Disability And Health Journal[JOURNAL]
Sun
200 papers
Factors associated with uncertainty in parents of children with developmental disabilities: A scoping review.
Choi H, Seomun G, Song J
Disabil Health J · 2026 Jan · PMID 40947341 · Publisher ↗
BACKGROUND: Parents of children with developmental disabilities (DD) experience ongoing uncertainty, which contributes to various physical and mental health challenges. However, studies mapping the factors influencing th...
BACKGROUND: Parents of children with developmental disabilities (DD) experience ongoing uncertainty, which contributes to various physical and mental health challenges. However, studies mapping the factors influencing this uncertainty and its effects on other variables remain scarce. OBJECTIVE: This study aimed to analyze and synthesize existing evidence on the factors influencing uncertainty among parents of children with DD and its impact on parental outcomes. METHODS: A scoping review was conducted following Arksey and O'Malley's framework. Relevant studies were identified through a literature review conducted across five databases-Medline/PubMed, CINAHL, Cochrane Library, Embase, and APA PsycArticles-up to March 1, 2024. Studies with English abstracts were included without time restrictions. RESULTS: Eight studies involving 1986 participants were analyzed. The identified influencing factors were categorized into health condition-related factors (e.g., the severity of the child's condition), family and community resources (e.g., maternal education level, trust in healthcare professionals, and appraisal support), and appraisals of uncertainty as either a risk (e.g., caregiver burden and marital conflict) or an opportunity (e.g., adaptation, quality of life, parenting efficacy, sense of coherence, optimism, and self-help). CONCLUSIONS: The findings of this study provide essential evidence for developing effective healthcare strategies to reduce parental uncertainty. By addressing these factors, the study aims to contribute to decreasing parental uncertainty and promoting the optimal development of children with DD.
Is disability prevalence higher in rural areas? Evidence from functional difficulty and nightlight data in 15 low- and middle-income countries.
Theiss K, Carpenter B, Hanass-Hancock J … +7 more , Kamalakannan S, Kulchar RJ, Murthy GVS, Pinilla-Roncancio M, Rivas Velarde M, Tetali S, Mitra S
Disabil Health J · 2026 Jan · PMID 40940252 · Publisher ↗
BACKGROUND: There has been emerging evidence from country-level studies that disability prevalence tends to be lower in urban areas than in rural areas. However, such studies are difficult to compare as countries use dif...
BACKGROUND: There has been emerging evidence from country-level studies that disability prevalence tends to be lower in urban areas than in rural areas. However, such studies are difficult to compare as countries use different ways of categorizing rural and urban areas. OBJECTIVES: We examine the association between disability measured through functional difficulties (seeing, hearing, walking, cognition, selfcare, communicating) and urban development measured through the satellite nightlight composite-an internationally comparable proxy for urban development. METHODS: We use Demographic and Health Survey data for 15 low- and middle-income countries (LMICs) with the Washington Group Short Set of questions on disability. This study uses multilevel random intercept models to estimate whether functional difficulties are negatively associated with village-level nightlight composite. RESULTS: While country level results vary, in the pooled sample, adults living in villages above the 80th percentile of nightlight activity have odds of reporting any functional difficulty that are 0.765 times those of adults in villages below the 80th percentile of nightlight (AOR = 0.765; 95 % CI = 0.717 to 0.816). The result is robust for each functional domain but the correlation is higher for hearing, cognition and communicating. CONCLUSIONS: In 15 LMICs, adults in rural areas are significantly more likely to have functional difficulties compared to adults in urban areas. Research is needed on the factors that drive such a correlation, including poorer living conditions and access to services in rural areas, differential access to resources and environmental barriers in rural and urban areas and potential differences in rural-urban migration opportunities across functional difficulty status.
Direct support professional perspectives on the value of virtual healthcare for adults with intellectual and developmental disabilities: Trends over four years.
Selick A, Bernier SL, Bobbette N … +2 more , Cardiff K, Lunsky Y
Disabil Health J · 2026 Jan · PMID 40818922 · Publisher ↗
BACKGROUND: Direct support professionals (DSPs) often play a critical role in supporting healthcare interactions for people with intellectual and developmental disabilities (IDD) but little is known about their experienc...
BACKGROUND: Direct support professionals (DSPs) often play a critical role in supporting healthcare interactions for people with intellectual and developmental disabilities (IDD) but little is known about their experience supporting virtual healthcare. OBJECTIVE: This study explored utilization of virtual care and DSP experiences of supporting virtual care at four time points in Ontario, Canada. METHODS: DSPs in Ontario were invited to participate in an online survey in 2020 (n = 867), 2021 (n = 428), 2022 (n = 698) and 2023 (n = 603). This study focuses on the subset of questions related to DSP experience supporting virtual healthcare. Descriptive statistics were used to summarize quantitative data and content analysis was used to analyze open text responses. RESULTS: Over the four surveys, reported utilization of phone-based care was consistently higher (53-60 %) than video-based care (20-30 %). DSPs were more likely to provide positive feedback for video-based care compared with phone-based care, however, there was a decline in positive feedback for both over the four surveys. Though video-based care in particular was identified as valuable for patients who struggle to attend in-person appointments, ongoing challenges were reported including technical issues and poor communication quality. CONCLUSIONS: Without the overwhelming concern of COVID transmission, for many patients, the benefits of virtual care may not outweigh the ongoing challenges. However, there appears to be a subset of people for whom virtual care can be critically important to support accessible care. DSPs require more training and resources to effectively support virtual healthcare visits.
The limited role of sex education and contraception use in unintended pregnancy by disability status among young adults.
Sullivan DL
Disabil Health J · 2026 Jan · PMID 40816993 · Publisher ↗
BACKGROUND: By examining young adult women with disabilities'(WWD) experiences with pregnancy, scholars have concluded that WWD are more likely to experience unintentional pregnancies compared to women without disabiliti...
BACKGROUND: By examining young adult women with disabilities'(WWD) experiences with pregnancy, scholars have concluded that WWD are more likely to experience unintentional pregnancies compared to women without disabilities. Yet, the reasons for this increase in unintended pregnancy observed among WWD remains unclear. While WWD lack access to sexual health education and reproductive health care, they continue to engage in sexual behaviors and experience pregnancy at similar rates compared to able-bodied women. OBJECTIVE: This study investigates if sexual health education and contraception use mediate the relationship between disability status and unintended pregnancy for women aged 15-24. METHODS: Data come from 2011 to 2019 National Survey of Family Growth and include a sample of 6988 women. The sample is examined descriptively using chi-square tests and t-tests. Mediated path analysis within a structural equation modeling (SEM) framework is used to analyze the relationship between sexual health education, contraception use, disability status, and unintended pregnancy. RESULTS: WWD were more likely to experience unintended pregnancy, less likely to receive sexual health education, and use less effective forms of contraception. No mediation effect of sexual health education or contraception use on the relationship between disability status and unintended pregnancy was found for this age group. CONCLUSION: Sexual health education and contraception use did not mediate the relationship between disability status and unintended pregnancy for young adult women with disabilities. More research is needed to adequately explore the mechanisms leading to increased unintended pregnancy among WWD, particularly across additional age groups.
Intersecting Inequalities: Non-Partner violence against poor women with disabilities in Egypt.
Abdelwahed A, Zhao X, Fouad D … +2 more , Amer E, Gendia MA
Disabil Health J · 2026 Jan · PMID 40803991 · Publisher ↗
BACKGROUND: Non-partner violence (NPV) against women with disabilities remains underexamined, particularly in resource-limited settings like Egypt. Intersecting vulnerabilities-gender, disability, and poverty-amplify ris...
BACKGROUND: Non-partner violence (NPV) against women with disabilities remains underexamined, particularly in resource-limited settings like Egypt. Intersecting vulnerabilities-gender, disability, and poverty-amplify risks. Structural inequalities and social marginalization further heighten violence, limit access to support systems, and exacerbate the vulnerabilities of women with disabilities, creating significant gaps in intervention and support. OBJECTIVE: This study investigates the prevalence and determinants of NPV among poor women with disabilities in Egypt, with a focus on how sociodemographic and disability-related factors shape risk. METHODS: Using data from the 2020 Violence Against Women With Disability Survey, this cross-sectional study analyzes 5616 women with physical, hearing, visual, or multiple disabilities. Descriptive statistics and logistic regression models were employed to examine lifetime and past-year experiences of NPV and associated characteristics. RESULTS: Nearly half (47.8 %) of women reported experiencing NPV since age 15, and 25.3 % experienced it in the past year. Higher risk was observed among younger women, unmarried, those living in Upper Egypt, those with early-onset or multiple disabilities, and those with lower educational attainment. Notably, employed women faced increased odds of NPV, possibly reflecting exposure in public or workplace settings. CONCLUSIONS: The findings emphasize the urgent need for disability-sensitive interventions that address structural inequality, stigma, and social exclusion. Interventions should prioritize inclusive legal protections, caregiver oversight, and access to accessible services, especially in underserved and rural regions. Targeted policies are essential to ensure safety, dignity, and justice for women with disabilities in Egypt.
Editorial transition at DHJO.
Mitra M
Disabil Health J · 2025 Oct · PMID 40783349 · Publisher ↗
Abstract loading — click title to view on PubMed.
Differences in substance use treatment receipt, perceived treatment need, and barriers to receiving treatment among US adults with and without disabilities, 2022-2023.
Abadie R, Cano M
Disabil Health J · 2026 Jan · PMID 40769851 · Publisher ↗
BACKGROUND: People with disabilities (PWD) are at higher risk of experiencing substance use (SU) disorders than those without a disability. While treatment for SU reduces mortality and morbidity, currently there are no n...
BACKGROUND: People with disabilities (PWD) are at higher risk of experiencing substance use (SU) disorders than those without a disability. While treatment for SU reduces mortality and morbidity, currently there are no national-level studies comparing US adults with and without disabilities in terms of SU treatment receipt, perceived need, and barriers. OBJECTIVE: To examine differences between US adults with and without disabilities in terms of SU treatment receipt, perceived need for treatment, and barriers to receiving treatment. METHODS: This cross-sectional study examined National Survey on Drug Use and Health (NSDUH) 2022-2023 data (n = 89,167 adults) on self-reported disability and past-year substance use disorder (SUD), SU treatment, unmet treatment need, and treatment barriers. Analyses included weighted prevalence estimates, chi-squared tests (corrected for the survey design), and binomial logistic regression. RESULTS: An estimated 10.0 % of adults with a disability, versus 3.9 % without a disability, reported receiving past-year SU treatment. For adults with a past-year SUD who did not receive treatment, reporting a disability was associated with 70 % higher odds (Adjusted Odds Ratio [AOR] 1.70; 95 % Confidence Interval [CI], 1.27-2.28) of "unmet need" for SU treatment (after adjusting for demographics). Among adults who reported an "unmet need" for SU treatment, barriers related to cost and stigma were reported more frequently in those with, compared to those without, a disability. CONCLUSIONS: Findings highlight elevated SU treatment need and barriers for PWD. Understanding the intersection of disability with the cascade of care, from screening to diagnosis and treatment of SU, is critical in improving health outcomes.
Incentivizing, enforcing and improving disability accessible health care: Current gaps and potential solutions.
Morris M, Lockhart S, Eberle K … +1 more , Oshita J
Disabil Health J · 2026 Jan · PMID 40750510 · Publisher ↗
BACKGROUND: Despite federal requirements for health care organizations (HCOs) to provide accessible care to patients with disability, care often remains inaccessible. OBJECTIVE: To explore stakeholders' perspectives of t...
BACKGROUND: Despite federal requirements for health care organizations (HCOs) to provide accessible care to patients with disability, care often remains inaccessible. OBJECTIVE: To explore stakeholders' perspectives of the effectiveness of federal requirements and factors motivating HCOs to provide accessible care to patients with disability. METHODS: We conducted 55 interviews with key informants (e.g., Disability Coordinators, researchers, policymakers, professional organizations, advocates) between May 2019 and August 2020. All interviews were conducted by qualitatively trained researchers and analyzed using content analysis methodology. RESULTS: We identified 3 themes: 1) existing laws are necessary, but not sufficient; 2) education is needed for health care organizations on disability as an equity issue; 3) health care is motivated by cost, quality and competition.Interview participants reported legal mandates as a major mechanism incentivizing healthcare organizations to invest in accessible care for patients with disability. These mandates, enforced through patient lawsuits and complaints, have been ineffective in driving systemic change.Additionally, organizational leaders lack knowledge on their legal obligations to provide equitable access to healthcare and the needs of patients with disability. Participants identified a need for research demonstrating that accessible care improves outcomes and costs. Finally, participants expressed a desire for methods to facilitate competition amongst healthcare organizations to encourage provision of accessible care. CONCLUSION: Federal requirements are necessary but insufficient in ensuring accessibility. Alternative solutions are needed which educate leadership and align with cost, quality and competition incentives. Diversifying the levers which incentivize accessible care could drive meaningful change in equitable healthcare for patients with disability.
Work from home and job Satisfaction: Differences by disability status among healthcare workers.
Rodgers YVM, Schur L, Hammond FM … +3 more , Edwards R, Cohen J, Kruse D
Disabil Health J · 2026 Jan · PMID 40731232 · Publisher ↗
BACKGROUND: Many workers with disabilities face negative stereotypical attitudes, pay gaps, and a lack of respect in the workplace, contributing to substantially lower job satisfaction compared to people without disabili...
BACKGROUND: Many workers with disabilities face negative stereotypical attitudes, pay gaps, and a lack of respect in the workplace, contributing to substantially lower job satisfaction compared to people without disabilities. Work from home may help to increase job satisfaction for people with disabilities. OBJECTIVE: This study analyzes how different measures of job satisfaction vary between people with and without disabilities, and the extent to which working from home moderates the relationship between disability and job satisfaction. METHODS: We use multivariable regression analysis to examine if the ability to work from home moderates the relationship between disability and indicators related to job satisfaction. The dataset draws on a novel survey of healthcare professionals. RESULTS: Results show that people with disabilities have relatively greater turnover intentions, lower sense of organizational commitment and support, weaker perceptions of openness and inclusion in the workplace, and worse relations with management and coworkers. Regressions indicate that working from home helps to improve most perceptions of work experiences but does so more for people without disabilities than for people with disabilities. CONCLUSIONS: The findings suggest that (a) some accommodations typically viewed as exceptions to meet the needs of people with disabilities have even greater benefits for the workforce at large and (b) because workers without disabilities also benefit from remote work, we cannot expect this accommodation to close job satisfaction gaps caused by inequities.
Unequal impact of housing, food, and healthcare hardships on depression among persons with disabilities: A quantile regression approach.
Park GR, Parikh M, Patel J
Disabil Health J · 2026 Jan · PMID 40713397 · Publisher ↗
BACKGROUND: While material hardships have been widely studied, less is known about whether baseline psychological health mitigates these hardships-or how its role varies by type of essential good or service (e.g., housin...
BACKGROUND: While material hardships have been widely studied, less is known about whether baseline psychological health mitigates these hardships-or how its role varies by type of essential good or service (e.g., housing, food, healthcare) among persons with disabilities. OBJECTIVE: This study examines how different types of material hardship-specifically housing, food, and healthcare hardships-affect psychological health across different points in the depressive symptom distribution among people with disabilities. METHODS: This study used data from the Disability and Life Dynamic Panel (DLDP) survey (2018-2020). Individual level fixed effects models were conducted to estimate within-individual differences in depressive symptoms in relation to housing, food, and healthcare hardships. Quantile regression was used to examine how the effects of material hardships vary across the distribution of depressive symptoms, allowing us to assess whether individuals with relatively better or worse psychological health are differently impacted. RESULTS: Individuals with mental disabilities and those categorized with brain lesion disorders reported higher levels of depressive symptoms and greater difficulties related to housing, food, and healthcare. Quantile regression results indicate that the association between these material hardships and depressive symptoms is more pronounced among individuals with higher baseline levels of depression. CONCLUSIONS: This study highlights the impact of material hardship on depression in individuals with disabilities, emphasizing the need for policies and support systems that address both material and psychological health needs.
The disability squeeze: Out-of-pocket expenses and unmet needs for disability-related goods and services in the U.S.
Morris ZA, Rennane S, Goodman N … +6 more , Mont D, Ballan M, Davis A, McGarity S, Ellison B, Weldeslassie G
Disabil Health J · 2026 Jan · PMID 40713250 · Publisher ↗
BACKGROUND: Few studies have quantified the higher cost of living with a disability and the extent of unmet needs for disability-related goods and services as experienced by adults with disabilities in the U.S. OBJECTIVE...
BACKGROUND: Few studies have quantified the higher cost of living with a disability and the extent of unmet needs for disability-related goods and services as experienced by adults with disabilities in the U.S. OBJECTIVE: To provide national estimates of total annual out-of-pocket disability-related expenditures, their burden, and the prevalence of unmet needs, and to investigate whether persons with disabilities from underserved communities experience disparate impacts from "the disability squeeze." METHODS: We designed and fielded a survey in June of 2023 to a nationally representative sample of adults with disabilities through the Understanding America Study, an online panel survey. Multivariate regression analyses examine correlates with out-of-pocket expenditures, the financial burden of the expenditures, and unmet needs. RESULTS: Among 1168 working-age adults with disabilities, mean annual expenditures on disability-related goods and services was $5341 in June 2023, equating to 20 % of household income. Additionally, 67 % of adults with disabilities reported an unmet need. Controlling for sociodemographic characteristics, adults with disabilities with incomes below the federal poverty level reported significantly lower expenditures (p < .05) but greater financial burden from their out-of-pocket expenses (p < .05). Hispanic persons with disabilities also reported significantly lower expenditures (p < .05) but higher rates of unmet need (p < .05). CONCLUSION: Adults with disabilities in the U.S. experience considerable financial strain from their disability-related expenses and sustain high rates of unmet needs with disproportionate impacts identified for those from underserved communities.
Associations of dynamic versus static disability with experiences of stigma and mental health.
Carel E, Woodman AC, Kellogg AJ … +1 more , Reid AE
Disabil Health J · 2026 Jan · PMID 40713249 · Publisher ↗
BACKGROUND: Prior research recognizes that the visibility of an individual's disability is salient to understanding experiences, such that greater visibility is associated with higher levels of stigma and symptoms of anx...
BACKGROUND: Prior research recognizes that the visibility of an individual's disability is salient to understanding experiences, such that greater visibility is associated with higher levels of stigma and symptoms of anxiety and depression. Yet, the dynamicity of a disability, defined as the extent to which severity of an impairment fluctuates, has been relatively understudied. We conducted the first known quantitative examination of dynamicity. HYPOTHESES: We hypothesized that mental health and chronic illnesses would be most frequently characterized as dynamic. We also expected that dynamicity would be associated with greater symptoms of anxiety and depression, and that these relationships would be mediated by greater experiences with discrimination and microaggressions. METHODS: The sample included 125 participants with disabilities who answered the Ableist Microaggression Scale, the Everyday Discrimination Scale, the Generalized Anxiety Disorder Screener-7, the Center for Epidemiological Studies Depression Scale, and an author-created six-question measure of disability dynamicity. RESULTS: Mental health conditions were rated by participants as highly dynamic. Consistent with our hypotheses, four linear regressions supported that, above and beyond demographic factors and disability visibility, dynamicity predicted more ableist microaggressions, discrimination, anxiety symptoms, and depressive symptoms. In mediation models, discrimination predicted both depressive and anxiety symptoms, whereas ableist microaggressions did not. Confidence intervals further supported that discrimination, but not microaggressions, mediated the relationship of dynamicity with anxiety and depressive symptoms. CONCLUSIONS: Disability dynamicity appears relevant to understanding stigmatizing experiences and resulting anxiety and depression symptoms. Recognition of this association can contribute to advancement of culturally competent mental health care for people with dynamic disabilities.
Accessibility and utilisation of reproductive healthcare services among women with disabilities in Lithuania: Insights from a mixed-methods study.
Grigaitė U, Aginskaitė S, Uscila R
Disabil Health J · 2026 Jan · PMID 40707346 · Publisher ↗
BACKGROUND: Women with disabilities worldwide face barriers to reproductive healthcare, including accessibility challenges and negative attitudes from medical professionals. These issues reflect multiple intersecting for...
BACKGROUND: Women with disabilities worldwide face barriers to reproductive healthcare, including accessibility challenges and negative attitudes from medical professionals. These issues reflect multiple intersecting forms of discrimination. OBJECTIVE: This study aims to examine how women with various disabilities in Lithuania access reproductive healthcare services, evaluate their experiences with these services, and explore the related attitudes of clinicians. METHODS: This cross-sectional study employs a mixed-methods convergent design. Quantitative and qualitative data were collected through an online survey (n = 154) and two focus groups with medical professionals (n = 12). Statistical and thematic analyses were performed using SPSS and MAXQDA. RESULTS: Over half of the women rated their reproductive healthcare experiences as average to very bad. Issues spanned preventive, general, pregnancy, labour, childbirth, and postpartum care. Participants with hearing, mobility, physical disabilities, and autism reported more issues, often citing inaccessible infrastructure, lack of Sign language interpretation, written consultations, or Easy-to-Read materials. Intellectual disabilities were also associated with reports of negative attitudes from medical professionals, highlighting widespread communication and support inadequacies. CONCLUSIONS: Improving reproductive healthcare for women with disabilities in Lithuania and globally requires educating medical professionals on the human rights-based model of disability and accessibility. Implementing individual accommodations in healthcare is essential and should involve medical staff, administrators, and policymakers. Ensuring access to sex education for women with disabilities and addressing societal stereotypes about their sexuality and motherhood are also vital. Further research with larger sample sizes is needed to evaluate and enhance the accessibility and quality of reproductive healthcare services for women with disabilities.
Environmental barriers to participation for people with spinal cord injury. The case of Ecuador.
Oña A, Pacheco Barzallo A, Toaquiza J … +1 more , Pacheco Barzallo D
Disabil Health J · 2026 Jan · PMID 40681457 · Publisher ↗
This study assesses the environmental barriers faced by people with spinal cord injury (SCI) in Ecuador. Using cross-sectional data from the International Spinal Cord Injury Survey (InSCI), we analyzed responses from 510...
This study assesses the environmental barriers faced by people with spinal cord injury (SCI) in Ecuador. Using cross-sectional data from the International Spinal Cord Injury Survey (InSCI), we analyzed responses from 510 participants across 23 provinces. We calculated the total environmental barrier index using the Nottwil Environmental Factor Inventory (NEFI) and applied regression analysis to identify key influencing factors. We also examined the severity of barriers by region, comparing rural and urban areas. Our findings reveal significant disparities. Individuals with lower incomes, those with tetraplegia, and those without a partner reported higher levels of environmental barriers. Rural residents were disproportionately affected. While both urban and rural participants cited long-distance travel and limited public access as top barriers, finances ranked higher in urban settings, whereas home access was more critical in rural areas. This is the first national study to map modifiable environmental barriers for people with SCI in Ecuador. The results point to clear spatial and economic inequalities, highlighting the need for targeted policies that improve public infrastructure to promote social inclusion.
Employment is associated with manual ability in adults with cerebral palsy - a population-based study.
Hedberg-Graff J, Rodby-Bousquet E, Lindgren A … +3 more , Manousaki E, Cloodt E, Pettersson K
Disabil Health J · 2026 Jan · PMID 40653400 · Publisher ↗
BACKGROUND: Employment rates are lower in adults with cerebral palsy (CP). Even though reduced manual ability is associated with limitations in daily activities, it is unclear whether employment rates are associated with...
BACKGROUND: Employment rates are lower in adults with cerebral palsy (CP). Even though reduced manual ability is associated with limitations in daily activities, it is unclear whether employment rates are associated with manual ability in adults with CP. OBJECTIVE: To analyze regular employment and employment rates (hours/week) in adults with CP and estimate their associations with manual ability relative to age and sex. METHODS: This was a cross-sectional study of adults with CP, aged 20-64 years, from the combined Swedish CP follow-up program and registry. Manual ability was classified as levels I-V using the Manual Ability Classification System (MACS). Logistic regression analysis was used. RESULTS: The study included 2304 adults with CP (1271 men; median age 28 years, interquartile range 20-64 years). Fewer than one in five (19 %) were employed, and about half (52 %) of these worked full time. The probability of employment in adults with MACS level II was almost half that of those with level I (OR 0.44; 95 % CI 0.34-0.57) and decreased with each MACS level to OR 0.01 (95 % CI 0.00-0.03) for MACS V. Limited manual ability was associated with a lower probability of working full time: ORs of 0.46 (95 % CI 0.30-0.72) for MACS II and 0.29 (95 % CI 0.16-0.56) for MACS III-V. CONCLUSION: Limited manual ability in adults with CP impacts both their likelihood of employment and employment rate. Greater manual ability is associated with a higher probability of regular employment and working full time.
Influences on bone mineral density among adults with mobility Limitations: Results from a national survey.
