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Final Program


Final Program

327 - Social Determinants of Health and Environmental Barriers for Young Adults with Disabilities

Thursday, February 27, 2025
5:00 PM - 6:30 PM MST
Objectives: Young adults with pediatric-onset disabilities often experience physical, social, and political barriers to social participation. We aimed to examine the associations of sociodemographic factors with self-reported environmental barriers in a sample of young adults with a history of acquired brain injury (ABI), neuromuscular disorders (NMD), and spina bifida (SB). We hypothesized that participants with historically marginalized identities would report more environmental barriers. 

Design: This was a cross-sectional study of patients followed by outpatient specialty rehabilitation medicine clinics at a children’s hospital in the western United States. Inclusion criteria included being 18-30 years of age and fluent in English or Spanish. Fifty-five participants completed the study (ABI=17, SB =10, NMD=28). Using generalized linear regression, independent variables were age, self-identified gender, race, ethnicity, condition, mobility status, and national area deprivation index (ADI). The total score on the Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-S), which quantifies physical, social, and political environmental barriers to participation in daily activities, was considered as the dependent variable. 

Results: With the CHIEF-S total score as the dependent variable, there were two significant interaction effects. The first was an interaction of condition and mobility status (β = 1.62, p = < .001). For those with NMD, use of a manual or power wheelchair was associated with higher CHIEF-S scores. Within the ABI and SB groups, not using mobility devices was associated with higher CHIEF-S scores. There was also an interaction of ADI and mobility status (β = 1.04, p = < .001), where more environmental barriers were reported among those who used power wheelchairs and experienced high neighborhood disadvantage. For those with lower neighborhood disadvantage, CHIEF-S scores did not differ based on mobility status. 

Conclusions: Environmental barriers during the transition to adulthood are influenced by sociodemographic and individual factors that should drive community-based supports for young adults with disabilities.