Hye Jin Nam, Han Nah Park, Sujin Lee, Gyeonga Kang, Ji Hye Shin, Bohye Kim, Ju Young Yoon
{"title":"A systematic review of Photovoice studies on health-promoting behaviors among individuals with disabilities: Insights from the socio-ecological model.","authors":"Hye Jin Nam, Han Nah Park, Sujin Lee, Gyeonga Kang, Ji Hye Shin, Bohye Kim, Ju Young Yoon","doi":"10.1016/j.dhjo.2025.101972","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101972","url":null,"abstract":"<p><strong>Background: </strong>Photovoice enables participants to document their lived realities through photography, fostering self-expression and deeper reflection.</p><p><strong>Objective: </strong>Leveraging these strengths, this study aimed to systematically review Photovoice research involving people with disabilities to explore the lived experiences with health-promoting behaviors.</p><p><strong>Methods: </strong>A systematic literature review was conducted in July 2024 using multiple electronic databases, including PubMed, EMBASE, CINAHL, Cochrane, and Medline. The search process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Quality appraisal was performed using the Critical Appraisal Skills Program. Identified facilitators and barriers to health-promoting behaviors among individuals with disabilities were mapped onto the Socio-Ecological Model to provide a structured analysis.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria for this review. At individual level, nine facilitators and seven barriers were identified. The interpersonal level revealed three facilitators and two barriers, while the institutional level included two facilitators and one barrier. At the community level, four facilitators and four barriers were found. No relevant factors were identified at the policy level.</p><p><strong>Conclusion: </strong>This study expands the existing literature on participatory research by systematically reviewing Photovoice studies that examine health-promoting behaviors among people with disabilities. By offering a comprehensive analysis of facilitators and barriers, this review enhances the understanding of lived experiences and informs future interventions aimed at fostering inclusive and supportive environments for health promotion.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101972"},"PeriodicalIF":3.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The excess Medicare costs of long-term medical condition or disability: A longitudinal population-based study of Australian children.","authors":"Kabir Ahmad, Rasheda Khanam, Byron Keating, Syed Afroz Keramat, Rubayyat Hashmi, Enamul Kabir, Hendrik Jürges","doi":"10.1016/j.dhjo.2025.101971","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101971","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the longitudinal relationship between the prevalence of childhood medical conditions or disabilities (MCoD) lasting at least six months and associated excess healthcare costs to the public payer (Medicare).</p><p><strong>Objective: </strong>To determine the additional federally funded Medicare costs for children who have a long-term medical condition or disability and to investigate whether these costs rise due to the recurring presence of the conditions over time.</p><p><strong>Methods: </strong>This study utilised data from the nationally representative Longitudinal Study of Australian Children, comprising Birth (B) and Kindergarten (K) cohorts, involving 9,224 children. Based on Medicare data linkage, the analysis included 54,285 observations longitudinally. Generalised linear models with a log link and gamma distribution were employed to estimate the impact of childhood MCoD on Medicare costs over 14 years for the B cohort and 12 years for the K cohort. All models were adjusted for demographic, socioeconomic, and selected child medical characteristics.</p><p><strong>Results: </strong>On average, children with long-term MCoD incurred excess Medicare costs ranging from A$494 to A$784 biennially, in the different age groups of 0-1 to 16-17 years, compared to children without such conditions. Nationally, this translates to an estimated total additional Medicare expenditure of A$313.0 million for a cohort of children from age 0-1 year to 16-17 years.</p><p><strong>Conclusion: </strong>The findings highlight the significant excess public Medicare costs associated with childhood MCoD in Australia. These results will be beneficial for future cost-effectiveness analysis and for improving public health planning aimed at improving support for children with long-term medical conditions or disabilities.