Cohort differences in mortality among U.S adults with versus without intellectual disability

• In Event: Disability in Society Section Roundtables
  In Refereed Roundtable (60 minute): Table 2. Disability, Health, and Healthcare

Abstract

Historically, U.S. adults with intellectual disability (ID) have experienced a “cascade of disparities,” resulting in poorer health outcomes and elevated mortality, particularly at younger ages compared with the general population. Although age-related mortality disparities in the ID population are well documented, no prior research has examined the potential birth cohort effects on mortality disparities among individuals with ID.
Using data from the 1986–2014 National Health Interview Survey linked to the 2019 Mortality Linked File, I examined cohort-specific mortality risk within and between populations with and without ID. Birth cohorts were conceptualized as reflecting distinct service system regimes that shaped the life trajectories of individuals with ID across historical periods: the institutional era (1904–1955), the transition to deinstitutionalization (1956–1969), and the deinstitutionalization era (1970–1996).
The study found that adults with ID experienced substantially higher mortality risk than those without ID, with disparities widening among more recent birth cohorts. Within the ID population, mortality risk was significantly higher for individuals born in more recent cohorts compared to those born during the institutional era (1904–1955). Possible explanations include mortality compression at younger ages among earlier cohorts exposed to institutionalization and comparatively weaker community-based supports during the deinstitutionalization era.
 

Author

• Nastassia Vaitsiakhovich, Syracuse University