Froehlich-Grobe Katherine, Jones Denton, Businelle Michael S, Kendzor Darla E, Balasubramanian Bjial A
Baylor Institute for Rehabilitation, Dallas, TX 75246, USA.
Pepperdine University, Campus Recreation, Malibu, CA 90263-4490, USA.
Disabil Health J. 2016 Oct;9(4):600-8. doi: 10.1016/j.dhjo.2016.04.007. Epub 2016 May 3.
Today one in five Americans have a disability and nearly half of Americans experiences a chronic condition. Whether disability results from or is a risk factor for chronic conditions, the combined effects of disability and chronic conditions warrants further investigation.
Examine the added impact of chronic conditions among those with and without disability on self-reported health status and behaviors.
2009 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed to examine the association of disability with unhealthy behaviors and poor health stratified by number of self-reported chronic conditions (0, 1, or 2+). Linear and logistic regression models accounting for the complex survey weights were used.
Participants with disability were 6 times more likely to report fair/poor self-rated health, reported 9 more unhealthy days in a month and 6 more days in a month when poor health kept them from usual activities, were 4 times more likely to be dissatisfied with life, had greater odds of being a current smoker, and were less likely to be physically active. Presence of chronic conditions in addition to disability was associated, in a dose-response manner, with poor health status and unhealthy behaviors.
People living with both chronic diseases and disability are at substantially increased risks for poor health status and unhealthy behaviors, further affecting effective management of their chronic conditions. Multi-level interventions in primary care and in the community that address social and environmental barriers that hinder adults with disability from adopting more healthy lifestyles and improving health are needed.
如今，五分之一的美国人患有残疾，近一半的美国人患有慢性病。无论残疾是慢性病的结果还是慢性病的危险因素，残疾和慢性病的综合影响都值得进一步研究。
研究慢性病对有残疾和无残疾人群自我报告的健康状况及行为的额外影响。
分析2009年行为危险因素监测系统（BRFSS）的数据，以研究残疾与不健康行为及健康状况不佳之间的关联，并根据自我报告的慢性病数量（0、1或2种以上）进行分层。使用了考虑复杂调查权重的线性和逻辑回归模型。
有残疾的参与者报告自我健康评价为一般/较差的可能性高6倍，每月报告有9天以上不健康，每月有6天以上因健康状况不佳而无法进行日常活动，对生活不满意的可能性高4倍，当前吸烟的几率更高，且身体活动较少。除残疾外，慢性病的存在与健康状况不佳和不健康行为呈剂量反应关系。
患有慢性病和残疾的人健康状况不佳和行为不健康的风险大幅增加，这进一步影响了他们慢性病的有效管理。需要在初级保健和社区层面进行多层次干预，以消除阻碍残疾成年人采取更健康生活方式和改善健康状况的社会和环境障碍。
