Area-Level Associations between Built Environment Characteristics and Disability Prevalence in Australia: An Ecological Analysis

The importance of health-promoting neighborhoods has long been recognized, and characteristics of local built environments are among the social determinants of health. People with disability are more likely than other population groups to experience geographic mobility and cost restrictions, and to be reliant on ‘opportunity structures’ available locally. We conducted an ecological analysis to explore associations between area-level disability prevalence for people aged 15–64 years and area-level built environment characteristics in Australia’s 21 largest cities. Overall, disability was more prevalent in areas with lower walkability and lower local availability of various neighborhood amenities such as public transport, healthier food options, public open space, physical activity and recreation destinations and health and mental health services. These patterns of lower liveability in areas of higher disability prevalence were observed in major cities but not in regional cities. Our findings suggest that geographically targeted interventions to improve access to health-enhancing neighborhood infrastructure could reduce disability-related inequalities in the social determinants of health.