Special Olympics Athletes Have Unmet Health Needs

NEW YORK (Reuters Health) - Many people with Down Syndrome and other intellectual disabilities have vision, hearing, dental and other health problems, but most doctors and dentists are not trained to deliver services to this population, according to the findings of two studies conducted by Special Olympics.

These adults have the same health care needs as those in the general population, but their needs are not being addressed in a "competent, comprehensive fashion," Dr. Stephen Corbin, dean of Special Olympics University and director of Health & Research Initiatives, told Reuters Health.

As a result, said Corbin, who led the first study, many are living with preventable, manageable conditions and are "falling through the cracks" of the public health system.

For his study, information was collected from 4,700 athletes from 146 countries who participated in 15,000 different Special Olympics Healthy Athletes health screenings during the 2003 Special Olympics World Summer Games in Ireland and the 2005 Special Olympics World Winter Games in Japan.

Based on those screenings, more than one in four athletes -- including 33 percent of those aged 8 to 17 years -- had never had an eye exam, and many needed eyeglasses to correct their farsightedness or nearsightedness. Many adults also failed basic hearing tests and many showed obvious signs of tooth decay, with 14 percent requiring urgent dental care.

Athletes also underwent foot screenings, and more than a quarter were found to have corns/calluses or ingrown toenails, respectively, and 16 percent had athlete's foot. Some athletes also showed signs of reduced bone mass and a few were found to have osteoporosis. What's more, nearly 40 percent of the athletes were overweight or obese.

Despite these widespread and numerable health concerns, "this population is not on the public health radar screen," Corbin said, explaining that the public health community views it as a "disability and rehabilitation issue more than a public health issue."

Yet, people with intellectual disabilities have higher needs than those in the general population coupled, in many cases, with a lower level of understanding, and intellectual stigma against their presence in some providers' offices, Corbin said.

In a second study, Dr. Matthew Holder, global medical advisor for Special Olympics, surveyed more than 2,500 individuals, including medical and dental school deans and residency directors, medical students and representatives of advocacy and patient care groups. He found that more than half of medical school deans and dental school deans, respectively, said that their graduates were "not competent" to treat patients with intellectual disabilities.

In fact, their responses revealed that an adult with an intellectual disability who lived in the general community would have to call at least 50 primary care physicians before he or she found one that had received a minimum amount of clinical training in treating people with such disabilities.

"People with intellectual disabilities in the United States cannot find good quality health care," Holder, also the executive director of the American Academy of Developmental Medicine and Dentistry, told Reuters Health. He said the reason for this is because "our health care professionals, mainly physicians and dentists, are not adequately trained."

Eighty-one percent of medical school deans said there was not enough curriculum time to include such training and 60 percent of dental school deans said there was both a "lack of curriculum time" and a lack of faculty members with expertise in treating people with intellectual disabilities. Yet, nearly 75 percent of medical students -- and a similar proportion of dentistry students, according to previous research -- are interested in treating people with intellectual disabilities. And, current findings show, more than two-thirds of medical school deans and three quarters of dental school deans agreed that students should receive such clinical training.

To address these health care needs, Special Olympics has recently developed a global vision curriculum that has been released to some optometry schools and has been translated into Mandarin in order to be disseminated in China in September. The organization is also creating a public Internet site whereby adults with intellectual disabilities can more easily access health care providers. On the site, which is also expected to be available by late September, health professionals will be able to identify themselves as willing to treat patients with intellectual disabilities.

The Special Olympics studies were supported by the US Centers for Disease Control and Prevention and Lions Club International.