Disability, environmental factors and non-fatal injury.
BACKGROUND
People with disabilities have high rates of non-fatal injury; they are also likely to experience environmental factors as barriers to functioning and participation in society. The reasons for the higher injury rates among those with disabilities have not been explained.


OBJECTIVE
To determine if problems with environmental factors influence the higher rates of injury among disabled compared with non-disabled.


METHODS
Data from a population-based, random-digit dial cross-sectional telephone survey were analysed to evaluate whether environmental factors as measured by the Craig Hospital Inventory of Environmental Factors explained higher injury rates among those with disabilities compared with those without. A total of 2511 Colorado adults (1997 with no disability, 386 with moderate disability, and 128 with severe disability) were included in the sample. All rated their experience of environmental factors and reported injuries within the previous 12 months. Logistic regression analyses were conducted to evaluate whether environmental factors could be confounding factors in the association between disability and non-fatal injury.


RESULTS
Disability and environmental barriers were independently associated with higher rates of injury. Environmental factors did attenuate the increased odds of experiencing an injury among those with severe disabilities, but these people continued to have significantly higher rates of injury after adjustment for environmental factors. The natural environment, social attitudes and policies were ranked highly as problems by all injured persons.


CONCLUSIONS
Injury prevention efforts need to focus on reducing disability-related injuries and reducing environmental barriers for all.
Leff
Marilyn
M
Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado, USA. marilyn.leff@colostate.edu
Stallones
Lorann
L
Xiang
Huiyun
H
Whiteneck
Gale
G
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D003120:Colorado / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult