Emerson Eric, Hatton Chris, Robertson Janet, Baines Susannah
Centre for Disability Research, Lancaster University, Lancaster LA1 4YT, UK.
BMC Public Health. 2014 Dec 9;14:1252. doi: 10.1186/1471-2458-14-1252.
There is extensive evidence from research undertaken on general population samples that people who have more extensive and closer social networks and people who report feeling connected to their local community tend to have better health. However, relatively few studies have examined the relationship between the social connectedness of people with intellectual disabilities and their health.
Secondary analysis of data from Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. We identified 279 participants aged 16-49 (1.1% of the unweighted age-restricted sample) as having intellectual disability, and 22,927 as not having intellectual disability. Multivariate logistic regression was used to investigate between group differences adjusting for potential confounding personal characteristics (e.g., gender).
British adults with intellectual disability had less favorable perceptions of important neighborhood characteristics and lower levels of social and civic participation than their non-disabled peers. Favorable perceptions of important neighborhood characteristics and higher levels of social and civic participation were associated with more positive self-rated health for adults with and without intellectual disability. For adults with intellectual disability this was particularly the case with regard to employment, feeling safe outside in the dark and being able to access services when needed. The between-group differences in perceptions of important neighborhood characteristics and levels of social and civic participation accounted for a significant proportion of the elevated risk for poorer self-rated health observed among adults with intellectual disability.
This study provides evidence to suggest that the health inequalities experienced by people with intellectual disabilities may be partially attributable to their less favorable perceptions of important neighborhood characteristics and lower levels of social and civic participation.
对普通人群样本进行的研究有大量证据表明,拥有更广泛、更紧密社交网络的人以及报告感觉与当地社区有联系的人往往健康状况更好。然而,相对较少的研究考察了智障人士的社会联系与他们健康之间的关系。
对“理解社会”项目的数据进行二次分析,该项目是一项关注英国公民生活经历的新纵向研究。我们确定了279名年龄在16 - 49岁之间的参与者(占未加权年龄限制样本的1.1%)为智障人士,22927名无智障人士。使用多变量逻辑回归来研究在调整潜在混杂个人特征(如性别)后的组间差异。
与非智障同龄人相比,英国成年智障人士对重要邻里特征的看法更不理想,社会和公民参与水平更低。对重要邻里特征的良好看法以及更高的社会和公民参与水平与有和没有智障的成年人更积极的自评健康状况相关。对于成年智障人士来说,在就业、在黑暗中外出时感到安全以及在需要时能够获得服务方面尤其如此。在对重要邻里特征的看法和社会及公民参与水平方面的组间差异,在成年智障人士中观察到的自评健康较差风险升高中占了很大比例。
本研究提供的证据表明,智障人士经历的健康不平等可能部分归因于他们对重要邻里特征的看法更不理想以及社会和公民参与水平更低。