Environmental barriers and subjective health among people with chronic spinal cord injury: A cohort study

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000275 · Published: July 1, 2015

Spinal Cord Injury Patient Experience Accessibility

Simple Explanation

Environmental barriers, such as inaccessible buildings or lack of support, can significantly affect the lives of individuals with disabilities. These barriers can limit access to employment, recreation, and other aspects of daily living. Previous research has shown that environmental barriers can lead to decreased life satisfaction, reduced social participation, and lower productivity for people with disabilities. This study investigates how these barriers impact the subjective health of individuals with chronic spinal cord injury (SCI). This study found that physical and structural barriers, such as inaccessible buildings, and barriers to services and assistance significantly predicted poorer subjective physical and mental health in individuals with chronic SCI over a 5-year period.

Study Duration

5 Years

Participants

1635 participants with chronic SCI

Evidence Level

Level 2: Prospective cohort study

Key Findings

1
Environmental barriers are prevalent among individuals with chronic SCI, with a significant percentage reporting issues with policies, physical structures, attitudes, support, services, and assistance.
2
Physical and structural barriers, such as inaccessible buildings, significantly predicted poorer subjective physical health outcomes in individuals with chronic SCI.
3
Barriers to services and assistance significantly predicted poorer subjective mental health outcomes in individuals with chronic SCI.

Research Summary

This study investigated the impact of environmental barriers on the subjective health of individuals with chronic spinal cord injury (SCI) over a 5-year period. The research found that physical/structural and service/assistance barriers significantly predicted poorer subjective physical and mental health outcomes. The authors conclude that addressing environmental barriers, particularly those related to physical structures and access to services, is crucial for improving the health and well-being of people with chronic SCI.

Practical Implications

Targeted Interventions

Interventions should focus on reducing physical/structural and service/assistance barriers to improve physical and mental health outcomes for people with chronic SCI.

Policy Changes

Advocate for policy changes that improve accessibility and support services for individuals with SCI.

Further Research

Future research should investigate the malleability of specific environmental barriers and explore intervention strategies to promote health after SCI.

Study Limitations

1
The study population was not representative of all persons with traumatic SCI.
2
The CHIEF-SF does not account for environmental factors that act as facilitators to health.
3
The study had an attrition rate of 36%, potentially introducing selection bias.

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