Differences in the Community Built Environment Influence Poor Perceived Health among Persons with Spinal Cord Injury

Arch Phys Med Rehabil, 2015 · DOI: 10.1016/j.apmr.2015.04.025 · Published: September 1, 2015

Spinal Cord Injury Accessibility Public Health

Simple Explanation

This study investigates how the physical characteristics of a community might affect the perceived health of people with spinal cord injuries (SCI). It looks at factors like the mix of different types of land use (residential, commercial, etc.) and the amount of open space available. The study found that people with SCI who live in communities with a greater mix of land uses are more likely to report feeling unhealthy. However, having more open space in the community seemed to have a positive effect on perceived health, although this effect was influenced by individual factors like background and socioeconomic status. These findings suggest that community design can play a role in the health and well-being of individuals with SCI, who may spend more time in their local communities due to mobility limitations. Further research is needed to understand how specific aspects of the built environment impact this population.

Study Duration

2000–2012

Participants

503 persons with chronic SCI

Evidence Level

Cross-sectional survey data

Key Findings

1
Persons with SCI residing in communities with more (versus less) mixed land use were more likely to report poor perceived health.
2
Persons with SCI living in areas with less open space were also more likely to report poor health compared to persons living in communities with more natural area
3
Persons living in highly mixed areas were significantly more likely to report poor health compared to persons living in communities with low land use heterogeneity

Research Summary

This study examined the relationship between the built environment and perceived health in a community-based sample of individuals with SCI, finding that greater land use heterogeneity was associated with poorer perceived health. While more open space was initially linked to better perceived health, this association was mitigated by individual background, impairment severity, and socioeconomic status. The findings contrast with studies in the general population that suggest positive health outcomes from greater residential density and land use heterogeneity, highlighting the unique needs of individuals with mobility limitations.

Practical Implications

Community Planning

Urban planners and policymakers should consider the specific needs of individuals with mobility limitations when designing communities, ensuring accessibility and access to resources.

Healthcare Practice

Healthcare practitioners should be aware of the potential impact of community characteristics on the long-term health and well-being of individuals with SCI, and incorporate this into care plans.

Advocacy

Disability advocates can use these findings to push for policies that promote accessible and supportive community environments for individuals with disabilities.

Study Limitations

1
Lack of generalizability due to focus on a single geographic area (New Jersey).
2
Older physical infrastructure of New Jersey may render results particular to this locale.
3
Data on household income and length of time in residence were unavailable.

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