BY H. BARRY WALDMAN DDS, MPH, PHD AND STEVEN P. PERLMAN DDS, MSCD, DHL (HON)
The facts are that these health behavior prospects are genuine possibilities as youngsters with disabilities reach their adult years. Repeated surveys do substantiate these consequences.
“Obesity, binge drinking and smoking – you’ve got to be kidding. My child is only 6, 10, or 12 years old. How could you think of that? He/she has enough difficulties with disabilities to even consider those eventualities.”
THE NUMBERS YOU USUALLY SEE
The numbers you usually see
• 56 million individuals with disabilities
• 38 million individuals with severe disabilities
• 171 thousand children less than five years with disabilities living in the communities of the country (includes only children with hearing and vision disabilities)
• 2.9 million children 5 to 17 years with disabilities living in the community1,2
If you are interested in determining the number of children with disabilities in your area, it is relatively easy to use the convenient computer search engines and turn up reports on the distribution of individuals with disabilities by number and proportion in Congressional Districts and states and by various demographic groups, including age, gender and race/ethnicity.1,2 For example, in 2012:
Among children less than five years of age with disabilities (includes only children with hearing and vision disabilities)
• The number ranged from about 90 in Rhode Island to 19,400 in Texas.
• The proportion ranged from about 0.1% in Hawaii to 1.9% in Delaware. (see Table 1)
Among children 5 to 17 years of age with disabilities
• The number ranged from about 4,300 in Alaska to 278,800 in Texas.
• The proportion ranged from about 3.2% in Alaska to 9.2% in Maine and 10% in Puerto Rico. (see Table 2)
WHAT THE FUTURE MAY HOLD
While it is important to maintain an awareness of the current numbers and proportion of youngsters with disabilities in our communities and the nation as a whole, it is equally (if not more important) to consider the future circumstances in which these youngsters may (will?) live. Rightfully, the concern should be directed to the potential economics of adults with disabilities (in 2010, the median monthly earning by individuals between 21 and 12 August 64 years with a disability was $1,961; compared to $2,724 for those with no disabilities). During the same year, among adults 18-64 years 29.2% of persons with disabilities and 13.6% of persons with no disabilities lived in poverty.1
Equally important, are considerations of the impact of the youngster’s health behaviors as he or she grows to adult years, specifically: obesity, binge drinking and smoking.
Obesity: a term that means that an individual weighs at least 20% more than what is considered a normal weight for that person’s height. It makes an individual more likely to have a series of conditions including:
• Heart disease and stroke
• High blood pressure
• Some cancers
• Gallbladder disease and gallstones
• Breathing problems, such as sleep apnea (when a person stops breathing for short episodes during sleep) and asthma.3
Not everyone who is obese has all of those problems. The risk rises if you have a family history of one of those conditions.3
In 2012 in the United States, among persons 18 years and over, 39.1% of individuals with disabilities were reported to be obese; compared to 24.5% of individuals with no disabilities.
• The reported proportion of obese individuals with disabilities ranged from 33.2% in Massachusetts to 45.2% in Louisiana.
• The reported proportion of obese individuals with no disabilities ranged from 18.1% in Colorado to 31.8% in Mississippi. (see Table 3)
Binge drinking: The definition of binge drinking in the United States is the consumption of five or more drinks in about a two hour period by men – or four or more drinks in the same period by women.
Binge drinking is associated with many health problems, including:
• Unintentional injuries (e.g., car crashes, falls, burns, drowning)
• Intentional injuries (e.g., firearm injuries, sexual assault, domestic violence)
• Alcohol poisoning
• Sexually transmitted diseases
• Unintended pregnancy
• Children born with Fetal Alcohol Spectrum Disorders
• High blood pressure, stroke, and other cardiovascular diseases
• Liver disease
• Neurological damage
• Sexual dysfunction, and
• Poor control of diabetes.4
According to national surveys
• One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge.
• While binge drinking is more common among young adults aged 18–34 years, binge drinkers aged 65 years and older report binge drinking more often—an average of five to six times a month.
• The prevalence of binge drinking among men is twice the prevalence among women.
• Binge drinkers are 14 times more likely to report alcohol impaired driving than non-binge drinkers.4
In 2012 in the United States, among persons 18 years and over, 11.8% of individuals with disabilities were reported to have been involved in binge drinking; compared to 18.5% of individuals with no disabilities.1
• The reported proportion of individuals with disabilities who had been involved in binge drinking ranged from 6.0% in Tennessee to 16.7% in Illinois.
• The reported proportion of individuals with no disabilities who had been involved in binge drinking ranged from 11.5% in West Virginia to 28.0% in Wisconsin. (see Table 4)
Smoking: Smoking is the leading preventable cause of death in the United States.
• Cigarette smoking causes more than 480,000 deaths each year in the United States. This is about one in five deaths.
• Smoking causes more deaths each year than all of the following combined
o Human immunodeficiency virus (HIV)
o Illegal drug use
o Alcohol use
o Motor vehicle injuries
o Firearm-related incidents 5
In 2012 in the United States, among persons 18 years and over, 26.0% of individuals with disabilities were reported to be smokers; compared to 16.9% of individuals with no disabilities.1
• The reported proportion of individuals with disabilities who are smokers ranged from 14.7% in Utah to 36.9% in Kentucky.
• The reported proportion of individuals with no disabilities who are smokers ranged from 9.5% in Utah to 25.8% in West Virginia. (see Table 5)
NOT MY CHILD
The facts are that these health behavior prospects are genuine possibilities as youngsters with disabilities reach their adult years. Repeated surveys do substantiate these consequences. We seek to ensure the future of children with disabilities with education, health insurance coverage, employment opportunities, guardianships, trust fund arrangements for financial security and any number of other measures. But in our zeal to establish these necessary safe guards, do we also adequately consider the long term health guidance measures to instill in our youngsters the potential realities that all too often adults with disabilities succumb to the consequences of obesity, binge drinking and smoking? •
ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; E-mail: firstname.lastname@example.org
Steven P. Perlman, DDS, MScD, DHL (Hon) is Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Private pediatric dentistry practice – Lynn MA.
1. Disability Compendium. Annual disability statistics compendium. Wed site: http://wwwdisabilitycompendium.
org. Accessed July 26, 2014.
2. Census Bureau. American Community Survey http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml.
Accessed July 26, 2014.
3. Web MD. Health risks linked to obesity. Web site: http://www.webmd.com/cholesterol-management/obesity-health-risks Accessed August 6, 2014.
4. Centers for Disease Control and Prevention. Fact sheets – binge drinking. Web site:
http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm Accessed August 6, 2014.
5. Centers for Disease Control and Prevention. Fact sheets – Health Effects of Cigarette Smoking. Web site:
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking Accessed August 6, 2014.