scholarly journals Prevalence of Wheelchair and Scooter Use Among Community-Dwelling Canadians

2016 ◽  
Vol 96 (8) ◽  
pp. 1135-1142 ◽  
Author(s):  
Emma M. Smith ◽  
Edward M. Giesbrecht ◽  
W. Ben Mortenson ◽  
William C. Miller
Keyword(s):  
Policy Research ◽  
Secondary Analysis ◽  
Household Survey ◽  
Demographic Characteristics ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Wheelchair Users ◽  
Mobility Impairments ◽  
Canadian Population ◽  
National Household Survey

Abstract Background Mobility impairments are the third leading cause of disability for community-dwelling Canadians. Wheelchairs and scooters help compensate for these challenges. There are limited data within the last decade estimating the prevalence of wheelchair and scooter use in Canada. Objective The aims of this study were: (1) to estimate the prevalence of wheelchair and scooter use in Canada and (2) to explore relevant demographic characteristics of wheelchair and scooter users. Design This study was a secondary analysis of a cross-sectional national survey. Methods The Canadian Survey on Disability (2012) collected data on wheelchair and scooter use from community-dwelling individuals aged 15 years and over with a self-identified activity limitation on the National Household Survey. Prevalence estimates were calculated as weighted frequencies, with cross-tabulations to determine the number of wheelchair and scooter users in Canada, by province, and demographic characteristics (ie, age, sex) and bootstrapping to estimate the variance of all point estimates. Results There were approximately 288,800 community-dwelling wheelchair and scooter users aged 15 years and over, representing 1.0% of the Canadian population. The sample included 197,560 manual wheelchair users, 42,360 powered wheelchair users, and 108,550 scooter users. Wheelchair and scooter users were predominantly women, with a mean age of 65 years. Approximately 50,620 individuals used a combination of 2 different types of devices. Limitations The results are representative of individuals living in the community in Canada and exclude individuals in residential or group-based settings; estimates do not represent the true population prevalence. Conclusion This analysis is the first in more than 10 years to provide a prevalence estimate and description of wheelchair and scooter users in Canada. Since 2004, there has been an increase in the proportion of the population who use wheelchairs and scooters, likely related to an aging Canadian population. These new prevalence data have potential to inform policy, research, and clinical practice.

scholarly journals Overt acts of perceived discrimination reported by British working-age adults with and without disability

2019 ◽  
Author(s):  
Eric Emerson ◽  
Allison Milner ◽  
Zoe Aitken ◽  
Lauren Krnjacki ◽  
Cathy Vaughan ◽  
...  
Keyword(s):  
Public Health ◽  
Negative Impact ◽  
Policy Research ◽  
Secondary Analysis ◽  
People With Disabilities ◽  
Public Health Problem ◽  
Health Staff ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Uk

Abstract Background Exposure to discrimination can have a negative impact on health. There is little robust evidence on the prevalence of exposure of people with disabilities to discrimination, the sources and nature of discrimination they face, and the personal and contextual factors associated with increased risk of exposure. Methods Secondary analysis of de-identified cross-sectional data from the three waves of the UK’s ‘Life Opportunities Survey’. Results In the UK (i) adults with disabilities were over three times more likely than their peers to be exposed to discrimination, (ii) the two most common sources of discrimination were strangers in the street and health staff and (iii) discrimination was more likely to be reported by participants who were younger, more highly educated, who were unemployed or economically inactive, who reported financial stress or material hardship and who had impairments associated with hearing, memory/speaking, dexterity, behavioural/mental health, intellectual/learning difficulties and breathing. Conclusions Discrimination faced by people with disabilities is an under-recognised public health problem that is likely to contribute to disability-based health inequities. Public health policy, research and practice needs to concentrate efforts on developing programs that reduce discrimination experienced by people with disabilities.

