New Zealand athletes with intellectual disabilities will miss out on an important four-yearly health screening, along with the postponement of the Special Olympics due to Covid-19.
The New Zealand Special Olympics was scheduled for December in Hamilton, but was postponed last week until 2022 due to Covid-19.
Special Olympics CEO Carolyn Young said the uncertainty around the current Delta outbreak and alert level changes had forced them to make the difficult decision for the 1600 athletes and coaches.
But while providing an inclusive space for people with intellectual disabilities to participate in sport, the games would have also been the site for a health screening programme for the athletes, who are often under-served by the health system.
Young said health outcomes for New Zealanders with intellectual disabilities was shockingly low when compared with other OECD countries.
Globally people with intellectual disabilities die 16 years prematurely due to undiagnosed and untreated conditions, but in New Zealand the gap is even wider.
"Females with an intellectual disability die 23 years earlier and males with an intellectual disability 18 years," Young said.
The Special Olympics provided free health screening to all athletes participating in the event, with a strict target of 5000 screenings every national games.
"There'll be eye examinations, dental examinations, hearing tests, podiatry assessments and general health and wellbeing," Young said.
Vision was one of the key areas targeted at the athlete screening programme, and optometrist and clinical director of the Opening Eyes programme Evan Brown had been involved in the Special Olympics for 20 years.
He said four out of every 10 athletes he saw would either need new glasses or be wearing the incorrect ones. Around 15 per cent would have some form of eye disease.
Figures were similar in dentistry with four in 10 with some form of tooth decay and one in 10 needing urgent treatment.
Brown said people with intellectual disabilities had a higher instance of health problems in the first place, but this was exacerbated by the fact that they under-complained.
"They often don't complain about the fact that they can't see, or that they've got a sore tooth or they can't hear," he said.
"We had a patient once who was 19 years of age and he was a swimmer."
"He was legally blind, he was over minus 10, but once corrected he could see really well."
"His parents came back and said it was the first time he went to a public toilet by himself. They thought it was because he struggled intellectually but really he just couldn't see where he was going."
Another part of the problem was that many health professionals weren't properly trained to treat patients with intellectual disabilities.
Many struggled to diagnose patients who could not express themselves. Unpleasant procedures such as dental checks and smear tests could also be traumatising for people with disabilities who may not be able to understand what was happening.
"An eye examination is quite a challenging process when you can't get good subjective data," Brown said.
"You're asking is this better or worse, and sometimes they can't tell you.
"You really need paediatric skills and what's called paediatric testing equipment, and the majority of optometry in New Zealand doesn't specialise in children."
Basketballer Chrissa Pearce was going to be competing in the Special Olympics for the first time this year, but had also attended the 2017 games to support her team.
She and her mum Helen said the Games provided a valuable space for people with intellectual disabilities to receive free healthcare safely.
"It's important in the medical field to have people you can relate to really well because you need to be able to communicate their needs," Helen said.
"If you just go to a random doctor or optometrist they might not actually be the right person."
Having worked in the field herself, Helen said she knew many families who were struggling to pay for medical expenses, which made the free service all the more valuable.
"To have a community like that is just fantastic," she said.
"It's friendly, it's free, it's non-judgmental – it means that everyone gets that same opportunity."
A Ministry of Health spokesperson confirmed the figures quoted were consistent with those published in a 2011 report, Health Indicators for New Zealanders with Intellectual Disability.
In comparing New Zealand life expectancy of people with intellectual or learning disabilities to all New Zealanders, the report found males with intellectual disabilities died 18.7 years prematurely and women 22.9 years.
The report also found around one in five disabled adults reported not visiting a GP due to cost, compared to 12.7 per cent of non-disabled adults.
They were 3.8 times as likely than non-disabled adults to be unable to collect a prescription due to cost.
But the Ministry said it was unclear this was lower than the global average, as New Zealand data may have been influenced by their definition of intellectual disability.
The study did not distinguish people who had developed an intellectual disability early in life from those who simply had a disability at the time of the study. For example, adults who developed dementia at an older age may have been included and influenced the results.
The spokesperson said data around disability in New Zealand was lacking, and "a priority for improvement".
"The reasons for the disparity in health outcomes for disabled New Zealanders are complex and nuanced," they said.
"They may include affordability and accessibility to care, socioeconomic status and health behaviours."
"It's also important to note that disabled people commonly have other health conditions."
Under the Disability Action Plan 2019 – 2023, the Ministry aimed to improve health outcomes for disabled people in New Zealand by implementing disability action plans, improving data and awareness in the workforce.