Official WHO statistics show that people with intellectual disabilities have a poorer overall health status, have lower educational access, experience barriers in daily life, particularly in access to health care and health education [SEC(2006)410]. Key risk factors for poor health issues have been documented such as no specialized disability training for health professionals, a lack of physical activity, limited access to basic health care services, and an overall lack of understanding on Intellectual Disability by the medical/clinical community.
In summary we can point out that people with intellectual disabilities*:

• have a wide range of chronic and acute health issues and conditions. In many instances, more frequent and severe symptoms than the general population.
• are twice as likely to have significant visual problems and at much younger age.
• are hardly ever engaged in vigorous physical activity and find it difficult to make themselves understood when speaking with health professionals.
• health conditions are may be similar to the general population, the impacts can be greater on those with ID.
• Experience higher mortality rates as a result of higher rates of cardiovascular diseases.

The general objective of SOEEF is to provide year around training and competition as well as well-being and health care initiatives for athletes across the EU 28.Furthermore the goal is to expand the network of trained coaches and health care professionals through training model, seminars and meetings. The ultimate goal is to engage more athlete, families, service providers and further stakeholders into Special Olympics programs to guaranty the growth of sport, well-being and health opportunities throughout the EUan as well as have positive impact on health and well-being of people with ID in general.

Official WHO statistics show that people with intellectual disabilities have a poorer overall health status, have lower educational access, experience barriers in daily life, particularly in access to health care and health education.
Key risk factors for poor health issues have been documented such as no specialized disability training for health professionals, a lack of physical activity, limited access to basic health care services, and an overall lack of understanding on Intellectual Disability by the medical/clinical community. In summary people with intellectual disabilities:
• have a wide range of chronic and acute health issues and conditions. In many instances, more frequent and severe symptoms than the general population.
• are twice as likely to have significant visual problems and at much younger age.
• are hardly ever engaged in vigorous physical activity and find it difficult to make themselves understood when speaking with health professionals.
• health conditions are may be similar to the general population, the impacts can be greater on those with ID.
• Experience higher mortality rates as a result of higher rates of cardiovascular diseases.

The general goal of SOEEF s is to provide year around training and competition as well as well-being and health promotion initiatives for athletes across the EU 28. Furthermore the goal is to expand the network of trained coaches and health care professionals through training model, seminars and meetings. The ultimate goal is to engage more athlete, families, service providers and further stakeholders into Special Olympics programs to guaranty the growth of sport, well-being and health opportunities throughout the EUan as well as have positive impact on health and well-being of people with ID in general.

SO initiatives aim to improve the health and well-being of people with intellectual disabilities in Member States through health screening clinics for persons with ID, training of health care professionals and education of athletes, care givers and families to empower them to better manage the health of people with ID. The initiatives help to address inequality of health care for people with ID through hands-on training for health care professionals and students who volunteer at the health screening clinics. The initiatives also tackle common health issues such as obesity, hypertension, poor fitness, bad vision and hearing, untreated tooth decay and pain. Screening results are captured in a comprehensive data base that provide detailed information of the health status to the public and health care authorities and can contribute to EU databases. The goal of SO health initiatives is to improve access for the 15 million people with ID in EU to the same quality health care and health care policy that the non-disabled population has access to and is impacted by. Most importantly the initiative shall empower people with ID and their families to take care of their well being themselves. The target group of Special Olympics are children and adults (age from 2) with an intellectual disability. The target group is particularly vulnerable and is often neglected and excluded from mainstream life. In many countries people with ID are still stigmatized and institutionalized and experience unequal access to quality health care, sport opportunities and general participation in mainstream social activities. According to WHO 2-3% of the general population have an intellectual disability which represents ca. 20million people in Europe and 15 Million people in the European Union.

Special Oympics mission is to provide year around sport, fitness and health opportunities for children and adults with an intellectual disability. The key Objectives for 2016 inculded:

Objective 1:
Organizing year around sport, training and competition opportunities across the EU 28 involving at least 12.000 athletes, coaches and families in 2016.


Objective 2:
Training of new sport directors to support the development of Special Olympics sport programming in different EU countries targeting 100 new coaches and 50 coach assistants.


Objective 3:
Improve health status of people with ID through year around health and well being programs across at least 12 EUan countries through at least 50 HA screening events performing at least 7000 screenings provided by at least 1000 health care professionals and students at no costs for the athletes. Furthermore to engage families and stakeholders from the field in seminars on health issues of people with ID and how to address them from a family perspective as well as training of at least 15 new Clinical Directors to implement new Healthy Athletes initiatives in new EUan countries. Furthermore, implementing fitness and community based health initiatives in selected European countries involving at least 100 athletes, 100 coaches and 100 families per country.


Objective 4:
High quality research on the impact of Special Olympics programming on the lives of those who are involved and broadly on the wider society. Conduct one major study on health status of people with intellectual disability and impact of sport in relation to the overall health and fitness of SO athletes .

