Health inequalities

People with a learning disability have worse physical and mental health than people without a learning disability.

On average, women with a learning disability die 23 years younger than women in the general population.

On average, men with a learning disability die 20 years younger than men in the general population (LeDeR, 2023; ONS, 2022).
 

Poor quality healthcare causes health inequalities and avoidable deaths

The 2022 Learning Disabilities Mortality Review (LeDeR) found the median age at death was 63 for adults with a learning disability. This is significantly less than the median age of death of 82 for men and 86 for women in the general population. This means the difference in median age at death between adults with a learning disability and the general population is 19 years for men and 23 years for women.

LeDeR also reported the odds of avoidable death for different levels of impairment:

• 39% of people with a mild learning disability died an avoidable death
  32% of people with a moderate learning disability died an avoidable death
  26% of people with a severe learning disability died an avoidable death
  3% of people with profound and multiple learning disabilities died an avoidable death
   

Poor quality healthcare causes avoidable deaths

The Confidential Inquiry into premature deaths of people with a learning disability also found that 38% of people with a learning disability died from an avoidable cause, compared to 9% in a comparison population of people without a learning disability (Heslop et al. 2013, p. 92). 

LeDeR found that 42% of deaths of people with a learning disability were avoidable (LeDeR, 2023).

Note: Mencap uses the term 'avoidable death' for deaths that could have been avoided by the provision of good quality healthcare.

Access to healthcare

A number of barriers are stopping people with a learning disability from getting good quality healthcare

These barriers include:

• a lack of accessible transport links
• patients not being identified as having a learning disability
• staff having little understanding about learning disability
• failure to recognise that a person with a learning disability is unwell
• failure to make a correct diagnosis
• anxiety or a lack of confidence for people with a learning disability
• lack of joint working from different care providers
• not enough involvement allowed from carers
• inadequate aftercare or follow-up care.

(Heslop et al. 2013; Tuffrey-Wijnes et al. 2013; Allerton and Emerson 2012).

Flu immunisation 

44.9% of patients with a learning disability received flu immunisations in 2017-18, a small increase from 41.9% in 2016-17 to (NHS Digital 2019).

Cancer screening 

In 2017/18, around half (52.5%) of women with a learning disability had been screened for breast cancer, compared to 68% of women without a learning disability.

Meanwhile, less than a third (31.2%) of eligible women with a learning disability had received cervical smear tests, in contrast to 73.2% of women with no learning disability.

Of those eligible for a colorectal cancer screening, 77.8% of people with a learning disability were screened, compared to 83.7% of those without (NHS Digital, 2019).