Article

OBJECTIVE: To assess the influence of community-level socioeconomic status (SES)
and urban composition on well-being after spinal cord injury (SCI)
rehabilitation. DESIGN: Retrospective analysis of cross-sectional survey data.
SETTING: Two participating centers in the SCI Model Systems (SCIMS) program.
PARTICIPANTS: Persons (N=1454) with traumatic SCI from New Jersey and Alabama
enrolled in the SCIMS database in 2000 to 2009. INTERVENTION: Not applicable.
MAIN OUTCOME MEASURES: Dichotomous measures of perceived health (ill vs good
health), life satisfaction (dissatisfied vs satisfied), and depressive symptoms
(presence of a syndrome vs not) to assess well-being. RESULTS: Multilevel
logistic regression was used to model community effects on each indicator of
well-being. The likelihood of ill health and dissatisfaction with life in people
with SCI, but not depressive symptoms, varied across communities. Community SES
was related inversely to the odds of reporting ill health. However, the odds for
dissatisfaction were higher in persons with SCI living in high SES and urban
communities. Associations between community predictors and dissatisfaction with
life were sustained after controlling for individual differences in injury
severity, SES, and demographics, whereas individual SES was a stronger predictor
of ill health than community SES. CONCLUSION: This research suggests that
community stratification influences the likelihood for diminished well-being for
persons with SCI after rehabilitation. Understanding the contribution of
communities in long-term outcomes after SCI rehabilitation is needed to inform
future interventions aimed at preventing disability in this population.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS