Researchers identify link between built environment and disability-related outcomes

Research may help delineate factors that affect how well a person with an acquired physical disability adjusts to living in the community

Kessler Foundation researchers have identified an association between the built environment and disability-related outcomes for adults with physical impairments. The article, Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults, was published in the July issue of Annals of Epidemiology (doi: 10.1016/j.annepidem.2014.05.003). The authors are Amanda Botticello, PhD, MPH, and Nicole Cobbold, BS, of Kessler Foundation, and Tanya Rohrbach, MS, of Raritan Valley Community College, Branchburg, NJ.

Investigators explored the associations between community and neighborhood land uses and community participation using cross-sectional data from 508 community-living adults with acquired chronic disabilities in New Jersey. These data were obtained from the national Spinal Cord Injury Model Systems database. "Studies show that neighborhood characteristics such as poor street conditions, homogeneous land use, traffic, and ambient hazards are largely predictive of more reported health problems, functional limitations, inactivity, and social isolation among older adults. The objective was to look at the impact of the built environment (or the physical features of geographic areas) on the members of the disabled population who are not generally visible in population-based studies, such as persons with chronic spinal cord injury. This line of research may help delineate factors that affect how well a person with an acquired physical disability adjusts to living in the community," said Dr. Botticello, a research scientist in Outcomes & Assessment Research at Kessler Foundation. Dr. Botticello is a co-investigator in the Northern New Jersey SCI System, and an assistant professor at Rutgers-New Jersey Medical School.

Participants' residential addresses were geocoded, enabling individual survey data to be linked with Geographic Information Systems data on land use and destinations. Results showed that living in communities with greater land use mix and more destinations was associated with a decreased likelihood of reporting optimal social and physical participation. Living in neighborhoods with large portions of open space, however, was positively associated with the reporting of full physical, occupational, and social participation.

"Overall our analysis suggested that the living conditions or natural aspects of the local community may be relevant to well-being for persons with physical disabilities living in densely populated regions like New Jersey," noted Dr. Botticello. "These findings focus attention on the environment as an important factor to be considered in disability-related outcomes. They are relevant to those who seek to improve the outlook for community participation, including outcomes researchers, policymakers, and professionals who care for people with disabilities."