scholarly journals Intersectional (in) equities in contact coverage of maternal and newborn health services in Nepal: insights from a nationwide cross-sectional household survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Resham B. Khatri ◽  
Yibeltal Alemu ◽  
Melinda M. Protani ◽  
Rajendra Karkee ◽  
Jo Durham
Keyword(s):  
Institutional Delivery ◽  
Secondary Analysis ◽  
Newborn Health ◽  
Household Survey ◽  
Universal Coverage ◽  
Maternal And Newborn Health ◽  
Multiple Forms ◽  
Wealth Status ◽  
Cross Sectional ◽  
Maternal And Newborn

Abstract Background Persistent inequities in coverage of maternal and newborn health (MNH) services continue to pose a major challenge to the health-care system in Nepal. This paper uses a novel composite indicator of intersectional (dis) advantages to examine how different (in) equity markers intersect to create (in) equities in contact coverage of MNH services across the continuum of care (CoC) in Nepal. Methods A secondary analysis was conducted among 1978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The three outcome variables included were 1) at least four antenatal care (4ANC) visits, 2) institutional delivery, and 3) postnatal care (PNC) consult for newborns and mothers within 48 h of childbirth. Independent variables were wealth status, education, ethnicity, languages, residence, and marginalisation status. Intersectional (dis) advantages were created using three socioeconomic variables (wealth status, level of education and ethnicity of women). Binomial logistic regression analysis was employed to identify the patterns of (in) equities in contact coverage of MNH services across the CoC. Results The contact coverage of 4ANC visits, institutional delivery, and PNC visit was 72, 64, and 51% respectively. Relative to women with triple disadvantage, the odds of contact coverage of 4ANC visits was more than five-fold higher (Adjusted Odds Ratio (aOR) = 5.51; 95% CI: 2.85, 10.64) among women with triple forms of advantages (literate and advantaged ethnicity and higher wealth status). Women with triple advantages were seven-fold more likely to give birth in a health institution (aOR = 7.32; 95% CI: 3.66, 14.63). They were also four times more likely (aOR = 4.18; 95% CI: 2.40, 7.28) to receive PNC visit compared to their triple disadvantaged counterparts. Conclusions The contact coverage of routine MNH visits was low among women with social disadvantages and lowest among women with multiple forms of socioeconomic disadvantages. Tracking health service coverage among women with multiple forms of (dis) advantage can provide crucial information for designing contextual and targeted approaches to actions towards universal coverage of MNH services and improving health equity.

Construct validity of the enfranchisement scale of the community participation indicators

2021 ◽  
pp. 026921552110409
Author(s):  
Jessica Kersey ◽  
Lauren Terhorst ◽  
Allen W Heinemann ◽  
Joy Hammel ◽  
Carolyn Baum ◽  
...  
Keyword(s):  
Construct Validity ◽  
Community Participation ◽  
Convergent Validity ◽  
Missing Values ◽  
Discriminant Validity ◽  
Secondary Analysis ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Cord Injury

Objective: This study examined the construct validity of the Enfranchisement scale of the Community Participation Indicators. Design: We conducted a secondary analysis of data collected in a cross-sectional study of rehabilitation outcomes. Subjects: The parent study included 604 community-dwelling adults with chronic traumatic brain injury, stroke, or spinal cord injury. The sample had a mean age of 64.1 years, was two-thirds male, and included a high proportion of racial minorities ( n = 250, 41.4%). Main measures: The Enfranchisement scale contains two subscales: the Control subscale and the Importance subscale. We examined correlations between each Enfranchisement subscale and measures of participation, environment, and impairments. The current analyses included cases with at least 80% of items completed on each subscale (Control subscale: n = 391; Importance subscale: n = 219). Missing values were imputed using multiple imputation. Results: The sample demonstrated high scores, indicating poor enfranchisement (Control subscale: M = 51.7; Importance subscale: M = 43.0). Both subscales were most strongly associated with measures of participation (Control subscale: r = 0.56; Importance subscale: r = 0.52), and least strongly associated with measures of cognition (Control subscale: r = 0.03; Importance subscale: r = 0.03). The Importance subscale was closely associated with depression ( r = 0.54), and systems, services, and policies ( r = 0.50). Both subscales were associated with social attitudes (Control subscale: r = 0.44; Importance subscale: r = 0.44) and social support (Control subscale: r = 0.49; Importance subscale: r = 0.41). Conclusions: We found evidence of convergent validity between the Enfranchisement scale and measures of participation, and discriminant validity between the Enfranchisement scale and measures of disability-related impairments. The analyses also revealed the importance of the environment to enfranchisement outcomes.

