Article

OBJECTIVE: To assess the association between characteristics of the built
environment and differences in perceived health among persons with spinal cord
injury (SCI) using objective measures of the local community derived from
Geographic Information Systems data. DESIGN: Secondary analysis of
cross-sectional survey data. SETTING: Community. PARTICIPANTS: Persons with
chronic SCI enrolled in the Spinal Cord Injury Model Systems database (N=503).
All cases were residents of New Jersey, completed an interview during the years
2000 through 2012, had a complete residential address, and were community living
at the time of follow-up. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE:
Perceived health. RESULTS: Bivariate tests indicated that persons with SCI
residing in communities with more (vs less) mixed land use and small (vs large)
amounts of open space were more likely to report poor perceived health. No
associations were found between perceived health and differences in the
residential or destination density of the community. Adjusting for variation in
demographic, impairment, quality of life, and community socioeconomic
characteristics accounted for the gap in the odds of reporting poor health
between persons living in areas with large versus small amounts of open space
(odds ratio [OR], 0.54; 95% confidence interval [CI], 0.28-1.02). However, even
after accounting for individual background differences, persons living in
communities characterized by more heterogeneous land use were twice as likely to
report poor health compared with persons living in less mixed areas (OR, 2.14;
95% CI, 1.12-4.08). CONCLUSIONS: Differences in the built characteristics of
communities may be important to the long-term health and well-being of persons
with SCI who may have greater exposure to the features of their local area
because of limited mobility. The results of this study suggest living in a
community with more heterogeneous land use was not beneficial to the perceived
health of persons with chronic SCI living in New Jersey. Further investigation is
needed to assess if the relationships observed in this analysis are influenced by
differences in infrastructure and resources across communities. Further research
is also needed to investigate the role built environment plays in the long-term
health and well-being of persons with SCI in other geographic locales.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS