Tracing the Historical Roots of Health Inequity Among People With Intellectual and Developmental Disabilities in the United States: Impact of Models, Advocacy, Legislation, and International Context.

Abstract

The history of inequity for people with intellectual and developmental disabilities (IDD) in the United States is a compelling story of social perceptions of disabilities, advocacy, legislation, and international influences. Although my focus here is on health inequities, the contributing factors equally influenced where people with IDD lived, worked, and recreated. This article provides a public health perspective for viewing intertwining advances in models of disability, the power of family and self-advocacy, and US legislation to create infrastructures for community-based training, services, and support. It includes periods of inhumane treatment and gross neglect of people with disabilities. All are considered within an international context of increasing recognition of the human rights of people with disabilities. Key organizations pushing for improvements include Special Olympics and Arc of USA. Beginning with the 1800s when people with severe disabilities were often institutionalized, I document changes in prevailing models of disability, the movement to deinstitutionalize people with IDD to community settings, and the recent push to reconceptualize disability to promote true inclusion with full human rights. Current issues and future directions are outlined to advance health equity. (<i>Am J Public Health</i>. 2026; 116(S2):S84-S93. https://doi.org/10.2105/AJPH.2026.308466).