Special Olympics Initiatives in 2016 focused on improving Special Olympics athletes health and overall fitness through a wide range of sport programming and health initiatives. By organizing year around sport training and competitions SO athletes have the opportunity to be engaged in regular physical activity and fitness. in 2016 SOEE partner program conducted a series of major sport events and sport program development activities throughout the year in the EU 28. In total over 40,500 athletes and over 3070 coaches and assistant coaches were involved in the events. Major Special Olympics Sport events took place in Austria (Test Games World Winter Games 2017) with over 970 athletes participating, SO Germany National summer games in Hannover (4800 athletes); SO Italy National Winter Games in Bormio (460 athletes), SO Poland National Winter Games, Zakopane (960 athletes) and SO Spain National Summer Games (800) athletes.

A second focus in SOEE is to provide comprehensive health information and free of charge health screenings through the Special Olympics Healthy Athletes program in 6 clinical areas (eye care, hearing, dental care, physiotherapy, podiatry and health promotion) as well as community based health and well beeing initiatives engaging health care professionals, families, coaches and other stakeholders such as Universities and medical schools. in 2016 Special Olympics partner programs of SOEEF conducted in total 126 Healthy Athletes screening events in 14 EU countries performing 18,000 screenings and health education to people with an intellectual disability (ID). 1040 clinical professionals, 1419 medical students and 508 non clinical volunteers have been involved in the events. Furthermore 2 community based health projects co funded by the EU health department have been organised in Romania and Greece. the goals of the SO Romania community based health project 2016 was to i) create a network of 4 university centers in Romania, where to implement Young Athletes program, to provide early developmental opportunities for pre-school children, utilizing guide motor activities, through an ongoing training program and unified sport events, including organized play, in order to increase their social interaction level, as well as the independent life skills; ii) to create a network of 8 health care professionals, trained in health care issues of people with learning disabilities and who provide adapted health care services, follow-up to this group on an on-going basis, and monitor follow-up services during the lifetime of the project; iii) Facilitating access of people with ID to quality medical services at local level for the lifetime of the project, and beyond (minimum 4 years) and iv) Educate and promote healthy lifestyle habits among SO young athletes and their families, caregivers and coaches. In Greece the program aimed at encouraging them into embracing a healthy lifestyle through activities and workshops that included exercising, cooking, nutritionist meetings and music therapy. The Project was held from September to December 2016, to two Centers of Special Education which fulfilled the requirements of the project The participants were 50 athletes, four coaches one nutritionist, one physiotherapist and one music therapist. In addition during the sessions six volunteers were assisting the coaches. One of program’s goals was to motivate athletes and their families to follow a more healthy way of life through suitable designed lessons. More precisely 50 athletes, 28 men (56%) and 22 women (44%), aged from 15 to 50 years old divided to 4 groups of 12/13 persons. Each group attended 3 times per week fitness
sessions, one time physical therapy and cooking session, while every two weeks attended the music therapy session. Every week athletes were monitored from a nutritionist.

Further activities included 6 Family Health forums in 6 different EU countries (Greece, Malta, Croatia, Estonia, Romania and Slovenia). In total 302

in 2016 SOEE partner program conducted a series of major sport events and sport program development activities throughout the year in the EU 28. In total over 40,500 athletes and over 3070 coaches and assistant coaches were involved in the events. Major Special Olympics Sport events took place in Austria (Test Games World Winter Games 2017) with over 970 athletes participating, SO Germany National summer games in Hannover (4800 athletes); SO Italy National Winter Games in Bormio (460 athletes), SO Poland National Winter Games, Zakopane (960 athletes) and SO Spain National Summer Games (800) athletes. Ongoing sport opportunities have a positive impact on people with ID such as improved physical and mental fitness, confidence, social integration and self awareness.

The SOPHIE study (http://www.specialolympics.ie/Portals/0/public_documents/Volunteers/SOPHIE_Executive_summary_final-pdf_18-10-2016.pdf) shows that SO athletes rated their own health-related quality of life as statistically significant better than non-athletes. SO Athletes are also physically fitter than people with ID that do not participate in Special Olympics.

In 2016 we were able to provide more Healthy Athletes events than in 2015 meaning we saw more athletes throughout Europe that received comprehensive health screenings and received health knowledge. In total 126 Healthy Athletes screening events in 14 EU countries were conducted performing over 18,000 screenings and health education to people with an intellectual disability (ID). 1040 clinical professionals, 1419 medical students and 508 non clinical volunteers have been involved in the events experiencing hands on training on how to screen and interact with people with ID and learn about health disparities in this population.