Haizelden J, Knol L, Turner L
Disabil Health J · 2026 Jan · PMID 40645811 · Publisher ↗
BACKGROUND: Risk factors for low bone mineral density (BMD) are widely recognized in the general population; however, influences on BMD in people with mobility limitations is not well understood. OBJECTIVE: To examine fa...
BACKGROUND: Risk factors for low bone mineral density (BMD) are widely recognized in the general population; however, influences on BMD in people with mobility limitations is not well understood. OBJECTIVE: To examine factors that influence BMD in US adults with mobility limitations, including demographic, anthropometric, and physical activity measures. METHODS: Cross-sectional analysis of NHANES 2013-2018 data, including 421 adults aged ≥20 years with self-reported walking difficulties. Risk factors for low bone mineral density were used including physical activity. Physical activity was assessed using the Global Physical Activity Questionnaire and recoded as meeting or not meeting the guidelines. Total BMD was measured with a dual-energy X-ray absorptiometry scan. Multiple linear regression was used to assess for differences in total BMD. RESULTS: BMD was significantly higher for males versus females (p < .001), Non-Hispanic blacks versus Non-Hispanic whites (p = .004), individuals who were overweight or obese compared to a people with healthy weights (p = .02, p < .001, respectively). As age increased, BMD decreased. No significant difference in BMD was found between participants meeting physical activity guidelines (1.084 ± 0.012 g/cm) and those who did not meet guidelines (1.076 ± 0.011 g/cm; p = .99). CONCLUSION: In adults with mobility limitations, traditional demographic and anthropometric risk factors significantly influenced BMD. Calcium intake, vitamin D intake and physical activity guideline adherence were not significant. These findings suggest the need for targeted research to more fully understand bone health determinants in this population.
Analyzing the relationship between ableist microaggressions and well-being in a cross-sectional sample of adults with varied disabilities.
Morean WM, Hayden A, Maccarrone A … +1 more , Bentley JA
Disabil Health J · 2026 Jan · PMID 40645810 · Publisher ↗
BACKGROUND: In prior research ableist microaggressions have correlated with higher measures of psychological distress. However, research has not yet examined the relationship between ableist microaggressions and well-bei...
BACKGROUND: In prior research ableist microaggressions have correlated with higher measures of psychological distress. However, research has not yet examined the relationship between ableist microaggressions and well-being as measured not merely by the absence of distressing mental health symptoms, but rather about effective functioning and flourishing. OBJECTIVE: The present study addressed this gap by analyzing the relationship between ableist microaggressions and well-being and assessing if different coping strategies moderate the relationship in a sample of adults with varied disabilities. METHODS: A cross-sectional survey was conducted with (n = 132) adults who self-identified as having a health condition that significantly impacts one or more major life activities. Participants were recruited online to complete a Qualtrics survey of measures of well-being, ableist microaggressions, coping, and depression symptoms. RESULTS: Ableist microaggression scores did not significantly predict well-being. Depression scores and disability visibility predicted well-being. In planned exploratory post-hoc analyses, those who endorsed having a more visible disabilities reported experiencing statistically significant more ableist microaggressions and statistically significant higher well-being scores than those endorsing less visible disabilities. CONCLUSIONS: Consistent with prior literature, depression scores predicted lower well-being. Participants with more visible disabilities reported experiencing more ableist microaggressions and also endorsed higher well-being. This research supports that depression and well-being are independent constructs. Further research needs to examine factors such as, positive disability identity, connection to the disability community, and disability pride, that might contribute to why those with more visible disabilities experience more ableist microaggression while also endorsing higher levels of well-being.
Intersecting disability and race implicit attitudes of health care professionals.
Friedman C
Disabil Health J · 2026 Jan · PMID 40634167 · Publisher ↗
BACKGROUND: Focusing on intersectionality is necessary not only to better understand how oppression impacts people, but also to reduce the harmful impacts of discrimination. While past research has separately found most...
