Lifestyle challenges and issues faced by individuals with intellectual and developmental disabilities: A review

 Corresponding author: S. Venkatesan Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Lifestyle challenges and issues faced by individuals with intellectual and developmental disabilities: A review S. Venkatesan * Formerly Dean (Research and Development), Professor and Head, Department of Clinical Psychology, All India Institute of Speech and Hearing, Mysore: 570006, Karnataka, INDIA. World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 Publication history: Received 08 October 2025; revised on 19 November 2025; accepted on 21 November 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.2.3908 Abstract Introduction: Individuals with intellectual and developmental disabilities (IDD) encounter unique lifestyle (LS) challenges that adversely affect their quality of life (QOL). These challenges arise from physical, social, and environmental barriers, necessitating a comprehensive examination of their multifaceted issues. Objectives: This review aims to synthesize existing literature on LS challenges faced by individuals with IDD, focusing on barriers in health, education, employment, and social inclusion, while identifying effective interventions and support systems to enhance their QOL. Generic Aim: The primary aim is to provide a comprehensive overview of the LS issues affecting individuals with such disabilities, highlighting the need for targeted interventions and support systems to enhance their quality of life. Method: A systematic review was conducted using databases such as PubMed, Scopus, and Google Scholar, analyzing studies published in the last decade. The search yielded 180 studies, with 120 meeting inclusion criteria. Results: The findings indicate that individuals with disabilities encounter significant barriers related to accessibility, social inclusion, and health care. Many studies highlighted the importance of community support and inclusive policies in mitigating these challenges. Key themes included restricted autonomy, health inequities, and social isolation. Effective interventions highlighted include community support programs and inclusive educational practices, which have shown to improve QOL indicators significantly. Conclusion: Addressing the LS challenges faced by individuals with IDD is crucial for promoting their empowerment and well-being. This review underscores the urgent need for targeted interventions, inclusive policies, and ongoing research to improve accessibility and support services, ultimately enhancing the quality of life for this population. Keywords: Barriers; Quality of Life; Accessibility; Health Issues; Social Inclusion; Empowerment; Support Services; Self-Determination. Employment 1. Introduction The term "lifestyle" (LS) has various meanings across academic and creative contexts. In academic and psycho-social terms, it encompasses ways of living, social habits, and cultural norms, while in creative contexts, it refers to daily routines and personal ethos. A more precise terminology for research might include “mode of living” or “life circumstances” (Abdullah et al. 2004). World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1768 Individuals with intellectual and developmental disabilities (IDD) face numerous LS challenges that impact their quality of life (QOL), including health, education, and social inclusion. Limitations in cognitive and adaptive functioning lead to poor QOL, restricted social integration, and increased caregiver burden, compounded by systemic marginalization (Meena, 2024; Glidden et al. 2021). Studies indicate that IDD individuals experience higher social isolation and discrimination, exacerbating mental health issues (Emerson and Hatton, 2007). Barriers to healthcare result in unmet medical needs (McKenzie et al., 2016), while educational systems often fail to accommodate students with IDD, hindering their growth (Lindsay, 2010). Employment opportunities are limited due to discrimination (Wehman et al., 2014), and despite global inclusive policies, QOL disparities persist, especially in low-resource settings (Kumar and Lal, 2024). A comprehensive review is essential to synthesize evidence and guide interventions that promote autonomy and well-being for IDD individuals in society (Brown, 2003). Health issues are common among individuals with IDD, with many facing obesity from inadequate nutritional education. For example, those with Down syndrome often lead inactive lifestyles and lack healthy eating knowledge (Rimmer, Yamaki, and Davis, 2016; Rimmer et al. 2010). Barriers to healthcare can lead to untreated conditions, as seen when young adults with autism avoid health check-ups due to anxiety. In education, students with IDD frequently lack necessary accommodations, which affects their academic performance and self-esteem. Social isolation due to stigma is prevalent, with teenagers facing exclusion from peer activities, leading to loneliness. Communication challenges hinder friendship formation, and workplace discrimination results in qualified individuals being overlooked, leading to underemployment. Even when employed, they often lack necessary support, such as structured environments for those with autism. Other LS challenges include difficulties with independent living, transportation access, and heightened mental health risks. Crises like the COVID-19 pandemic have intensified these issues, highlighting the need for tailored interventions to improve societal inclusion (Courtenay and Perera, 2020). Scope, Aims and Objectives This study comprehensively examines existing literature on support and resources for individuals with IDD. It focuses on key areas that impact their QOL, including healthcare access, nutritional education, health maintenance, educational accommodations, vocational training, social inclusion, independent living skills, mental health support, crisis preparedness, and advocacy. By exploring these aspects, the study seeks to enhance understanding of the current support landscape for individuals with IDD and identify areas for improvement. This review aims to • Synthesize existing literature on LS challenges experienced by individuals with IDD across identified specific domains. • Identify systemic barriers and contextual factors that exacerbate marginalization and reduce quality of life. • Highlight inclusive interventions and policy frameworks that promote autonomy, dignity, and well-being. • Map research gaps to guide future interdisciplinary studies and inform evidence-based practices. • Advance advocacy efforts by framing LS issues within a rights-based and ecological perspective. 2. Operational definitions Intellectual Disabilities (ID) are characterized by significant limitations in intellectual functioning and adaptive behavior, affecting daily skills. Typically, an IQ score of 70 or lower on standardized tests, along with deficits in at least two areas such as communication or self-care, defines ID. Symptoms must manifest before age 18 (Brown and Percy, 2011). Developmental Disabilities (DD) include a variety of chronic conditions that arise during the developmental period, resulting in challenges related to physical, learning, language, or behavior. Examples include Autism Spectrum Disorder (ASD), Cerebral Palsy, Down Syndrome, and Fragile X Syndrome. These disabilities must present before age 22 and significantly restrict major life activities like self-care and communication, often requiring lifelong support (Gidden et al. 2021). Lifestyle (LS) encompasses the behaviors, activities, and choices that define an individual's way of living, particularly for those with IDD. It includes daily living skills, social interactions, leisure activities, and health-related behaviors, reflecting how individuals engage with their environment and make choices that enhance their quality of life (QOL) (Schalock and Verdugo, 2012). Key components of LS involve personal care, social relationships, leisure pursuits, and health practices, such as nutrition and exercise (Vandenbos, 2020). World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1769 It's crucial to distinguish between life skills and LS. Life skills—like time management and emotional regulation— underpin LS choices and influence daily living. For example, a minimalist lifestyle can indicate strong decision-making skills. Understanding these skills is vital for recognizing LS adaptations across cultures and life stages, as they are essential for self-sufficiency. Practical life skills include personal care, household management, financial management, transportation, and social communication (Smith, 2021; Johnson, 2019; McCoy, 2018). While LS represents the overall way of living, living skills are specific abilities that support day-to-day functioning, both critical for personal development and well-being, especially for individuals with IDD. 3. Conceptual framework and theories Understanding LS for IDD is shaped by various theoretical frameworks that provide insight into their experiences and challenges. One of the foundational theories is Ecological Systems Theory, developed by Bronfenbrenner in the late 1970s. This theory posits that individuals exist within a network of interconnected systems. At the core is the microsystem, which includes immediate environments like family and peers. Surrounding this are the mesosystem, comprising community and services; the exosystem, which encompasses broader influences such as policies and media; and the macrosystem, reflecting cultural norms and legislation. For instance, consider a child with IDD who benefits from family support within their microsystem and attends a specialized school in their mesosystem. However, if local policies in the exosystem do not support inclusive education, or if societal attitudes in the macrosystem are negative towards disabilities, the child may face significant barriers to social integration and academic success. Another important framework is the Social Model of Disability (Oliver, 1990). shifts the focus from individual impairments to the societal barriers that hinder participation. For example, a community center without wheelchair access serves as a societal barrier that limits opportunities for individuals with mobility impairments. By improving accessibility, such environments can foster social inclusion and enhance overall quality of life. The Socio-Cultural Perspective further emphasizes how societal norms and values influence the experiences of individuals with IDD. In some cultures, individuals with IDD may be perceived as burdens, leading to social isolation. Conversely, cultures that celebrate diversity and inclusion often create community programs that actively involve individuals with IDD in social events, promoting acceptance and integration (Brown and Percy, 2019). Social Cognitive Theory (Bandura, 1986) highlights the importance of self-efficacy and social learning. Programs that incorporate peer mentorship can significantly enhance self-efficacy among individuals with IDD. For instance, when peers demonstrate cooking skills, participants may feel motivated to try cooking themselves, thereby improving their daily living skills. The Theory of Planned Behavior (Ajzen, 1991), categorizes the factors influencing behavior into attitudes, subjective norms, and perceived behavioral control. A health promotion initiative aimed at individuals with IDD might work to change attitudes toward healthy eating. By offering cooking classes that involve family members, such initiatives can positively influence subjective norms and enhance perceived control over food choices. The Transtheoretical Model, developed by Prochaska and DiClemente in 1982, outlines the stages of behavioral change. For instance, a physical activity program tailored for individuals with IDD could utilize motivational interviewing techniques to assess readiness for change, helping participants transition from awareness to action by gradually increasing their activity levels (Bartlo, Klein, and Abbeduto, 2011). Social Change Theory examines how cultural and structural changes impact patterns of LS. Campaigns that highlight the achievements of individuals with IDD can help shift societal perceptions, promoting greater acceptance and integration. Additionally, Consumerism Theory explores how consumption behaviors influence LS. Educational programs that teach individuals with IDD about budgeting and consumer rights empower them to make informed purchasing choices, enhancing their independence and selfadvocacy. Finally, the Adaptive Decision-Making Framework integrates various theories to encourage LS behavior changes. Digital tools, such as mobile applications, can assist individuals with IDD in managing their daily routines by providing reminders for medication, exercise, and social activities. These tools help users set goals, track their progress, and receive positive reinforcement, facilitating meaningful changes in their lifestyles (Zhang, Lakens, and IJsselsteijn, 2021). Together, these theoretical frameworks offer a comprehensive understanding of the experiences and lifestyle challenges faced by individuals with IDD, highlighting the importance of a supportive and inclusive environment. World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1770 4. Review of literature Individuals with IDD face distinct LS challenges that vary considerably on both local and global scales. Global issues affecting their well-being and rights include discrimination, limited access to education and employment, and societal stigma (Goffman, 1963). Conversely, local challenges are often community-specific, such as difficulties with transportation, communication barriers, and obtaining adequate housing and daily support. In high-income countries like the United States, individuals frequently encounter obstacles related to healthcare, education, and job opportunities (Havercamp and Scott, 2015). In low-income countries, challenges may involve severe stigma, inadequate healthcare services, and a lack of educational resources (Mitra et al., 2013). Cultural attitudes toward disability also shape these experiences; for instance, collectivist cultures may emphasize family support, while individualistic cultures may focus on independence and self-advocacy (Shakespeare, 2013). This diversity highlights the need for context-specific policy interventions to improve the QOL for individuals with IDD globally. The literature on LS for adults with IDD identifies various barriers, facilitators, and effective interventions. Caton et al. (2012) highlighted the significant knowledge gaps and obstacles that hinder them from adopting healthy LS, emphasizing the need for increased awareness and education to improve health outcomes. A systematic review by Humphries et al. (2009) revealed notable challenges in nutrition for adults with IDD, pointing to the necessity for customized nutritional guidance and support. Overwijk et al. (2022) examined programs aimed at empowering direct support professionals to promote healthy LS among individuals with moderate to profound IDD, finding that training and resources for caregivers are essential for encouraging healthier habits. Steenbergen et al. (2017) conducted a systematic analysis of LS strategies, showing that personalized interventions tailored to individual needs are effective. Suarez-Balcazar et al. (2018) investigated the barriers to healthy living from the viewpoints of both youth with disabilities and their parents, highlighting the importance of these perspectives in developing effective strategies. Lloyd et al. (2016) discussed the impact of stress on families with IDD, emphasizing the need for robust support systems to improve their QOL. Lastly, McKenzie et al. (2017) focused on communication challenges among individuals with IDD, stressing the importance of effective communication strategies to enhance social engagement and overall QOL. Research gaps Research gaps regarding LS issues faced by individuals with IDD indicate critical areas for future interdisciplinary studies. A major gap is the insufficient data on how LS factors—such as nutrition, physical activity, and social engagement affect health outcomes for this population (Heller et al., 2011). More investigation is needed into the effectiveness of tailored interventions that focus on mental health and well-being (Sullivan et al., 2018). Additionally, the influence of life events, family dynamics, and support systems on promoting healthy LSs remains under-explored (Hulbert-Williams and Hastings, 2008; McGrew et al., 2017). Addressing these gaps can lead to evidence-based practices that improve the QOL for individuals with IDD by incorporating insights from health, psychology, and social sciences. The literature emphasizes the importance of comprehensive support systems, targeted interventions, and ongoing education for enhancing health and well-being in this demographic (Steenbergen et al., 2017). 5. Method This review systematically compiles peer-reviewed literature on the LS challenges faced by individuals with IDD. Following PRISMA guidelines, the methodology ensures transparency and replicability. The inclusion criteria focused on studies that examined LS domains such as health, education, employment, and social inclusion within IDD populations (Table 1). Data extraction was carried out using a structured coding sheet to capture various study characteristics, while a narrative synthesis was employed to identify patterns, gaps, and recurring themes across the research. Each study was assessed using the Mixed Methods Appraisal Tool (MMAT; Hong et al., 2018), which evaluates qualitative, quantitative, and mixed-methods research based on alignment with research questions, rigor in data collection, and clarity of findings. As this review involves secondary data analysis, ethical approval is not required; however, only studies with institutional ethical clearance were included (Venkatesan, 2009). Ethical considerations in reviewing LS studies for IDD encompass several issues. Informed consent is essential, as researchers must ensure participants comprehend the study's purpose, risks, and benefits, which can be difficult due to cognitive limitations (Fisher, 2018). There is also a significant risk of exploitation, as individuals with IDD may be susceptible to coercion (Harris et al., 2020). Researchers must protect the confidentiality of sensitive information and consider how their findings might shape public perceptions of this vulnerable population (Lunsky et al., 2019). Additionally, cultural sensitivity is crucial to avoid misrepresentations in LS statements (Beauchamp and Childress, 2019). World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1771 Table 1 Swimlane Diagram showing Study Selection Process Phase Actions Identification (N = 299) Database search: PubMed, Google Scholar, Scopus, Web of Science, PsycINFO, ERIC, JSTOR, ata sources: Books, Book Chapters, Original Research Articles, Systematic Reviews, Meta Analysis, Commentaries, and Editorials included. Search Strategy was comprehensive and conducted across databases using Boolean combinations of keywords such as, "intellectual disability" OR "developmental disability" AND "lifestyle", "quality of life", “social inclusion”, “employment", etc. study characteristics (author, year, title, name of journal or publisher) Initial records identified Screening (N = 197) Duplicate records removed Titles and abstracts reviewed Irrelevant studies excluded Eligibility (N = 140) Full-text articles assessed Inclusion criteria applied Studies with limited relevance, grey literature, Pre-prints, Blogs, News Articles, Media Reports, Conference Proceedings, Thesis and Dissertations, Clinical Trial Registers, Field Notes, Observation Data, Non-English Publications, and Institutional Reports excluded Final Selection (N = 120) Studies included in the review Timeline Publications: till 2000: 14; 2001-10: 23; 20011-20: 82; >2021: 21 Data extracted and analyzed Findings synthesized into key themes 6. Results Table 2 highlight significant trends in the obtained the present literature search on LS in persons with IDD covering the frequency by years of publication, themes or topics of study, and format or journals of publication. The Journal of Intellectual Disability Research and Disability and Society are among the most frequently published journals in this area. The frequency of publications shows a marked upward trend over time. From a modest 14 publications before 2000, the output nearly doubled to 23 between 2001 and 2010. A significant surge occurred during 2011–2020, with 82 publications, indicating a period of heightened research activity or institutional support. Post-2021, the count drops to 21, suggesting either a recent slowdown or an incomplete data capture for the current decade. Walters (1990) introduced Lifestyle Theory, suggesting that biologically influenced LS choices may contribute to criminal behavior, integrating sociological perspectives to explain crime patterns. Abdullah et al. (2004) pioneered research on promoting healthy living among PWD, outlining strategies to improve physical activity, nutrition, and overall wellness. Their work emphasized inclusive health promotion tailored to PWD, marking a significant step toward equitable well-being initiatives and highlighting the need for targeted interventions within this population. Other common themes or topics in this compilation of references include Self Determination (N: 47; 33.57 %), Quality of Life (N: 26; 18.57 %), Employment (N: 5; 3.57 %), Health Inequities (N: 25; 17.86 %), and the impact of COVID-19 on people with IDD. Some of them are elaborated below. The keyword "Self Determination" appears 47 times, emphasizing its vital role in promoting autonomy and others (Table 2). The derived Chi-Square statistic suggests a statistically significant association among these themes, reflecting their inter-connections in current research with he need for ongoing investigation into these critical issues. World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1772 Table 2 Frequency Counts of Themes/Topics covered in the review of literature Sno. Keyword N Percent* 1 Self Determination 47 33.57 2 Intellectual Disabilities 36 25.71 3 Quality of Life 26 18.57 4 Review Papers 25 17.86 5 Incarcerated People 25 17.86 6 Health Inequities 25 17.86 7 Adults 12 8.57 8 Indian Studies 11 7.86 9 Families 10 7.14 10 Education 9 6.43 11 Barriers 8 5.71 12 Social 8 5.71 13 Lifestyles 7 5.00 14 Support 7 5.00 15 Theory 6 4.29 16 Adolescence 6 4.29 17 Criminal Justice 6 4.29 18 Employment 5 3.57 Total 299 *Against the assumed total of 140 references; X2:40.25; DF: 32; p: <0.05; S. 6.1. Self-determination The concept of self-determination (SD) is rooted in Self-Determination Theory, which posits that autonomy, competence, and relatedness are essential for intrinsic motivation and well-being (Ryan and Deci, 2000). SD is a critical component that has positive impact on various aspects of life, including education, employment, and overall QOL for individuals with IDD as shown below. Table 3 Summary of research papers retrieved on self determination Author/s Year Findings Wehmeyer and Schwartz 1997 A strong correlation exists with QOL, indicating that greater SD leads to higher life satisfaction and overall well-being MacNeil and Anderson 1999 Discussed the role of leisure activities in empowering IDD through inclusion or by providing opportunities for participation in leisure to promote SD and overall well-being Algozzine et al. 2001 Targeted interventions significantly enhance SD skills, underscoring the importance of strategic support Wehmeyer and Bolding 2001 Examined how transitioning adults to community-based work and living environments enhances their SD, personal autonomy, and QOL Wehmeyer and Garner 2003 Investigated the influence of personal characteristics, such as age, gender, and cognitive abilities, on their SD and autonomous functioning. World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1773 Wehmeyer 2007 provided practical strategies for promoting SD in students with IDD, emphasizing the need for educational practices that empower them to make choices and take control of their lives. Wehmeyer 2013 Explained SD as the ability to make choices, establish goals, exert control, and take decisions that affect one's life; how it fosters a sense of self-esteem, autonomy, empowerment, and greater life satisfaction. Wehmeyer Frielink, Schuengel, and Embregts, 2020 2018 Framework highlights the importance of personal agency in achieving meaningful life outcomes Wehmeyer and Garner 2018 Review noted its positive impact on various life outcomes, including autonomy, QOL, better educational and employment prospects. Wehmeyer and Palmer 2018 Identified effective strategies for promoting SD in students, enhancing their decision-making, self-advocacy, and goal-setting skills. Wehmeyer and Shogren 2016 Stress the need for ongoing exploration for understanding the predictors of SD Shogren et al. 2015 Improve social relationships and boost participation in community activities Carter et al. 2009 Found adolescents with severe IDD often lack opportunities to develop these skills, highlighted the need for structured programs that facilitate SD. Meral et al. Dean et al. Curryer, Stancliffe, and Dew, 2023 2021 2015 Studies covered family dynamics, involvement, and parenting styles in fostering SD Mumbardó-Adam et al. 2024 2020 2017 Studies that explored the vital role of contextual factors, such as social support, bullying, and access to resources mediate SD Hughess 2022 Access to support services and resources impact self-esteem and, in turn, individuals' confidence in making decisions about their lives Chou et al. 2017 Compared SD levels among students with different disabilities, including ASD, who require tailored support Griffin et al 2019 Highlighted that individuals who experience bullying feel undermined in their self-esteem and autonomy Schillaci et al., 2021 Gender affects SD and autonomy, as societal expectations and norms differ by these variables Medforth and Boyle, Wehman et al. Pomeranz, 2023 2014 2017 Studies that showed sustained support, education and employment are pivotal in enhancing SD Torres et al 2023 Longitudinal study showing SD develops over time Söderström et al 2021 Assistive technology plays crucial role in promoting SD Jones et al 2018 Can inform future interventions and policies aimed at improving their lives Kuld et al. 2023 A systematic review and meta-analysis to explore strategies for promoting SD Mallander 2015 Examined the experiences of young adults with ID in Sweden, focusing on their power, SD, and self-organization in daily life. Nota et al. 2007 Found positive correlation between SD, social skills, and QOL Randall et al. 2023 Examined a self-monitoring intervention to improve SD Shogren et al. 2018 Highlighted predictors like self-advocacy and social support World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1774 Sheppard and Unsworth 2011 Examined the development of everyday skills and SD in fostering independence Shogren and Broussard 2011 Explored self-perception of SD as crucial although barriers to its realization persist. Shogren and Singh 2022 Investigated the impact of mindfulness-based interventions on SD to enhance overall well-being self-awareness and emotional regulation. Vaucher et al. 2021 Investigated how social care professionals perceive and understand SD. Vicente Sánchez et al. 2022 Conducted a construct analysis of SD from a professional perspective. Vicente et al. 2020 Examined the mediating role of opportunities in fostering SD reinforcing the importance of creating supportive environments Rendall et al. Grigal and Hart, Shogren et al. 2023 2018 2018 Highlight interventions and predictors that enhance SD and employment outcomes for individuals with IDD in postsecondary education settings Wehmeyer and Shogren 2020 Discussed the relationship between SD and autonomous motivation in educational settings Zhang et al. 2023 Investigate post-secondary education outcomes for individuals with IDD, focusing on SD, independent living, employment, and the implications of the COVID-19 pandemic Sinclair, Gilson, and Dulas 2024 Emphasized that fostering SD within employment settings significantly enhance job satisfaction and career development empowering them to pursue meaningful work opportunities Taylor et al. 2019 Highlighted the importance of a family systems support and dynamics approach enhance SD, foster independence and decision-making skills 6.2. Quality of life QoL for individuals with IDD is a complex concept that includes aspects such as physical health, emotional well-being, social inclusion, and personal autonomy. Enhancing QoL for this group is vital, particularly as care models shift from institutionalization to community living (Claes et al., 2025). Historically, long-term institutional placements often resulted in neglect and inadequate care. Research indicates that transitioning to community settings has led to improved emotional well-being, better health outcomes, reduced mortality rates, and increased social interaction opportunities (Bhaumik et al., 2011; Chowdhury and Benson, 2011). Several key factors impact QoL outcomes for individuals IDD, including supported accommodation, physical activity, and family involvement (Blick et al., 2015; Francis et al., 2014). The level of support, the physical environment, and the extent of individual choice within supported accommodation greatly affect QoL. These elements promote autonomy and create tailored support systems, leading to higher life satisfaction among residents (Bigby and Beadle-Brown, 2018; Walsh et al., 2010; Neely-Barnes, Marcenko, and Weber, 2008). Improved physical health correlates with better health outcomes and increased life satisfaction, highlighting the need for active LS in holistic care strategies (Blick et al., 2015). Strong family involvement enhances QoL by fostering emotional well-being and self-determination through active participation in care and decision-making (Rogers et al., 2012). The conceptualization and measurement of QoL in individuals with IDD have evolved over the years (Claes et al. 2025; Schalock et al. 2012a; 2012b; 2010; 2008; 2002a; 2002b; Schalock, Bonham, and Verdugo, 2008) have developed tools and frameworks that encompass various QoL domains, including personal development, social inclusion, and emotional well-being (Sexton, et al. 2016; Verdugo et al. 2005). These frameworks are essential for evaluating the effectiveness of interventions aimed at enhancing QoL. For instance, the QOL-PMD (Petry et al. 2009) provides a structured approach to assess the QoL of individuals with profound intellectual and multiple disabilities. Such tools facilitate the identification of areas needing improvement and help tailor interventions to meet individual needs (Bhaumik, Tyrer, and Ganghadaran, 2011; Verdugo et al. 2005). Improving the QoL for individuals with IDD requires a holistic approach. Meena (2024) emphasizes key strategies, including the promotion of SD, which empowers individuals to make choices that enhance their satisfaction and autonomy (Wehmeyer and Schwartz, 1997). Zijlstra et al. (2015) stress the importance of strengthening social World Journal of Advanced Research and Reviews, 2025, 28(02), 1767–1789 1775 networks, as community connections provide emotional support and encourage engagement. Participation in community activities not only enhances social skills but also reduces feelings of isolation, thereby improving QoL (Fahey et al., 2010). Understanding the various factors influencing the experiences of individuals with IDD is essential for enhancing their QoL. Supportive living conditions, active family involvement, and community integration are crucial for achieving positive outcomes. Ongoing research and effective strategy implementation are vital for helping individuals with IDD lead fulfilling lives in inclusive communities, ultimately enriching their QoL (Bigby and Beadle-Brown, 2018). 6.3. Health Inequalities Health inequalities have a profound impact on individuals with ID, worsening their LS challenges. Key social determinants, including SES, education, and healthcare access, significantly contribute to these disparities. Many of them face obstacles in accessing healthcare, leading to unmet medical needs and poorer health outcomes (Houtrow, Kuhlthau, and Van Cleave, 2016; WHO, 2011). Stigma and discrimination can result in social isolation, which restricts engagement and active LSs (Marmot, 2005). Research shows that people with ID are more vulnerable to chronic conditions due to insufficient preventive care and health education (Krahn et al., 2015; 2006). Addressing these inequalities requires a comprehensive approach, including policy reforms to ensure equitable access to resources. Evenhuis (2001; 2000) underscores the need for comprehensive health services tailored to the needs of aging adults with ID. Bunton and MacDonald (2002) highlight health as a social construct influenced by cultural, economic, and political factors, suggesting that societal norms shape health perceptions. Understanding health in this context can lead to more effective public health strategies that address the root causes of health disparities. Sutherland, Couch, and Iacono (2002) emphasize the importance of customized healthcare services for adults with IDD, while Emerson and Hatton (2007) advocate for interventions that tackle social and economic factors contributing to such inequalities. Anderson et al. (2013) examined the research on health and wellness for adults with IDD and advocated targeted interventions to improve health outcomes in this population. Havercamp et al (2015, 2020a; 2020b) highlighted significant health disparities faced by adults with IDD. Their reviews emphasize the need for a public health perspective that focuses on access to care, preventive services, and tailored health interventions. They advocate for comprehensive strategies to improve the overall health and wellness of individuals with IDD, underscoring the importance of integrating health equity into public health initiatives. In conclusion, the collective insights from these studies highlight the critical need for a paradigm shift in how health services are designed and delivered to these individuals. By recognizing and addressing the disparities they face, we can move towards a more equitable healthcare system that supports the overall wellness of this vulnerable population. McKenzie, Whitley, and Craig (2016) discovered that individuals with ID face more physical and mental health challenges than the general population, highlighting the need for improved healthcare access. McGuire and Bhatia (2018) stressed the importance of targeted health promotion strategies and inclusive practices for this group. McKenzie and Murray (2018) explored significant disparities in mental health care, focusing on social determinants like SES and education, and proposed a new approach to enhance health outcomes for marginalized groups. O'Connor and Anderson (2020) identified various barriers preventing healthcare access for these individuals, advocating for essential policy reforms. In India, Rao, Sharma, and Verma (2023) examined the systemic challenges these individuals face in accessing healthcare and recommended strategies to improve equity and service delivery. Mehta et al. (2024) conducted a systematic review and meta-analysis on the oral health of children with IDD in India, revealing significant challenges and the urgent need for targeted dental care and preventive measures. Nair et al. (2023) developed a community-based model to address long-term health issues in children with ID, emphasizing the role of family and community collaboration in health promotion. Rigles (2019) highlighted how families with disabilities can encourage healthy LS, while Tewari (2018) advocated for educational strategies that promote physical activity and nutrition among children with ID in inclusive school settings. 6.4. Incarcerated people The intersection of IDD with the criminal justice system has garnered increasing attention in recent years, revealing a complex landscape of challenges and systemic issues. Research indicates that individuals with IDD face unique difficulties during incarceration, necessitating a deeper understanding of their experiences (Crowe and Drew, 2021; Ben-Moshe, 2013). The prevalence of IDD among incarcerated populations is alarmingly high. A systematic review by Fazel et al. (2008) highlighted that approximately 12,000 prisoners exhibit signs of intellectual disabilities, raising concerns about the support and resources available for this vulnerable group. García-Largo et al. 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