title: Understanding disability and the 'social determinants of health': how does disability affect peoples' social determinants of health?
abstract: OBJECTIVE
  The purpose of this study was to investigate how an individual's social determinants of health are affected by the acquisition of physical disability in adulthood. The secondary aim was to report the described facilitators and barriers to living with a disability.
  
  
  METHODS
  This qualitative study used an exploratory, descriptive approach. Nine individuals with a neurologically derived disability were purposively recruited from a rehabilitation center in northern Queensland. Participation in the study involved semi-structured interviews. QSR NVivo was used for the data analysis process.
  
  
  RESULTS
  Changes to social determinants of health resulting from the acquisition of disability had substantial flow-on consequences in all aspects of life for the individual and those close to them. Income had the greatest influence over the other social determinant of health. Following the acquisition of disability, the reduced inflow and increased outflow of finances had subsequent negative effects on housing, transport and social interactions, and also personal relationships.
  
  
  CONCLUSIONS
  When considering changes to the social determinants of health resulting from disability acquisition, it is impractical to view these changes and those affected in isolation. Consideration of this multidimensional effect on life associated with the acquisition of disability will be useful in disability research, advocacy and support services. Implications for Rehabilitation Social determinants of health are known to have a direct influence on health status. As social determinants of health decrease, morbidity and mortality rates increase. Following the acquisition of disability, there is a decline in social determinants of health. This decline affects quality of life for individuals' with a disability, and those closest to them. The effects of declining social determinants of health may inhibit the rehabilitation process. Thus, it is important to acknowledge the multifaceted impact the acquisition of disability has on peoples' lives, and the consequences this may have for their rehabilitation.
authors.affiliation: a College of Public Health, Medical and Veterinary Sciences , James Cook University , Townsville , Australia.
authors.forename: Amanda
authors.identifier: http://orcid.org/0000-0003-3006-442X
authors.initials: A
authors.lastname: Frier
authors.affiliation: b College of Healthcare Sciences , James Cook University , Townsville , Australia.
authors.forename: Fiona
authors.identifier: http://orcid.org/0000-0002-7927-6098
authors.initials: F
authors.lastname: Barnett
authors.affiliation: a College of Public Health, Medical and Veterinary Sciences , James Cook University , Townsville , Australia.
authors.forename: Sue
authors.identifier: http://orcid.org/0000-0001-6687-6003
authors.initials: S
authors.lastname: Devine
authors.affiliation: c College of Healthcare Sciences , James Cook University , Cairns , Australia.
authors.forename: Ruth
authors.identifier: http://orcid.org/0000-0002-2546-2581
authors.initials: R
authors.lastname: Barker
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D006233:Persons with Disabilities; D004651:Employment; D005260:Female; D006798:Housing; D006801:Humans; D007182:Income; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D064890:Social Determinants of Health; D012944:Social Support; D014186:Transportation
keywords: Social circumstances; acquisition of disability; neurological conditions; research; societal conditions; socio-economic factors