BACKGROUND: Focusing on intersectionality is necessary not only to better understand how oppression impacts people, but also to reduce the harmful impacts of discrimination. While past research has separately found most health care professionals are implicitly (unconsciously) biased against disability, and implicitly biased against people of color, and some also self-report explicit (conscious) biases, to our knowledge, there is little to no research about health care professionals' intersectional attitudes. Yet, we do know that health care professionals' attitudes and biases impact the quality of care they provide and the outcomes of those they serve. Thus, it is critical to uncover more information about their explicit and implicit attitudes, especially intersectional attitudes. OBJECTIVE: The aim of this study was to examine the intersecting disability and race attitudes of health care professionals. METHODS: We had 784 health care professionals complete the Intersecting Disability and Race Attitudes Implicit Association Test (IDRA-IAT) and an explicit measure (January-March 2025). RESULTS: Health care professionals implicitly preferred nondisabled white people (M = 0.18) the most, then disabled white people (M = 0.08), and then disabled (M = -0.12) and nondisabled people of color (M = -0.14) the least. There was a significant gap between participants' explicit and implicit attitudes, with self-report explicit attitudes showing an opposite pattern as implicit attitudes, suggesting health care professionals may be unaware of the scope of their implicit biases. CONCLUSIONS: Everyone deserves high quality healthcare; until we reduce health care professionals' biases, health equity will not be possible.
Bayesian modeling of underreported disabilities: Gender insights from the Bangladesh national household survey.
Sakamoto M, Kakuta N
Disabil Health J · 2026 Jan · PMID 40634166 · Publisher ↗
BACKGROUND: According to the World Health Organization, about 16 % of the global population has a disability, with many residing in developing countries. The Washington Group (WG) on Disability Statistics recommends the...
BACKGROUND: According to the World Health Organization, about 16 % of the global population has a disability, with many residing in developing countries. The Washington Group (WG) on Disability Statistics recommends the WG Short Set on Functioning to foster consistent, internationally comparable measures. However, this data is subject to biases due to societal misunderstandings and misreporting, including false positives and, more commonly, false negatives, particularly in developing countries. OBJECTIVE: This paper examines discrepancies between reported and actual numbers of persons with disabilities and aims to advance methodological approaches and highlight the challenges faced by persons with disabilities in Bangladesh. METHODS: We employ a classification error modeling framework with a binary response variable and a Bayesian approach to estimate the true percentage of persons with disabilities and investigate associations with social variables. The 2016 Household Income and Expenditure Survey from Bangladesh serves as our case study. RESULTS: Bayesian analysis suggests a prevalence of 7.71 %-4.8 times higher than the raw estimates-with a notable false negative rate of 0.79 under the WG's initially recommended guidelines, which define persons with "at least a lot of difficulty" as disabled. The rate drops to 0.33 when "some difficulty" is also included. The findings underscore the detrimental effects of disability on educational attainment, earning capacity, and marital experiences, highlighting the need for targeted support, especially for male persons with disabilities up to the junior secondary level. CONCLUSIONS: This study emphasizes the importance of a deeper understanding of the complexities of disability data and the societal structures that influence its reporting to inform effective policy and support mechanisms.
Obesity prevalence in two national cohorts of children with disabilities: Patterns over time and by disability subgroups.
Cooc N, Bacon-Yates A, Gee KA
Disabil Health J · 2026 Jan · PMID 40619292 · Publisher ↗
BACKGROUND: Obesity in the United States disproportionately affects children with disabilities, yet little is known about how their obesity rates change over time or differ across disability subgroups. OBJECTIVE: This st...
BACKGROUND: Obesity in the United States disproportionately affects children with disabilities, yet little is known about how their obesity rates change over time or differ across disability subgroups. OBJECTIVE: This study examined changes in obesity rates in two nationally representative cohorts of children from kindergarten to grade five. Obesity rates were further disaggregated for four less examined disability subgroups: speech or language impairment (SLI), specific learning disability (SLD), intellectual disability (ID), and autism spectrum disorder (ASD). METHODS: Data from the Early Childhood Longitudinal Study-Kindergarten (ECLS-K: 1999 and ECLS-K: 2011) on two cohorts of children (approximately N = 9800 and N = 8500) were analyzed using logistic regression. RESULTS: In both cohorts, obesity among children with disabilities increased from kindergarten (16-18 %) to grade five (26-31 %), at which point their rates were nearly 4-7 percentage points higher than children without disabilities. Obesity rates and grade-level trends were similar by disability subgroups in both cohorts. CONCLUSIONS: Our results underscore the importance of tracking dietary, behavioral, and physical activity changes in children with disabilities that may increase or mitigate their risks of obesity. Targeted obesity prevention efforts should also extend to children in the less severe SLI and SLD categories.
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