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101971"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shifting perspectives: Mental health and transition to adulthood in youth with cerebral palsy.","authors":"Maggie Sheridan, Jensine Clark","doi":"10.1016/j.dhjo.2025.101970","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101970","url":null,"abstract":"<p><p>Cerebral palsy (CP) is a lifelong condition that affects 1.5-3.4 per 1000 children worldwide. As they grow older, these children must transition from pediatric to adult healthcare services. This transition comes with stress and uncertainty for a population that is already at a higher risk of poor mental health. This paper discusses what is known about mental health in youth with CP and its impact on their transition within the medical system. It also uses a biopsycho-ecological framework to understand how transition impacts several domains of their life including family structure and social participation. Actionable guidance for medical providers and caregivers is given to promote a healthier transition process.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101970"},"PeriodicalIF":3.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Liu-Galvin, Frank A Orlando, Arch G Mainous
{"title":"Association of disability and inflammation: Potential risks to a vulnerable population.","authors":"Rachel Liu-Galvin, Frank A Orlando, Arch G Mainous","doi":"10.1016/j.dhjo.2025.101969","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101969","url":null,"abstract":"<p><strong>Background: </strong>Disabilities are prevalent and linked to a wide variety of functional limitations, while inflammation, a key factor in chronic disease development and progression, is not a screening or treatment target and is therefore very rarely detected. Understanding the association between disabilities and inflammation is essential to address potential risks in this vulnerable population.</p><p><strong>Objective: </strong>To determine whether individuals with disabilities are more likely to have elevated inflammation compared to those without.</p><p><strong>Methods: </strong>In this cross-sectional study of a nationally representative sample of U.S. adults in the 2021-2023 National Health and Nutrition Examination Survey, survey-weighted logistic regression examined the associations between disabilities and high-sensitivity C-Reactive Protein (hs-CRP) levels. Adjusted models controlled for age, sex, race/ethnicity, poverty, health insurance, hypertension, diabetes, coronary heart disease, stroke, rheumatoid arthritis, and smoking.</p><p><strong>Results: </strong>Individuals with disabilities had higher odds of hs-CRP >3 mg/L (adjusted OR: 1.46, 95 % CI: 1.21-1.76) and >10 mg/L (adjusted OR: 1.61, 95 % CI: 1.17-2.22) compared to those without disabilities. Physical disabilities were significantly associated with hs-CRP >3 mg/L (adjusted OR: 1.61, 95 % CI: 1.26-2.07) and >10 mg/L (adjusted OR: 1.94, 95 % CI: 1.47-2.55). Mental disabilities were associated with elevated hs-CRP in unadjusted but not adjusted models.</p><p><strong>Conclusions: </strong>Disabilities, particularly physical disabilities, are associated with elevated inflammation, which may reflect underlying biological processes, reduced mobility, or cumulative health burden. The increased burden of systemic inflammation among individuals with disabilities supports consideration of hs-CRP as a potential marker for identifying elevated health risk in this population.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101969"},"PeriodicalIF":3.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hugo Bessaguet, Charlotte Coeurdacier De Gesnes, Diana Rimaud, Bruno Fernandez, Pierre Flori, Philippe Berthelot, Marilyne Peyroche, Yann Boulon, Ahmed Adham, Pascal Giraux, Vincent Gautheron, Rodolphe Charles, Etienne Ojardias
{"title":"Does a one-week disability awareness training influence medical students attitudes? A French mixed-methods study.","authors":"Hugo Bessaguet, Charlotte Coeurdacier De Gesnes, Diana Rimaud, Bruno Fernandez, Pierre Flori, Philippe Berthelot, Marilyne Peyroche, Yann Boulon, Ahmed Adham, Pascal Giraux, Vincent Gautheron, Rodolphe Charles, Etienne Ojardias","doi":"10.1016/j.dhjo.2025.101968","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101968","url":null,"abstract":"<p><strong>Background: </strong>Disability is experienced by approximately 1.3 billion individuals worldwide. Therefore, people with disabilities (PWD) are part of every physician's patient base, regardless of specialty. Specific educational programs are needed, as medical students and physicians still report discomfort in taking histories, performing clinical examinations and making differential diagnoses when dealing with PWD.</p><p><strong>Objective: </strong>We hypothesized that participation in a one-week disability awareness training, including theoretical sessions, practical workshops with PWD, and 3-day immersive training courses, would significantly improve the quantitative and qualitative outcomes of medical students toward PWD.