Do Communities Matter After Rehabilitation? The Effect of Socioeconomic and Urban Stratification on Well-being After Spinal Cord Injury

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2011 Mar 1

PMID 21353828

Citations 15

Authors

Amanda L Botticello

Yuying Chen

Yue Cao

David S Tulsky

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the influence of community-level socioeconomic status (SES) and urban composition on well-being after spinal cord injury (SCI) rehabilitation.

Design: Retrospective analysis of cross-sectional survey data.

Setting: Two participating centers in the SCI Model Systems (SCIMS) program.

Participants: Persons (N=1454) with traumatic SCI from New Jersey and Alabama enrolled in the SCIMS database in 2000 to 2009.

Intervention: Not applicable.

Main Outcome Measures: Dichotomous measures of perceived health (ill vs good health), life satisfaction (dissatisfied vs satisfied), and depressive symptoms (presence of a syndrome vs not) to assess well-being.

Results: Multilevel logistic regression was used to model community effects on each indicator of well-being. The likelihood of ill health and dissatisfaction with life in people with SCI, but not depressive symptoms, varied across communities. Community SES was related inversely to the odds of reporting ill health. However, the odds for dissatisfaction were higher in persons with SCI living in high SES and urban communities. Associations between community predictors and dissatisfaction with life were sustained after controlling for individual differences in injury severity, SES, and demographics, whereas individual SES was a stronger predictor of ill health than community SES.

Conclusion: This research suggests that community stratification influences the likelihood for diminished well-being for persons with SCI after rehabilitation. Understanding the contribution of communities in long-term outcomes after SCI rehabilitation is needed to inform future interventions aimed at preventing disability in this population.

Citing Articles

Urban-Rural Disparities in Community Participation after Spinal Cord Injury in Ontario.

Amiri M, Alavinia M, Farahani F, Khasiyeva N, Burley M, Kangatharan S Healthcare (Basel). 2024; 12(20).

PMID: 39451503 PMC: 11507304. DOI: 10.3390/healthcare12202089.

Social participation of adults aging with long-term physical disabilities: A cross-sectional study investigating the role of transportation mode and urban vs rural living.

Desai R, Hollingsworth H, Stark S, Putnam M, Eyler A, Wehmeier A Disabil Health J. 2023; 16(4):101503.

PMID: 37455234 PMC: 10686629. DOI: 10.1016/j.dhjo.2023.101503.

The effect of rurality and distance from care on health outcomes, environmental barriers, and healthcare utilization patterns in persons with traumatic spinal cord injury.

Whelan A, McVeigh S, Barker P, Glennie A, Wang D, Chen M Spinal Cord. 2023; 61(7):399-408.

PMID: 37169867 PMC: 10173934. DOI: 10.1038/s41393-023-00898-y.

Toward Improving the Prediction of Functional Ambulation After Spinal Cord Injury Through the Inclusion of Limb Accelerations During Sleep and Personal Factors.

Rigot S, Boninger M, Ding D, McKernan G, Field-Fote E, Hoffman J Arch Phys Med Rehabil. 2021; 103(4):676-687.e6.

PMID: 33839107 PMC: 8596977. DOI: 10.1016/j.apmr.2021.02.029.

Well on wheels intervention: Satisfaction with life and health for adults with spinal cord injuries.

Silveira S, Ledoux T, Johnston C, Kalpakjian C, OConnor D, Cottingham M J Spinal Cord Med. 2018; 43(1):60-68.

PMID: 30557093 PMC: 7006815. DOI: 10.1080/10790268.2018.1554333.

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