Finding the right doctor at the right time can be universally complex, but new research published in BMJ Open indicates that there are significant health disparities between Deaf and the general population in the UK.
Researchers from the School for Social and Community Medicine at the University of Bristol led the study – the largest of its kind in the world – to compare access to care and overall health status of Deaf and hearing individuals. They found that Deaf adults in the UK have high rates of known risk factors for chronic, non-communicable diseases (e.g., cardiovascular disease, hypertension, diabetes, and depression).
In the study, nearly 300 Deaf participants aged 20 to 82 years volunteered to receive free health assessments. The health checks were standardized, and included the following: answering questions based on the Health Survey for England (HSE); a fasting blood test; and blood pressure, BMI, and body fat percentage measurements.
Data from the health assessments were compared to those of the general population. Among Deaf individuals overall, there was a lack of awareness regarding health issues, as well as under-diagnosis and under-treatment of chronic conditions that could put them at risk for preventable illness.
Poorer Access Equates to Poorer Health
Specifically, 72% of male Deaf participants were overweight or obese compared to 65% of men from the general population. A similar disparity was found among women, with 71% of female Deaf participants overweight or obese compared to 58% of women from the general population.
Looking at blood pressure, 37% of Deaf participants had high blood pressure, compared to 21% reported by the general population. Here poor health awareness was a significant issue, as only 23% of the Deaf sample reported having high blood pressure. Of those Deaf participants who indicated that they did not have high blood pressure, 29% of them did at their health assessments. Only 6% of the general population was unaware of their increased blood pressures.
Overall, Deaf participants had similar rates of diabetes to the general population, but were less likely to be aware of the problem and more likely to have inadequate control when they have been diagnosed with diabetes.
Despite having relatively poorer health, Deaf participants were much less likely to use tobacco or alcohol. The average smoking rate among UK residents is 21% for men and 20% for women, compared to 8% for Deaf individuals of both genders.
Self-reported alcohol consumption was quite low comparatively, at 5.4 units per week for men and 3.4 units per week for women. In comparison, the mean levels of self-reported alcohol consumption for the general UK population are 15.6 units for men and 9.5 units for women.
There were some potentially significant limitations to the Bristol study, including a lack of access to participants’ personal health records, and a reliance on self-reporting, which can bias results in both directions (i.e., over-reporting of some issues, under-reporting of others). Overall, however, this study offers a unique perspective on health disparities among different-abled persons in the UK.
Communication Issues Lead to Frustration
In addition to poorer health, the costs of underserving the Deaf population are financial (i.e., for both the patient and the NHS). Frustration is related to wasted time, anxiety, and being ignored in a time of need, according to an article published in the British Journal of General Practice.
Contact with a general practitioner or health center can be a frustrating pen-and-paper exchange, as most receptionists and physicians do not communicate using sign language. Paul Welsh, Communications Director at Deaf Health Charity SignHealth, told nuviun:
“Research shows that, at the moment, 45% of Deaf people who use sign language as their main form of communication can only make an appointment by walking into the [health center] and struggling with a receptionist who doesn't understand sign language.”
SignHealth claims this inequality is caused by a lack of interpreters at consultations, inadequate booking procedures, and almost non-existent health information in sign language. The charity claims poor communication is leading to missed diagnoses and ineffective treatment.
"This is unintentional neglect, likely to lead to shortened lives," according to Steve Powell, Chief Executive of SignHealth. "A basic lack of knowledge on the part of health professionals is leaving a vulnerable community with inadequate healthcare."
SignHealth has collaborated with information and communication technology companies and governments to address the disparities in health, health literacy, and access to care. InterpreterNow is an interpretation service available during business hours for those that communicate using British Sign Language (BSL) and their service providers. All that’s needed is an Internet-connected computer (or handheld device) with a webcam. InterpreterNow is used in health centers, hospitals, and even grocery stores to help ensure that Deaf people receive the information and services they need.
When they found that health advice in sign language was practically non-existent, SignHealth created an online health information library in BSL. The growing library uses YouTube videos to convey health information and lifestyle advice, from the importance of exercise to coping with grief.