination opportunities in East African immigrants settling in Australia. Journal of Immigrant and Minority Health 10, 263–268.
| Incomplete immunity and missed vaccination opportunities in East African immigrants settling in Australia.Crossref | GoogleScholarGoogle Scholar |
Smith M (2006) Refugees in Australia: changing faces, changing needs. The Medical Journal of Australia 185, 587–588.
Smith M (2009) Refugee health. Medical Observer 5, 23–25.
Turk V, Burchell S, Burrha S, Corney R, Elliot S, Kerry S, Molloy C, Painter K (2010) An evaluation of the implementation of hand held health records with adults with learning disabilities: a cluster randomized controlled trial. Journal of Applied Research in Intellectual Disabilities 23, 100–111.
| An evaluation of the implementation of hand held health records with adults with learning disabilities: a cluster randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
van Schrojenstein Lantman-de Valk MJ (2005) Health in people with intellectual disabilities: current knowledge and gaps in knowledge. Journal of Applied Research in Intellectual Disabilities 18, 325–333.
| Health in people with intellectual disabilities: current knowledge and gaps in knowledge.Crossref | GoogleScholarGoogle Scholar |
Wen X (2004) Estimates of prevalence of intellectual disability in Australia. Journal of Intellectual & Developmental Disability 29, 284–289.
| Estimates of prevalence of intellectual disability in Australia.Crossref | GoogleScholarGoogle Scholar |
Woodland L, Burgner D, Paxton G, Zwi K (2010) Health service delivery for newly arrived refugee children: a framework for good practice. Journal of Paediatrics and Child Health 46, 560–567.
| Health service delivery for newly arrived refugee children: a framework for good practice.Crossref | GoogleScholarGoogle Scholar |