Deprivation, ethnicity and the prevalence of intellectual and developmental disabilities
Deprivation, ethnicity and the prevalence of intellectual and developmental disabilities
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DOI：
10.1136/jech.2010.111773
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发表时间：
2012-03-01
影响因子：
6.3
通讯作者：
Emerson, Eric
中科院分区：
文献类型：
--
作者：
Emerson, Eric
背景据报道，在某些形式的智力和发育障碍中存在社会梯度和族裔差异。然而，关于地区贫困、种族和其他形式的智力残疾和发展性残疾之间的联系的信息尚不确定。目的评估家庭劣势、地区贫困和种族与智力和发展性残疾识别之间的独立关联。方法横断面调查从7-15岁的英国儿童(n=518万)的教育记录中提取的关于家庭劣势、地区贫困、种族和已识别的智力和发展性残疾的数据进行多水平多变量分析。结果家庭的社会经济地位越低，智力和发展性残疾的识别率越高，特别是不那么严重的智力残疾形式。更高的区域剥夺独立地与较轻形式的智力残疾的识别率增加有关，但对严重的多发性智力残疾和自闭症谱系障碍的识别率降低。一般而言，少数族裔地位与智力和发育障碍的识别率较低有关。这一一般模式的例外包括吉普赛/罗曼尼和爱尔兰血统的旅行者儿童中较低程度的智力残疾的识别率，以及巴基斯坦和孟加拉血统的儿童中较严重的智力残疾的识别率。结论发育已经受到影响的儿童(特别是智力残疾程度较轻的儿童)暴露在本身不利于健康发展的社会条件下的风险增加。
Background Social gradients and ethnic disparities have been reported in some forms of intellectual and developmental disabilities. However, information on the association between area deprivation, ethnicity and other forms of intellectual and developmental disabilities are inconclusive.Aim To estimate the independent association between household disadvantage, local area deprivation, ethnicity and the identification of intellectual and developmental disability.Methods Cross-sectional survey involving multilevel multivariate analyses of data extracted from educational records on household disadvantage, local area deprivation, ethnicity and identified intellectual and developmental disability in a sample of English children aged 7-15 years (n=5.18 million).Results Lower household socio-economic position was associated with increased rates of identification of intellectual and developmental disabilities especially less severe forms of intellectual disability. Higher area deprivation was independently associated with increased rates of identification of less severe forms of intellectual disability but decreased rates of identification of profound multiple intellectual disability and autism spectrum disorder. Minority ethnic status was, in general, associated with lower rates of identification of intellectual and developmental disabilities. Exceptions to this general pattern included higher rates of identification of less severe forms of intellectual disability among Gypsy/Romany and Traveller children of Irish heritage, and higher rates of identification of more severe forms of intellectual disability among children of Pakistani and Bangladeshi heritage.Conclusions Children whose development is already compromised (and especially children with less severe intellectual disabilities) are at increased risk of exposure to social conditions that are themselves inimical to healthy development.