Abstract Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco and less likely to access some health services and promotion activities than those who do use these services. In addition, they are more likely to be exposed to some known social determinants of poorer health (greater material hardship, greater neighborhood deprivation, reduced community, and social participation).