Person-Level Determinants of Independent Living for People who are Paralyzed

Background:   While a substantial body of research exists that examines the links between environmental factors such as access to health care, transportation and features of the built environment and independent living, relatively less attention has been paid to the role that person-level factors play in an individual’s ability to live independently in the community.

Purpose: This paper will analyze the relationship between nine person-level factors and self-reported independent living status for the approximately 5.6 million Americans living with paralysis.

 Methodology: Data comes from a national, random digit dial survey of over 70,000 households completed by faculty from multiple universities and the Centers for Disease Control in 2012-2013. “Independent Living” is measured by four variables taken from the Behavioral Risk Factor Surveillance System: difficulties in ambulation, self-care, cognition and independent living. Person-level variables include race, income, education; health risk factors (obesity and smoking); age; use of preventive care and type of health insurance. Using multivariate analysis, the relationship of each of the person-level variables to self-reported ability to live independently is analyzed.

Findings/Significance: While the analysis is now being completed, results show that there are strong correlations between multiple determinants and independent living status. While some person-level variables such as age or race cannot be changed, others such as health risk behaviors, access to preventive care and insurance type are disparities that can be addressed through policies, programs and services. Findings can be used to provide decision support to inform disability policies targeted at increasing independent living for people with disabilities.