Healthy Athletes data suggest a number of important implications. First, the prevalence of most health indicators are alarmingly high regardless of gender, age, or region. Second, we observed some interesting differences by gender and age. For example, the 20-29 age group had rates as high as the oldest age group for gait abnormalities. Additionally, 8-19 year olds had the highest rate of never having had an eye exam (which can greatly affect educational achievement as well as participation in sports), and had the second highest rate of untreated tooth decay. There were also some differences by gender. For example, females had lower rates of low bone mineral density despite having a higher risk for osteoporosis in the general population due to estrogen and biological influences. Similarly, females had higher rates of overweight in youth and higher rates of obesity among adults. This may speak to the life course effect of BMI (i.e., females are more likely to be overweight in adolescence and continue gaining weight into adulthood), which highlights the need for early interventions such as Special Olympics sports and Healthy Athletes. While males were more likely to have never had an eye exam, females were more likely to need a new prescription. The greatest differences were observed by region. This is unsurprising, due to both the social and economic determinants of health that vary widely by country, but also due to cultural differences in health promotion and healthcare. This information is critical to understanding how to further improve the impact of Healthy Athletes around the world. Although we do not have comparable measures in the general population for most of the health indicators, we do find that individuals with ID have rates of missing teeth that are twice as high as the general population, and are nearly 10% more likely to be obese. The health issues described in this report are strong risk factors for serious and/or chronic health problems, and more importantly, have a significant impact on quality of life. Healthy Athletes has allowed us to understand the magnitude of these issues, but more needs to be done to address the systemic barriers to achieving equitable h

Special Olympics activities are critical to improve athletes health and fitness, raise awareness and to train parents, coaches, care givers and health care professionals on adapted health services for people with intellectual disabilities. There are best practices that show direct impact of these initiatives with these target groups. For example the community based health programs targeting on healthy nutrition and weight management. Within the Wellness Opportunity Project implementation in overweight athletes of Special Olympics Hellas medical Services conducted medical measurements and estimates. 49 athletes participated, twenty-two females and twenty seven males. Nutritionists, physiotherapists and nurses coordinated the program and provided guidance and follow up for the athletes. The provided instructions for the diet as well as exercises by physiotherapists were decisive for the results that were observed. With the above interventions and information provided to the athlete’s parents on issues related to nutrition and exercise an average weight loss of almost 3 kg body weight and 3 cm of waist circumference in male athletes and 2.5 kg body weight and 4 cm of waist circumference in female athletes within only 3 months. Another best practice to be mention are the efforts of Special Olympics Romania creating networks of families and health care providers such as medical universities and individual health care professionals that are trained to provide critical follow up care for children and adults with ID in their communities. With a series of family health forums and Young Athletes (Athletes with ID of age 2-7) SO Romania provided critical health information to parents and young athletes sport opportunities to promote healthy life style choices and the importance of physical activity especially for person with special needs. As a result a network of 4 new Universities was established with 58 University staff receiving training on adapted health care needs for special needs persons as well as volunteer opportunities at SO Young Athletes demonstration events. Furthermore in total 71 families and care givers attended these events to learn first hand from Special Olympics staff and trained health care professionals about critical health issues children with ID face.

In collaboration with Special Olympics with Ireland the SOPHIE Project (Special Olympics Programmes Health Impact Evaluation) was led by DCU’s School of Nursing and Human Sciences in collaboration with the School of Health and Human Performance, DCU, the University of York, and the School of Nursing and Midwifery, Queen’s University Belfast. The aim of the research was to explore whether people with intellectual disabilities (ID) who took part in Special Olympics (SO) programmes are healthier and happier than people with ID who do not take part. The results of the study show that athletes rated their own health-related quality of life as better than non-athletes, and this was statistically significant (p = 0.03). Non-athletes reported higher rates of depression than athletes, also statistically significant (p = 0.07). in relation to physical activity Athletes self-reported significantly (p = 0.002) more mean minutes of moderate to vigorous physical activity (MVPA) daily (28.8 ± 32) than non-athletes (9.7 ± 22). A significantly (p < 0.000) greater distance was walked in the six-minute walking test by athletes (541 ± 103) compared to non-athletes (436 ± 100.6). A health profile score calculated by combining scores from body mass index, blood pressure, meeting ≥ 30 minutes MVPA daily and distance walked in the six-minute walking test showed that SOI athletes scored a significantly (p = 0.013) higher overall health profile (2.18 ± 0.81) than non-athletes (1.64 ± 0.70). Regarding nutrition Seventy-five per cent of the sample were overweight or obese, but there was no statistical difference between athletes and non-athletes in terms of body mass index o

Dissemination activities in relation to the target group Special Olympics Athletes: the dissemination tools are in first place SO health related activities like training, competition and Healthy Athletes screening events as a driver for visibility of our activities to the public. Furthermore SOEEF provides information and educational leaflets, brochures or scorecards (in local language) that demonstrate how to manage the athlete’s health on their own based on the recommendation they received from the health care professionals at Healthy Athletes events (e.g. Healthy Athletes passport).

Furthermore we participated in two international health related conferences to provide information about the work and outcomes of SO initiatives: 2nd International Motion for Life Conference in Malaga, Spain October 2017 and the EU cluster meeting on nutrition and physical activity, Budapest November 30 – December 2, 2016. the Special Olympics health initiatives were also presented at the Special Olympics Leadership conference in Slovenia, October 24-26, 2016. These meeting are an opportunity to provide an overview of the work of Special Olympics and its outcomes to the wider public, health care professionals and organisations as well as other stakeholders.