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Geographic variation in participation for physically disabled adults: The contribution of area economic factors to employment after spinal cord injury

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  • Botticello, Amanda L.
  • Chen, Yuying
  • Tulsky, David S.
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    Abstract

    This study investigates the role of area economic characteristics in predicting employment–a key aspect of social participation for adults with physical disabilities–using data from a national registry of persons with spinal cord injury (SCI). SCI results in chronic impairment and most commonly occurs during young adulthood when working is a key aspect of the adult social role. Geocoded data were collected from two of the 14 SCI Model Systems (SCIMS) centers involved in the National SCIMS database and used to link individual-level data with area-level measures extracted from the 2000 US Census. The analysis included participants of working-age (18–64 years) and living in the community (N=1013). Hierarchical generalized linear modeling was used to estimate area-level variation in participation and the relative contribution of area-level economic indicators, adjusted for individual-level health, functioning, and background characteristics. The likelihood of employment for adults with SCI varied by area and was associated with area SES and urbanicity, but not area unemployment. These findings suggest that variation in area economic conditions may affect the feasibility of employment for persons who experience chronic physical disability during adulthood, thus limiting full participation in society.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 8 ()
    Pages: 1505-1513

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:8:p:1505-1513

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    Keywords: Spinal cord injury; Physical disability; Participation; Employment; Area effects; USA;

    References

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    1. Scheffler, Richard M. & Brown, Timothy T. & Syme, Leonard & Kawachi, Ichiro & Tolstykh, Irina & Iribarren, Carlos, 2008. "Community-level social capital and recurrence of acute coronary syndrome," Social Science & Medicine, Elsevier, vol. 66(7), pages 1603-1613, April.
    2. Zunzunegui, Maria-Victoria & Forster, Mathieu & Gauvin, Lise & Raynault, Marie-France & Douglas Willms, J., 2006. "Community unemployment and immigrants' health in Montreal," Social Science & Medicine, Elsevier, vol. 63(2), pages 485-500, July.
    3. Freedman, Vicki A. & Grafova, Irina B. & Schoeni, Robert F. & Rogowski, Jeannette, 2008. "Neighborhoods and disability in later life," Social Science & Medicine, Elsevier, vol. 66(11), pages 2253-2267, June.
    4. Moon, Sangho & Shin, Jaeun, 2006. "The effect of the Americans with Disabilities Act on economic well-being of men with disabilities," Health Policy, Elsevier, vol. 76(3), pages 266-276, May.
    5. Fone, David & Dunstan, Frank & Williams, Gareth & Lloyd, Keith & Palmer, Stephen, 2007. "Places, people and mental health: A multilevel analysis of economic inactivity," Social Science & Medicine, Elsevier, vol. 64(3), pages 633-645, February.
    6. Clarke, Philippa J. & Ailshire, Jennifer A. & Nieuwenhuijsen, Els R. & de Kleijn - de Vrankrijker, Marijke W., 2011. "Participation among adults with disability: The role of the urban environment," Social Science & Medicine, Elsevier, vol. 72(10), pages 1674-1684, May.
    7. Verbrugge, Lois M. & Jette, Alan M., 1994. "The disablement process," Social Science & Medicine, Elsevier, vol. 38(1), pages 1-14, January.
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