</p><p><strong>Methods: </strong>We conducted a monocentric prospective mixed-methods study targeting 3rd year medical students, using quantitative measurements through repeated synchronous surveys, evaluating disability attitudes in health care (DAHC) scores and performed qualitative explorations through individual semidirected interviews, evaluating students' feelings and attitudes toward PWD.</p><p><strong>Results: </strong>A total of 218 students (mean age: 21.1 ± 1.4 years) were included in the study. While 60 % of the participants reported no prior working experience with PWD, there was a significant improvement in paired-DAHC scores 3 months after the training (+1.32, p = 0.003). Improvements were predominantly observed in comfort levels during interaction and in discriminatory attitudes. This practical experience was positively reported in the semidirected interviews, in which a facilitated transition from unfamiliarity to informed empathy and knowledge was reported.</p><p><strong>Conclusions: </strong>The implementation of disability awareness trainings in compulsory medical curricula should be prioritized to improve future physician's skills and attitudes when caring for PWD.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101968"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth L Zeilinger, Theresa Wagner, Amelie Fuchs, Manon Schroeder, Nadine Brunevskaya, Jakob Pietschnig, Pavol Mikula, Matthias Unseld
{"title":"Healthcare disparities in colorectal cancer prevention for people with intellectual and developmental disabilities: A caregiver perspective.","authors":"Elisabeth L Zeilinger, Theresa Wagner, Amelie Fuchs, Manon Schroeder, Nadine Brunevskaya, Jakob Pietschnig, Pavol Mikula, Matthias Unseld","doi":"10.1016/j.dhjo.2025.101967","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101967","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) screening is crucial for early detection, but people with intellectual and developmental disabilities (IDD) face significant healthcare disparities, including lower screening rates.</p><p><strong>Objective: </strong>This study explores barriers and facilitators to CRC screening for individuals with IDD from the caregiver perspective.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 13 caregivers (eight women, mean age 45) of individuals with IDD in Austria and analyzed using thematic analysis. A modified version of the Bowel Cancer Awareness Measure (CAM) questionnaire was used to assess CRC-related healthcare literacy of the caregivers.</p><p><strong>Results: </strong>The modified CAM revealed low CRC knowledge among caregivers, with gaps in symptom and risk factor recognition and low self-reported confidence in symptom detection. Four themes emerged from the interviews: (1) Improving access to inclusive healthcare, highlighting systemic healthcare challenges, inclusive environments, clinician expertise, and health education; (2) Managing IDD-specific challenges, including communication difficulties, reliance on routines, and comorbidities; (3) The critical role of caregiver support, focusing on the empowerment of people with IDD; and (4) Challenging stigma and bridging social gaps, addressing stereotypes and social segregation of people with IDD.</p><p><strong>Conclusions: </strong>This study serves as a case study, illustrating how the exclusion of people with IDD from the design of preventive healthcare perpetuates inequities in CRC screening, and emphasizing the need for more inclusive systems and practices. Addressing these shortcomings requires improved knowledge and educational resources, disability-sensitive training for professionals, accessible healthcare environments and systemic efforts to promote autonomy and reduce stigma.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101967"},"PeriodicalIF":3.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kirstin E Yuzwa, Farah Bacchus-Misir, Siobhan Galeazzi-Stirling, Eva Cohen, Peter Athanasopoulos, Sander L Hitzig, Christine L Sheppard
{"title":"Social and attitudinal barriers to the provision of accessible housing in Canada: A qualitative study.","authors":"Kirstin E Yuzwa, Farah Bacchus-Misir, Siobhan Galeazzi-Stirling, Eva Cohen, Peter Athanasopoulos, Sander L Hitzig, Christine L Sheppard","doi":"10.1016/j.dhjo.2025.101966","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101966","url":null,"abstract":"<p><strong>Background: </strong>Housing is a critical social determinant of health and for individuals with accessibility needs, having a roof over one's head is not enough. For people requiring accessibility features to enter and exit their home, use the bathroom, or prepare meals, the absence of these features can limit social participation, increase reliance on caregivers, and negatively impact health, dignity, and safety.</p><p><strong>Objective: </strong>This article presents a qualitative study with members from diverse key interest groups across the housing, disability, healthcare, and policy sectors to identify social and attitudinal barriers limiting accessible housing and home modifications options in Canada.</p><p><strong>Methods: </strong>Semi-structured interviews and a demographic survey were conducted with 59 people. Participants included people with lived experience of disabilities and other end-users of accssible housing (i.e., family caregivers and people from the Deaf community), as well as cross-sectoral professionals with expertise in accessible housing. Inductive codebook thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>Four prevailing themes were identified from the data, including a lack of prioritization by policy makers and housing developers, cost-benefit appraisals of including accessibility features, discriminatory attitudes towards the aesthetics of accessibility and towards end-users, and underestimating of the need for preventative accessibility.</p><p><strong>Conclusions: </strong>Attitudinal barriers are contributing to a lack of prioritization of accessibility in housing in Canada. To create a more inclusive housing landscape and improve public health, investments in accessible housing, policy advancement, and new regulatory measures are recommended.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101966"},"PeriodicalIF":3.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension prevalence and coverage and intellectual disability: a systematic review and meta-analysis.","authors":"Rodrigo Vargas-Fernández, Akram Hernández-Vásquez, Hannah Kuper","doi":"10.1016/j.dhjo.2025.101965","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101965","url":null,"abstract":"<p><strong>Background: </strong>People with intellectual disabilities (ID) frequently experience poorer health and lower treatment coverage compared to those without ID, yet differences in hypertension prevalence and treatment coverage remain unclear.</p><p><strong>Objective: </strong>To estimate the pooled prevalence ratio (PR) of hypertension and hypertension treatment coverage comparing adults with and without ID.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, PsychINFO, Global Health and Global Index Medicus on June 6, 2024. We included observational and intervention studies that estimated the prevalence of hypertension and/or treatment coverage. The risk of bias was assessed using the Newcastle-Ottawa Scale tool. We undertook a random-effects meta-analysis to estimate the pooled PR with 95 % confidence intervals (CI). Sources of heterogeneity were explored through sensitivity and subgroup analyses, and meta-regression.</p><p><strong>Results: </strong>21 studies from 10 countries across three regions were included. The pooled PR were 0.71 (95 % CI: 0.47-1.05) for hypertension and 0.61 (95 % CI: 0.47-0.81) for hypertension treatment coverage. Only one study adjusted for age; most reported unadjusted estimates, making them prone to confounding. 14 studies were rated as high risk of bias. Subgroup analysis and meta-regression revealed variability in the methods used to diagnose ID, with sample size emerging as the primary source of variability in the effect estimates.</p><p><strong>Conclusions: </strong>This systematic review showed that adults with ID have a similar prevalence of hypertension, but lower hypertension treatment coverage compared to those without disabilities. However, these results should be interpreted with caution due to the lack of adjustment for confounding in the association and variability in the diagnosis of ID.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101965"},"PeriodicalIF":3.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors associated with uncertainty in parents of children with developmental disabilities: A scoping review.","authors":"Heejung Choi, GyeongAe Seomun, Jeongeun Song","doi":"10.1016/j.dhjo.2025.101962","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101962","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101962"},"PeriodicalIF":3.3,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Theiss, Bradley Carpenter, Jill Hanass-Hancock, Sureshkumar Kamalakannan, Rachel J Kulchar, G V S Murthy, Monica Pinilla-Roncancio, Minerva Rivas Velarde, Shailaja Tetali, Sophie Mitra
{"title":"Is disability prevalence higher in rural areas? Evidence from functional difficulty and nightlight data in 15 low- and middle-income countries.","authors":"Katherine Theiss, Bradley Carpenter, Jill Hanass-Hancock, Sureshkumar Kamalakannan, Rachel J Kulchar, G V S Murthy, Monica Pinilla-Roncancio, Minerva Rivas Velarde, Shailaja Tetali, Sophie Mitra","doi":"10.1016/j.dhjo.2025.101964","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101964","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101964"},"PeriodicalIF":3.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}