Abstract
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Background: People with physical and psychological disabilities face some of the greatest health inequities in modern society. Understanding opportunities for health from a multifactorial perspective is important to develop evidence-based strategies to promote heath and strengthen community action, especially for people in vulnerable situations. Few studies have focused on explaining intersectional differences in relationships between environmental and participatory factors and health among populations with different disability types and severity. This study aims to explore differences in associations between environmental, perception and participation factors, on self-rated health among middle-aged adults with and without physical or psychological disabilities.
Method: Data stem from the fourth wave of the Trøndelag Health Study 2019, using a sub-sample of participants aged 45-64 years (N=38 246; mean age=54.4). Predictors, including built environment (public transport, paths, services, facilities, nature, and urban green spaces), perceptions (safety and enjoyment) and participation (community, artistic, outdoor activities, and sports), were regressed in self-rated health in a hierarchical model whilst controlling for demographic and socioeconomic confounders. Predictors of self-rated health among sub-groups with slight, moderate and severe physical or psychological disability, and those who reported no disability were identified.
Results: Among those reporting severe levels of disability, fewer significant predictors were observed and explained higher variance of health, compared to those with lesser severity or no disability. Employment, accessible public transport and nature spaces, and participation in outdoor activities and sports emerged as consistent predictors of health across groups. Contact with nature, including urban green spaces, displayed a stronger relationship with health among people with psychological than with physical disability.
Conclusion: Results suggest that the influence environmental and participation factors have on health varies among adults with physical and psychological disabilities, and with different severities. More severe disability indicated access to fewer health-relevant resources. Findings imply that a renewed focus on environmental assets and opportunities for participation for improved health among people with physical and psychological disabilities may contribute to reduce health inequities and contribute to better health outcomes in the target population.
Background: People with physical and psychological disabilities face some of the greatest health inequities in modern society. Understanding opportunities for health from a multifactorial perspective is important to develop evidence-based strategies to promote heath and strengthen community action, especially for people in vulnerable situations. Few studies have focused on explaining intersectional differences in relationships between environmental and participatory factors and health among populations with different disability types and severity. This study aims to explore differences in associations between environmental, perception and participation factors, on self-rated health among middle-aged adults with and without physical or psychological disabilities.
Method: Data stem from the fourth wave of the Trøndelag Health Study 2019, using a sub-sample of participants aged 45-64 years (N=38 246; mean age=54.4). Predictors, including built environment (public transport, paths, services, facilities, nature, and urban green spaces), perceptions (safety and enjoyment) and participation (community, artistic, outdoor activities, and sports), were regressed in self-rated health in a hierarchical model whilst controlling for demographic and socioeconomic confounders. Predictors of self-rated health among sub-groups with slight, moderate and severe physical or psychological disability, and those who reported no disability were identified.
Results: Among those reporting severe levels of disability, fewer significant predictors were observed and explained higher variance of health, compared to those with lesser severity or no disability. Employment, accessible public transport and nature spaces, and participation in outdoor activities and sports emerged as consistent predictors of health across groups. Contact with nature, including urban green spaces, displayed a stronger relationship with health among people with psychological than with physical disability.
Conclusion: Results suggest that the influence environmental and participation factors have on health varies among adults with physical and psychological disabilities, and with different severities. More severe disability indicated access to fewer health-relevant resources. Findings imply that a renewed focus on environmental assets and opportunities for participation for improved health among people with physical and psychological disabilities may contribute to reduce health inequities and contribute to better health outcomes in the target population.
