Tools developed to examine neighbourhood economic effects on spinal cord injury outcomes

Researchers have developed robust measures of neighbourhood economic factors to study how social determinants influence health outcomes after spinal cord injury (SCI). The study reveals that individuals in disadvantaged neighbourhoods face higher risks of poor health, emphasising the need for public policy to address environmental inequities.

Research scientists developed and validated two composite measures – neighbourhood socioeconomic status and socioeconomic disadvantage – using data from the U.S. Census Bureau’s American Community Survey and the national Spinal Cord Injury Model Systems database, respectively.

“These measures are an advancement for studying social determinants of health in SCI research. They provide critical tools that other researchers can use so that including indicators of neighbourhood environmental factors can become standard in future rehabilitation outcomes studies,” said lead author and principal investigator Dr. Amanda Botticello.

“Our findings highlight the importance of understanding how the environment influences health, community integration, and the development of disparities in these outcomes over time. This research can guide targeted interventions to improve quality of life for those living with SCI.”

The authors write: “…exposure to adverse conditions such as poverty and unemployment that limit access to broader resources to promote health may negatively affect all residents of an area irrespective of personal income, education, and employment status.

“These results are consistent with the sizable literature on the negative effects of neighbourhood disadvantage on health in the general population and add to the call to improve the conditions of highly disadvantaged areas to address broader inequalities in health and wellbeing.”

Then go on to say: “The results of our validity analysis suggest that the neighbourhood SES measure may be a useful proxy for personal SES characteristics such as income, which are often difficult to obtain from survey respondents and may be complex to measure for people with disabilities, who may receive assistance from government programs and other resources to supplement living expenses.

“Our neighbourhood disadvantage measure may be used in future SCIMS research to identify health inequalities and inform where community-based interventions and policies can be directed to improve the environmental factors that are critical to shaping the opportunities for people with SCI.”