Asthma and asthma-related health care utilization among people without disabilities and people with physical disabilities
Michelle L. Stransky, Ph.D.Press enter key for correspondence informatio, Robert McGrath, Ph.D., Amanda Reichard, Ph.D., Monica McClain, Ph.D.,Kimberly G. Phillips, M.A., Andrew Houtenville, Ph.D., Charles E. Drum, M.P.A., J.D., Ph.D.
Background - Previous research has shown that people with disabilities have higher rates of some chronic diseases and receive poorer disease-specific care than their counterparts without disabilities. Yet, little is known about the relationship between asthma and disability.
Objective - This study examines whether differences in the prevalence of asthma, asthma flare, and asthma-related measures of health care quality, utilization and cost exist among people with physical limitations (PL) and without any limitations.
Methods - Data from the 2004–2010 Medical Expenditure Panel Survey were pooled to compare outcomes for working-age adults (18–64) with PL to those with no limitations.
Results - People with PL had higher rates of asthma (13.8% vs. 5.9%, p < 0.001) and recent asthma flare (52.6% vs. 39.6%, p < 0.001) than people without limitations. There were no differences in health care quality, utilization or cost between people with PL and people without limitations in multivariate analyses.
Community and social participation among adults with mobility impairments: A mixed methods study
Vidya Sundar, Ph.D., O.T.R./L., Debra L. Brucker, Ph.D., Megan A. Pollack, M.S., O.T.R./L.e, Hong Chang, Ph.D.
Background - Community and social participation is a complex phenomenon that is influenced by personal and environmental factors and is linked to a good quality of life and well-being. Individuals with mobility impairments are at risk of experiencing limitations in participating in community activities due to a wide range of factors.
Objective - To understand community participation as defined by adults with mobility impairments and to examine relationships among factors that influence community participation.
Methods - A mixed-methods study design was used. In-depth interviews of 13 adults with mobility impairments were conducted and themes related to community participation were identified. Data from the Americans' Changing Lives Survey were used to construct variables that mimic the themes from the qualitative phase and structural equation modeling was used to examine the relationships among those variables including community participation.
Results - Individuals with mobility impairments identified health and function, neighborhood factors and self-efficacy as possible factors influencing participation in community activities. Findings from the SEM suggest a strong causal pathway between health and function and community and social participation. Neighborhood factors and health and function had a significant impact on self-efficacy, and a possible indirect effect through self-efficacy on community and social participation.
Conclusions - Our study provides new empirical evidence that health and function have a significant impact on community and social participation. Our quantitative findings did not support the direct influence of neighborhood factors in community and social participation, yet these factors may have an indirect role by influencing the self-efficacy of individuals with mobility impairments.