scholarly journals Health, Personal, and Environmental Predictors of Wheelchair-Use Confidence in Adult Wheelchair Users

2015 ◽  
Vol 95 (10) ◽  
pp. 1365-1373 ◽  
Author(s):  
Brodie M. Sakakibara ◽  
William C. Miller ◽  
Janice J. Eng ◽  
François Routhier ◽  
Catherine L. Backman
Keyword(s):  
Clinical Intervention ◽  
Environmental Variable ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Environmental Predictors ◽  
Cross Sectional ◽  
Wheelchair Users ◽  
Interpersonal Support ◽  
Personal Variables ◽  
Health Related

Background There are no predictive models of wheelchair-use confidence. Therefore, clinicians and researchers are limited in their ability to screen for and identify wheelchair users who may be more prone to low wheelchair-use confidence and may benefit from clinical intervention. Objective The purpose of this study was to identify health-related, personal, and environmental factors that predict perceived wheelchair-use confidence in community-dwelling adults who use manual wheelchairs. Design A cross-sectional study was conducted. Methods Community-dwelling manual wheelchair users (N=124) were included in the study if they were ≥50 years of age, had ≥6 months of wheelchair use experience, and had no cognitive impairment. The Wheelchair Use Confidence Scale was used to assess wheelchair-use confidence. The sociodemographic information form, Functional Comorbidity Index, Seating Identification Tool, Interpersonal Support and Evaluation List, and Home and Community Environment Instrument captured the independent variables. Blocks of health, personal, and environmental variables were sequentially entered into the regression model. Results Five personal variables (age, standardized beta [β]=−0.18; sex, β=−0.26; daily hours of wheelchair occupancy, β=0.20; wheelchair-use training, β=0.20; and wheelchair-use assistance, β=−0.34) and one environmental variable (need for seating intervention, β=−0.18) were statistically significant predictors, explaining 44% of the confidence variance. Limitations The sample comprised volunteers and, therefore, may underrepresent or overrepresent particular groups within the population. The study's cross-sectional research design does not allow for conclusions to be made regarding causality. Conclusion Older women who use wheelchairs and who require assistance with wheelchair use may have low wheelchair-use confidence. The same is true for individuals who have no formal wheelchair-use training, who are in need of a seating intervention, and who report few hours of daily wheelchair use. These wheelchair users may require clinical attention and benefit from intervention.

scholarly journals Prevalence of mental disorders and associated disability: Results from the cross-sectional CZEch mental health Study (CZEMS)

2019 ◽  
Vol 60 ◽  
pp. 1-6 ◽  
Author(s):  
T. Formánek ◽  
A. Kagström ◽  
P. Cermakova ◽  
L. Csémy ◽  
K. Mladá ◽  
...  
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Mental Disorders ◽  
Psychotic Disorders ◽  
Household Survey ◽  
Community Dwelling ◽  
Health Study ◽  
Prevalence Rates ◽  
Linear Regression Models ◽  
Cross Sectional

