title: Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults.
abstract: OBJECTIVE
  There is a need for empirical support of the association between the built environment and disability-related outcomes. This study explores the associations between community and neighborhood land uses and community participation among adults with acquired physical disability.
  
  
  METHODS
  Cross-sectional data from 508 community-living chronically disabled adults in New Jersey were obtained from among participants in national Spinal Cord Injury Model Systems database. Participants' residential addresses were geocoded to link individual survey data with Geographic Information Systems data on land use and destinations. The influence of residential density, land use mix, destination counts, and open space on four domains of participation were modeled at two geographic scales-the neighborhood (i.e., half mile buffer) and community (i.e., five mile) using multivariate logistic regression. All analyses were adjusted for demographic- and impairment-related differences.
  
  
  RESULTS
  Living in communities with greater land use mix and more destinations was associated with a decreased likelihood of reporting optimum social and physical activity. Conversely, living in neighborhoods with large portions of open space was positively associated with the likelihood of reporting full physical, occupational, and social participation.
  
  
  CONCLUSIONS
  These findings suggest that the overall living conditions of the built environment may be relevant to social inclusion for persons with physical disabilities.
authors.affiliation: Outcomes and Assessment Department, Kessler Foundation Research Center, West Orange, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark. Electronic address: abotticello@kesslerfoundation.org.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Botticello
authors.affiliation: Department of Science and Engineering, Raritan Valley Community College, Branchburg, NJ.
authors.forename: Tanya
authors.initials: T
authors.lastname: Rohrbach
authors.affiliation: Outcomes and Assessment Department, Kessler Foundation Research Center, West Orange, NJ.
authors.forename: Nicolette
authors.initials: N
authors.lastname: Cobbold
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004777:Environment; D004779:Environment Design; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D012111:Residence Characteristics; D058992:Social Participation; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation
keywords: Disability; GIS; Neighborhood/place; Participation