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introduction Introduction

Neurodiversity refers to the natural differences in how human brains function, encompassing a range of neurological conditions such as autism, Attention Deficit Hyperactivity Disorder (ADHD), dyslexia, dyspraxia, and Fetal Alcohol Spectrum Disorders (FASD). Individuals whose brain functions differ from societal norms are referred to as neurodivergent, while those with typical cognitive functioning are termed neurotypical.

The neurodiversity framework promotes acceptance and inclusion, highlighting the unique strengths and perspectives of neurodivergent individuals and their contributions to society. However, neurodivergent people often face inequities in accessing education, healthcare, and employment due to environments and systems that are designed with neurotypical norms in mind. This Key Topic Summary (KTS) focuses on the public health implications of neurodiversity, aiming to identify challenges, promote inclusion, and reduce inequalities for neurodivergent individuals.

why is it important to population health Why is it important to Population Health?

Neurodiversity is important to population health for many reasons:

Neurodivergent individuals often experience significant barriers to accessing services and opportunities, leading to poorer outcomes in health, education, and employment. Key challenges include:

  • Health inequities: Neurodivergent individuals face higher rates of preventable physical and mental health conditions, including anxiety, depression, and addiction.
  • Mortality disparities: People with autism live an average of 16 years less,1 and those with ADHD around 13 years less,2 than neurotypical individuals. People with FASD face even greater life expectancy challenges.
  • Impact on families and communities: Neurodivergent individuals often require ongoing support from families, friends, and carers, which can strain social networks and resources.
  • Economic consequences: Unemployment and underemployment are common among neurodivergent adults, impacting financial stability and perpetuating cycles of inequality.

Public health efforts must address these disparities by promoting inclusive environments, reducing systemic barriers, and fostering greater understanding and acceptance of neurodivergent individuals.

the derbyshire population approach The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of neurodiversity within The Derbyshire Population Health Approach:

• Prevention Prevention

While the underlying causes of neurodivergent conditions are not entirely understood, proactive measures can reduce associated health inequalities and improve quality of life:

  • Early intervention: Early identification of neurodivergent conditions can lead to timely support for children and families, enhancing outcomes in education and mental health.
  • Awareness campaigns: Initiatives such as PEACE guides, which promote understanding of sensory needs, communication styles, and mental health considerations, can improve inclusivity in workplaces, schools, and healthcare settings.
  • FASD prevention: Promoting alcohol abstinence during pregnancy can eliminate the risk of FASD, a neurodivergent condition entirely preventable through behavioural changes.
  • Training for professionals: Educating healthcare workers, educators, and employers on neurodivergent needs can create more accessible and supportive environments.
• Population Population

Neurodiversity affects individuals across all demographics, but certain groups experience unique challenges:

  • Gender disparities: While males are more frequently diagnosed with autism and ADHD, evidence suggests this may reflect biases in diagnostic criteria and societal stigma, leading to underdiagnosis in females.
  • Intersectionality: Neurodivergent individuals from ethnic minority or low-income backgrounds face compounded barriers due to systemic inequalities in education, healthcare, and social services.
  • Age-related needs: Neurodivergent children often require specialised support in school environments, while older adults face unique challenges related to late diagnosis and accessing appropriate care.
• Evidence Evidence

The public health approach to neurodiversity leverages evidence to understand the unique challenges faced by neurodivergent individuals and to develop effective interventions. Key areas include:

Prevalence and Inequalities

  • Prevalence: Approximately 15-20% of the population is neurodivergent,3 encompassing conditions such as autism, ADHD, dyslexia, and others.
  • Health inequities: Neurodivergent individuals face increased barriers to healthcare, education, and employment, contributing to significant health inequalities. This population experiences higher rates of preventable physical health conditions, mental health issues, and reduced life expectancy compared to neurotypical individuals.
    • Autistic individuals, on average, live 16 years less than neurotypical individuals.4
    • Those with ADHD live approximately 13 years less,5 and individuals with FASD often have a life expectancy of just 34 years.6,7
  • Local context: In Derbyshire, up to 50% of autistic individuals experience anxiety, and between 30% and 60% are diagnosed with both autism and ADHD, further compounding their health challenges.

Barriers to Healthcare

  • Access challenges: Neurodivergent individuals often struggle with overstimulating healthcare environments, inaccessible communication methods, and difficulties navigating or locating appointments.
  • Misdiagnosis and overlooked conditions: Physical and mental health symptoms are frequently misattributed to neurodivergent conditions, resulting in missed or delayed diagnoses of co-occurring issues such as gastrointestinal disorders. Between 30% and 70% of autistic individuals experience chronic gastrointestinal problems like constipation or irritable bowel syndrome.8
  • Higher mortality rates: Neurodivergent individuals face significantly higher preventable mortality rates. For example, the LeDeR review found 42% of deaths among neurodivergent individuals were preventable, compared to 22% in the general population.9

Mental Health Impacts

  • Poor mental health prevalence: Neurodivergent individuals experience substantially higher rates of anxiety, depression, and trauma than neurotypical populations.
    • 66% of autistic individuals have considered suicide, and 35% have attempted it.10
  • Youth-specific challenges: Autistic children often face sensory overload and social exclusion in mainstream schools, resulting in bullying, rejection, and isolation, which negatively impact their social and emotional development.

Economic and Social Inequities

  • Employment disparities: Neurodivergent individuals are significantly underrepresented in the workforce:
    • Only 30.6% of autistic adults are employed11, compared to 81.9% of non-disabled individuals.
    • Adults with ADHD are 60% more likely to be dismissed from jobs and 30% more likely to face employment-related difficulties.12
  • Addiction and risky behaviours: Neurodivergent individuals are more likely to engage in addictive behaviours, such as gambling or substance abuse, often linked to impulsivity and social isolation. ADHD, in particular, is associated with higher rates of risky behaviours due to reward-seeking tendencies.
  • Social isolation: Many neurodivergent individuals experience loneliness, exacerbating health inequalities and reducing overall quality of life.

Gaps in Evidence

  • Limited research: Despite the prevalence of neurodivergent conditions, there is insufficient data on their specific health and social needs. This limits the development of targeted interventions.
  • Emerging issues: Further research is needed on the connection between neurodivergent conditions and behaviours like addiction, as well as on strategies to address health disparities and improve life expectancy for neurodivergent populations.

Key Opportunities

  • Data-driven approaches: Expanding data collection at local and national levels can provide insights into the specific needs of neurodivergent individuals and inform the design of inclusive services and policies.
  • Engaging lived experience: Including neurodivergent individuals and their families in research, service design, and policymaking can help identify effective solutions and create services that are truly person-centred.
• Causes Causes

While the exact causes of neurodivergent conditions remain uncertain, genetic factors are known to play a significant role. Environmental influences, such as prenatal exposure to toxins or adverse childhood experiences, may also contribute. Addressing these broader determinants can reduce the wider impacts of neurodiversity-related health inequalities:

  • Social determinants: Poverty, lack of access to education, and social isolation exacerbate challenges for neurodivergent individuals.
  • Environmental barriers: Overstimulating physical environments, inaccessible workplaces, and rigid educational systems hinder participation and integration.

Understanding and addressing these root causes requires a multi-faceted approach that considers both individual and systemic factors.

• Collaboration Collaboration

Effective collaboration is essential to improve outcomes for neurodivergent individuals:

  • System partnerships: The Derbyshire Autism Boards work to align system partners, including Local Authorities (LAs), healthcare providers, and community organisations, to improve autism services and identify gaps.
  • Lived experience: Incorporating the voices of neurodivergent individuals and their families in policymaking ensures that initiatives reflect their needs and priorities.
  • Cross-sector collaboration: Education, health, and social care services must work together to provide seamless support for neurodivergent individuals, addressing gaps in diagnosis, service provision, and long-term care.

It should also be noted that there are legal requirements by LAs and NHS to support autistic people under the Autism Act 2009, Care Act 2014, Childrens and Families Act 2014, Childrens Act 1989 and the Equalities Act 2010.

latest derbyshire data Latest Derbyshire Data

Trend Data

Derbyshire Quilt

Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.