AbstractIntroduction:We aimed to estimate the prevalence of current mental disorders in the Czech population, and to identify associated disability.Methods:We conducted a representative cross-sectional household survey of the Czech adult, community-dwelling population. We used the Mini International Neuropsychiatric Interview (M.I.N.I.), WHO Disability Assessment Schedule (WHODAS) 2.0, and Self-Identification as Mentally Ill (SELFI) scale alongside sociodemographic and other covariates. We reached 75% response rate. Descriptive statistics of the sample were assessed and median (M) disability levels with interquartile range (IQR) according diagnosis were calculated on a scale ranging from 12 to 50. Linear regression models were used to identify factors associated with disability.Results:In our sample of 3 306 participants,21.9% experienced a mental disorder in 2017. Prevalence rates for mood, anxiety, alcohol use, non-alcohol substance use, and psychotic disorders corresponded to 5.5%, 7.3%, 10.8%,2.9%, and1.5%respectively. Alcoholdependencewasidentifiedin6.6%,andmajordepressionin4.0%of the sample. Disability in the general population was significantly lower (M = 12; IQR = 12, 17) than in those with mood (M = 20; IQR = 14; 29), anxiety (M = 18; IQR = 13; 26), alcohol use (M = 14; IQR = 12; 18), non- alcohol substance use (M = 15; IQR = 12; 19), or psychotic disorders (M = 22; IQR = 16.4; 29.4).Conclusions:People with mental disorders have considerably elevated disability in comparison to mentally healthy participants. The prevalence of mental disorders in the Czech Republic is mostly in line with European prevalence rates but it is lower for anxiety disorders and two times higher for alcohol use disorders.

scholarly journals Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1738
Author(s):  
Jaime Pajuelo-Ramírez ◽  
Harold Torres-Aparcana ◽  
Rosa Agüero-Zamora ◽  
Antonio M. Quispe
Keyword(s):  
Abdominal Obesity ◽  
Household Survey ◽  
Cross Sectional Study ◽  
Inverse Association ◽  
Cross Sectional ◽  
Age And Gender ◽  
Younger Men ◽  
Andean Countries ◽  
National Household Survey ◽  
And Gender

Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20,489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.86 (95% CI: 0.75 to 0.97); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.98 (95% CI: 0.87 to 1.11), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender (p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.

scholarly journals Comorbidity and healthcare use for individuals with CVD in the Ireland: a cross-sectional, population-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025305 ◽  
Author(s):  
Karyn Morrissey
Keyword(s):  
Health Service ◽  
Service Use ◽  
Household Survey ◽  
Population Based ◽  
Health Service Use ◽  
Cross Sectional Survey ◽  
Service Usage ◽  
Cross Sectional ◽  
National Household Survey ◽  
Nationally Representative

ObjectiveThis study explores the factors associated with health service use for individuals with cardiovascular disease (CVD) and comorbidity in the Ireland.DesignPopulation-based cross-sectional survey.SettingNationally representative health and health service use survey from the 2010 Quarterly National Household Survey was analysed.Primary outcome measuresFour outcome variables were examined: no CVD, CVD only, CVD with CVD-related comorbidities and CVD with non-CVD-related comorbidity.ResultsOf the 791 individuals reporting doctor-diagnosed CVD, 77% had a second morbidity. Using type of healthcare coverage as a proxy for socioeconomic status, both CVD-related and non CVD-related comorbidity increases the use of health service usage substantially for individuals with CVD, particularly general practitioner services (8.47, CI 4.49 to 15.96 and 5.20, CI 2.10 to 12.84) and inpatient public hospital care (3.64, CI 2.93 to 4.51 and 3.00, CI 2.11 to 4.26).ConclusionThis study indicated that even when demographic and socioeconomic factors are controlled for, comorbidity significantly increases the risk of accessing health services for individuals with CVD.

scholarly journals Measuring the Protective Effect of Health Insurance Coverage on Out-of-Pocket Expenditures During the COVID-19 Pandemic in the Peruvian Population

2021 ◽  
Author(s):  
Akram Hernández-Vásquez ◽  
Carlos Rojas-Roque ◽  
Antonio Barrenechea-Pulache ◽  
Guido Bendezu-Quispe
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Household Survey ◽  
Interrupted Time Series ◽  
Health Insurance Coverage ◽  
Interrupted Time Series Analysis ◽  
Cross Sectional ◽  
Treatment Groups ◽  
Quasi Experimental ◽  
National Household Survey

Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the COVID-19 pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were i) the proportion of individuals who incurred OOP expenditures and ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (p=0.916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (p=0.073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures.

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