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Ableism at the Bedside: People with Intellectual Disabilities and COVID-19
Caitlin Chicoine1, Erin E Hickey2, Kristi L Kirschner2
1From the Department of Pediatrics, University of Cincinnati College of Medicine; Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, OH (CC); Department of Academic Internal Medicine, University of Illinois College of Medicine, Chicago (EEH); Departments of Medical Education, Neurology and Rehabilitation, and Academic Internal Medicine, University of Illinois College of Medicine, Chicago (KLK); Advocate Medical Group Adult Down Syndrome Center, Department of Family Medicine, Advocate Lutheran General Hospital, Park Ridge, IL (BAC). caitlin.chicoine@cchmc.org.
Abstract:
People with intellectual and developmental disabilities have a higher risk of mortality from COVID-19 than the general population. Providers may assume that this is due to the burden of comorbidities for this population; however, the disparity in mortality persists even when controlling for comorbidities. We review the current policies and practices that may be contributing to this higher level of mortality. We contend that pervasive ableism among medical providers leads to a variation in the medical care options that are provided to people with intellectual disabilities and their families. Due to this bias, poor outcomes for people with intellectual disabilities may become a self-fulfilling prophecy. We make recommendations to address the modifiable factors that are contributing to the higher level of mortality for people with intellectual disabilities who are infected with COVID-19, provide strategies to combat ableism within the medical field, and discuss the unique role of the primary care physician as an advocate.
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