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

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

Arch Phys Med Rehabil, 2011 · DOI: 10.1016/j.apmr.2010.08.028 · Published: March 1, 2011

Spinal Cord InjuryRehabilitationPublic Health

Simple Explanation

This study investigates how the socioeconomic status (SES) and urban environment of a community affect the well-being of individuals with spinal cord injury (SCI) after they have completed rehabilitation. The study found that community SES was related inversely to the odds of reporting ill health, meaning people in lower SES communities are more likely to report being in ill health. However, dissatisfaction with life was higher in people with SCI living in high SES and urban communities. These findings suggest that the community environment plays a role in the long-term well-being of individuals with SCI, and understanding this role is important for developing interventions to improve outcomes after rehabilitation.

Study Duration
2000 to 2009
Participants
1454 persons with traumatic SCI
Evidence Level
Not specified

Key Findings

  • 1
    The likelihood of ill health and dissatisfaction with life in people with SCI varied across communities.
  • 2
    Community SES was related inversely to the odds of reporting ill health.
  • 3
    The odds for dissatisfaction were higher in persons with SCI living in high SES and urban communities.

Research Summary

This study assessed the influence of community-level socioeconomic status (SES) and urban composition on well-being after spinal cord injury (SCI) rehabilitation. The 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.

Practical Implications

Targeted Interventions

Interventions should consider community SES to improve health outcomes for individuals with SCI.

Urban Planning

Urban planning and development should address factors contributing to dissatisfaction among individuals with SCI.

Further Research

Further research is needed to understand the mechanisms through which communities impact the well-being of individuals with SCI.

Study Limitations

  • 1
    Use of a subsample of the SCIMS database from 2 distinct regions that is not fully representative of persons with SCI.
  • 2
    Considerable heterogeneity within counties for SES and urban composition.
  • 3
    Analysis of self-reported outcomes, which provide just one dimension of health and functioning after SCI

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