Access to Primary Care and Dental Care Services Among Persons with Intellectual and Developmental Disabilities (IDDs) during the COVID-19 Pandemic

Background and Purpose:

Individuals with intellectual and developmental disabilities (IDDs) have long faced disparities in healthcare access, including difficulties in obtaining primary and dental care. The COVID-19 pandemic exacerbated these barriers, yet little is known about national trends during this period. This study examines how the pandemic influenced access to primary and dental care among children and adults with IDDs, with a particular focus on disparities by age, race/ethnicity, income, and geographic location.

Methods:

Using 2018–2022 data from the National Core Indicators—Intellectual and Developmental Disabilities (NCI-IDD) Adult and Child Family Surveys, we conducted descriptive and logistic regression analyses. Two binary outcome variables were constructed to reflect challenges in accessing primary care and dental services. Models were stratified by child and adult populations and adjusted for demographic, household, and socioeconomic characteristics, including rural residence, income, race, and caregiver education. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.

Results:

Significant disparities were found across sociodemographic groups. Among adults, Asian Americans had 72% higher odds of experiencing challenges in primary care access (OR=1.72, 95% CI: 1.44–2.05) and 41% higher odds for dental access (OR=1.41, 95% CI: 1.25–1.60) compared to White adults. Adults from households with no earned income also faced significantly higher risks of challenges accessing care (primary care OR=1.94, 95% CI: 1.56–2.40; dental care OR=1.96, 95% CI: 1.71–2.25). For children, rural residence was associated with increased odds of facing dental care access barriers (OR=1.24, 95% CI: 1.09–1.40), and Asian children had significantly higher odds of challenges in both primary (OR=1.51, 95% CI: 1.22–1.86) and dental care access (OR=1.59, 95% CI: 1.36–1.85). Challenges peaked during the pandemic in 2020 (e.g., primary care access for children OR=1.43, 95% CI: 1.14–1.81) and declined by 2022 among adults.

Conclusions and Implications:

The COVID-19 pandemic amplified existing inequities in health care access among individuals with IDDs. These findings highlight the need for targeted public health strategies, including improved provider training, integration of telehealth, and enhanced emergency preparedness for families with IDDs. Policies should prioritize resilience and equity in healthcare systems to address intersectional vulnerabilities in this population.