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Using multi-level modeling to capture "environment" in analysing disability survey data

Susan Kinne, PhD, Center for Disability Policy & Research, University of Washington, 146 North Canal Street, Box 358652, # 313, Seattle, WA 98103-8652, 206 685 4769, susaki@u.washington.edu

We understand that disability results from interaction of a person's abilities and the demands of their environment, but survey samples, our population data on people with disabilities, describe the person, not the environment. Multi-level statistical analyses incorporating individual- and neighborhood-level variables are used in public health to understand environmental influences, but are rarely applied to disability. This paper uses BRFSS data on disability and a measure of social capital to explore neighborhood-level effects.

METHODS: Data from the 2004 Washington State BRFSS were linked to Census 2000 data on respondents' zipcodes. Zipcode, not an ideal measure of neighborhood, is a better approximation than county or MMSA. Multiple logistic regression examined the relation of disability, individual and zipcode-level variables to the social capital measure, “Generally speaking, would you say that ‘most people can be trusted' or that ‘you can't be too careful in dealing with people'?”

RESULTS: People with disabilities were less likely than those without disabilities to report trust in others. The difference persisted with controls for age, race, gender, education, income, health and not-good mental health days. The socioeconomic status (SES) of one's zipcode was independently related to social capital response, with individual demographics and disability controlled (O.R. 1.06, 95% c.i. 1.03-1.09). Higher zipcode SES increased the probability of trust for all but non-disabled respondents with highest income.

CONCLUSIONS: The relation between zipcode SES and social capital responses raises questions, but suggests that multi-level modeling may bring environment into analysis of survey data on disability.

Learning Objectives:

Keywords: Disability, Methodology

Presenting author's disclosure statement:

Any relevant financial relationships? No

Environmental Issues

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA