Improving the health of people with intellectual disability: past progress and future directions

Over the past decades substantial progress has been made in addressing health disparities of people with intellectual disability. The "era of awareness" (pre-2005) identified a "cascade of disparities" of more adverse health conditions, less attention to health needs, poorer health care access, and fewer opportunities for health improvement. This occurred alongside emerging governmental recognition of the poor health of people with intellectual disability. The "era of assessment" (2005-2015) saw advances in improved health data, population health surveillance, attention to environmental contributors, and passage of the Convention on the Rights of Persons with Disabilities. Research extended from clinical samples to population-based studies with greater focus on social determinants of health. The "era of context" (2015-2025) was characterized by the COVID-19 pandemic, technology, and greater inclusion of people with intellectual disabilities in their communities. Data advances included a disability data framework, clearer disability definitions and identification, and greatly expanded data-linkage research to inform programs and policies. Disability health competencies were developed in multiple countries for multiple disciplines. For the coming decade, we anticipate greater use of technology, especially Artificial Intelligence, expansion of the "inclusion movement," and attention to ableism. Data linkage and analysis in multiple countries will map longitudinal health trajectories. We anticipate a much-needed resurgence in attention to mental health. Global climate change will demand inclusive emergency preparedness. Future advances require that research, health care, service programs, and communications be co-designed with people with intellectual disability and their supporters. Focus and funding are critical through investment proportionate to need.