Housing that fails to meet the needs of people with disabilities may have far-reaching consequences. Living situations that impede independence and community integration, for example, can adversely affect health and wellbeing over the long term. More than 70% of people with spinal cord injury use wheelchairs and other assistive technology, complicating their search for affordable, accessible housing. Despite the magnitude of this problem, little research has been conducted on residential mobility patterns among people with acquired disabilities, including spinal cord injury.
Data from the National Spinal Cord Injury Statistical Center database suggests that the population with spinal cord injury may be at risk for residential instability. To address the need for greater insight, researchers conducted a detailed survey. Their article, "Residential mobility and reasons for moving among people living with spinal cord injury: Results of a multisite survey study," (doi:10.46292/sci23-00030) appeared online in a special issue of Topics in Spinal Cord Injury Rehabilitation on December 1, 2023.
The authors are Amanda L. Botticello, PhD, MPH, and Lauren Murphy, PhD, of Kessler Foundation, Michael Boninger, MD, and Lynn Worobey, PhD, DPT, ATP, from the University of Pittsburgh School of Medicine, Thomas N. Bryce, MD, of Icahn School of Medicine at Mount Sinai, Susan Charlifue, PhD, at Craig Hospital, Jennifer Coker, PhD, Mary Joan Roach, PhD, of Case Western University and MetroHealth System, and Michael Scott, MD, at Rancho Los Amigos National Rehabilitation Center.
The researchers surveyed 690 people enrolled in six Spinal Cord Injury Model System Centers in the U.S., from July 2017 to October 2020. Participants were asked whether they had moved in the past 12 months, how far they had moved, and their primary reason for moving. A sample from the 2019 American Community Survey served as a comparison. Median household income for residential neighborhoods from the American Community Survey provided socioeconomic information.
Participants with spinal cord injury moved at a rate comparable to that of the general population – 16.4%. Movers tended to be younger, more recently injured, as well as healthier and higher functioning, but also less advantaged socioeconomically," said Dr. Botticello, lead author, associate director of the Center for Outcomes & Assessment Research and vice chair for research education at Rutgers New Jersey Medical School. "Having fewer resources may mean less ability to modify existing housing and a greater need to move for better accessibility," she speculated.
Reasons for moving differed by age group, with younger adults moving for family reasons and accessibility, while housing quality was the primary reason among older adults. The fact that people aged 45 to 64 were far more likely to move for housing reasons is telling, according to Dr. Botticello. "People with spinal cord injury appear to be deferring moves to their preferred housing situations until middle age. This age-related difference may reflect an extended search for optimal housing for this population," she observed.
Understanding the underlying reasons for residential mobility among persons with disabilities is essential to ensuring the availability of community-based supports and services for this population including healthcare and employment as well as housing.
Our survey suggests that helping people achieve their housing goals earlier should be a priority for policymakers. This may have a substantial impact on quality of life for individuals with spinal cord injury and may promote independent living for people with disabilities in general."
Amanda L. Botticello, PhD, MPH, Kessler Foundation
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