Contextualizing disability: a cross-sectional analysis of the association between the built environment and functioning among people living with spinal cord injury in the United States

Amanda L. Botticello*, David Tulsky, Allen Walter Heinemann, Susan Charlifue, Claire Kalpakjian, Mary Slavin, Rachel Byrne, Tanya Rohrbach

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study design: Secondary analysis of cross-sectional data from a multisite cohort study. Objectives: To analyze the association between the built environment and physical functioning reported by adults living with chronic spinal cord injury (SCI). Setting: Four US Spinal Cord Injury Model Systems centers in New Jersey, Colorado, Illinois, and Michigan. Methods: Participants were from the Spinal Cord Injury-Functional Index/Capacity (SCI-FI/C) development study. Survey data from N = 402 participants were geocoded for analysis. Geographic Information Systems (GIS) analysis was used to define five- and half-mile buffer areas around participants’ residential addresses to represent the community and neighborhood environments, respectively, and to create measures of land use, residential density, destination density, and park space. The relationships between these built environment features and four domains of physical functioning—basic mobility, wheelchair mobility, self-care, and fine motor function—were modeled using ordinary least squares (OLS) regression. Results: People with paraplegia living in neighborhoods with more destinations and a nearby park reported higher levels of self-care functioning. For people with tetraplegia, living in a community with more destinations was associated with better wheelchair mobility and fine motor functioning, and living in a neighborhood with high land use mix was associated with higher fine motor functioning scores. Conclusions: The association between the built environment and functioning after SCI is supported and in need of further investigation. Understanding the environmental context of disability may lead to community-based interventions and effective public policy that will attenuate the experience of limitations and promote accessibility on a larger scale.

Original languageEnglish (US)
Pages (from-to)100-109
Number of pages10
JournalSpinal Cord
Volume57
Issue number2
DOIs
StatePublished - Feb 1 2019

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Spinal Cord Injuries
Cross-Sectional Studies
Wheelchairs
Self Care
Geographic Mapping
Geographic Information Systems
Quadriplegia
Paraplegia
Public Policy
Systems Analysis
Least-Squares Analysis
Buffers
Cohort Studies

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Botticello, Amanda L. ; Tulsky, David ; Heinemann, Allen Walter ; Charlifue, Susan ; Kalpakjian, Claire ; Slavin, Mary ; Byrne, Rachel ; Rohrbach, Tanya. / Contextualizing disability : a cross-sectional analysis of the association between the built environment and functioning among people living with spinal cord injury in the United States. In: Spinal Cord. 2019 ; Vol. 57, No. 2. pp. 100-109.
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abstract = "Study design: Secondary analysis of cross-sectional data from a multisite cohort study. Objectives: To analyze the association between the built environment and physical functioning reported by adults living with chronic spinal cord injury (SCI). Setting: Four US Spinal Cord Injury Model Systems centers in New Jersey, Colorado, Illinois, and Michigan. Methods: Participants were from the Spinal Cord Injury-Functional Index/Capacity (SCI-FI/C) development study. Survey data from N = 402 participants were geocoded for analysis. Geographic Information Systems (GIS) analysis was used to define five- and half-mile buffer areas around participants’ residential addresses to represent the community and neighborhood environments, respectively, and to create measures of land use, residential density, destination density, and park space. The relationships between these built environment features and four domains of physical functioning—basic mobility, wheelchair mobility, self-care, and fine motor function—were modeled using ordinary least squares (OLS) regression. Results: People with paraplegia living in neighborhoods with more destinations and a nearby park reported higher levels of self-care functioning. For people with tetraplegia, living in a community with more destinations was associated with better wheelchair mobility and fine motor functioning, and living in a neighborhood with high land use mix was associated with higher fine motor functioning scores. Conclusions: The association between the built environment and functioning after SCI is supported and in need of further investigation. Understanding the environmental context of disability may lead to community-based interventions and effective public policy that will attenuate the experience of limitations and promote accessibility on a larger scale.",
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Contextualizing disability : a cross-sectional analysis of the association between the built environment and functioning among people living with spinal cord injury in the United States. / Botticello, Amanda L.; Tulsky, David; Heinemann, Allen Walter; Charlifue, Susan; Kalpakjian, Claire; Slavin, Mary; Byrne, Rachel; Rohrbach, Tanya.

In: Spinal Cord, Vol. 57, No. 2, 01.02.2019, p. 100-109.

Research output: Contribution to journalArticle

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T2 - a cross-sectional analysis of the association between the built environment and functioning among people living with spinal cord injury in the United States

AU - Botticello, Amanda L.

AU - Tulsky, David

AU - Heinemann, Allen Walter

AU - Charlifue, Susan

AU - Kalpakjian, Claire

AU - Slavin, Mary

AU - Byrne, Rachel

AU - Rohrbach, Tanya

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