Preventing deaths of people with disabilities in care: Smoking, obesity and other lifestyle risks

The NSW Ombudsman reviews the deaths of people with disabilities in care and makes recommendations to reduce preventable deaths.

Leading causes of death of people with disabilities in care include heart disease, lung cancer, bowel cancer and respiratory disease.

Many of these deaths are due to health risks associated with smoking, poor diet and lack of physical activity. With support, people with disabilities can reduce many of these lifestyle risk factors that can lead to death.


Smoking is a major, preventable factor causing the deaths of people with disabilities in care – particularly people in licensed boarding houses. Smoking rates amongst licensed boarding house residents are much higher than the general population, and they tend to be heavy smokers.

Of the licensed boarding house residents who died in 2010 and 2011, 88% had smoked. This included  all of the people who died from lung cancer, pneumonia, chronic obstructive pulmonary disease (COPD), and most of those who died from ischaemic heart disease.

It is important that people with disabilities in care who smoke, and the people who support them, have access to information about the assistance that is available to quit. This includes information about nicotine replacement therapy and medication options, and quit smoking programs and resources.

To reduce preventable deaths, it is critical that people with disabilities who smoke have every opportunity to quit, with proactive and ongoing support to do so.

Obesity, poor diet, and lack of physical activity are associated with deaths from heart disease and bowel cancer, as well as chronic health problems such as diabetes. These risk factors tend to be common among people with disabilities in care.

For example, over one-third of people in disability accommodation services and over half of the people in licensed boarding houses who died in 2010 and 2011 were overweight or obese. Heart disease, heart attack and COPD were common causes of the deaths of the people who were obese or severely obese.

Our reviews have found that action is required to help people with disabilities in care to increase healthy eating and physical activity, and to reduce sedentary behaviour.

Supporting someone with lifestyle risk factors

Identify the risks

It is important to identify people who face health risks related to smoking, obesity, poor diet and lack of physical activity, and to provide support to help them to reduce these risks.

  • Assist them to have a comprehensive yearly health review with their GP. Make sure that the doctor has full information about the person’s health, support needs and any changes.
  • Work with the person (and their GP) to help them to understand the risks and the support they can get to improve their health.

Take action

Reducing lifestyle risk factors can require multiple attempts over an extended period of time. It is important that comprehensive support is provided to make it as easy as possible for the person to make positive health changes.

  • Work with the person and their GP to identify what you need to do to support them to quit smoking, and increase healthy eating and physical activity. This may include supporting them to access nicotine replacement therapy, and working with them to build exercise into activities they enjoy.
  • Look for opportunities to work together with other services and health providers to help the people you support to make better health choices. This may include seeking input from a dietician on meal options; and accessing training on how to support people to quit smoking, such as the free training provided by the Cancer Council.
  • Assist the person to see health care providers and specialists as required, such as respiratory specialists and dieticians. Help the person to follow the recommendations.
  • Know what to do if the person becomes sick or is hurt, including how to provide first aid.*Know what to do if the person becomes sick or is hurt, including how to provide first aid.
  • Work with the person and their GP to support them to access preventative and community health programs.

Resources and further information

Reviewable deaths

Health care and people with intellectual disability

  • NSW Council for Intellectual Disability Healthier Lives fact sheets at

Preventative and community-based health programs

Contact us for more information

Level 24,
580 George Street
Sydney NSW 2000
Toll free (outside Sydney metro) 1800 451 524 

National Relay Service 133 677
Telephone Interpreter Service (TIS)
131 450
We can arrange an interpreter through TIS or you can contact TIS yourself before speaking to us.

© Crown Copyright, NSW Ombudsman, May 2013
This publication is released under a Creative Commons license CC BY 4.0.

Publication metadata

ISBN 978-1-921884-97-9
Category Fact sheets
Publication Date 8 May 2013