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}
{"title":"Author Information","authors":"","doi":"10.1016/S1936-6574(25)00172-4","DOIUrl":"10.1016/S1936-6574(25)00172-4","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101943"},"PeriodicalIF":3.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934066","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}
Nathaniel Scherer, Ketmany Chanthakoummane, Anousin Homsana, Mark T Carew, Latsamy Siengsounthone, Hannah Kuper, Bounhome Soukkhaphone, Lena Morgon Banks
{"title":"Prevalence, predictors and consequences of reported discrimination against children with disabilities in Lao PDR: a cross-sectional analysis in Xiengkhouang Province.","authors":"Nathaniel Scherer, Ketmany Chanthakoummane, Anousin Homsana, Mark T Carew, Latsamy Siengsounthone, Hannah Kuper, Bounhome Soukkhaphone, Lena Morgon Banks","doi":"10.1016/j.dhjo.2025.101963","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101963","url":null,"abstract":"<p><strong>Background: </strong>Children with disabilities are at increased risk of discrimination, contributing to exclusion from services and community life.</p><p><strong>Objective: </strong>This study investigates the prevalence, predictors and consequences of reported discrimination against children with disabilities in Lao People's Democratic Republic (Lao PDR).</p><p><strong>Methods: </strong>Data were collected in the baseline assessment for a non-randomised controlled trial of a cash-plus programme for children with disabilities in Xiengkhouang Province, Lao PDR. Assessment was conducted May to October 2023. Data on reported discrimination was collected using a tool based on a validated measure. Experience of discrimination in the past 30 days was classified into \"any\" and \"frequent\". Children aged ≥8 years reported directly on their experiences of discrimination. Caregivers provided proxy response for children <8 years or for children ≥8 years who had severe difficulties communicating.</p><p><strong>Results: </strong>405 children with disabilities aged ≤18 years were recruited. Prevalence of any reported discrimination in the past 30 days was 72.3%, and of frequent discrimination 28.4%. Reported discrimination was more common against children with cognitive disabilities (aRR: 1.55, 95% CI: 1.03-2.33), Hmong/Lu Mien children (aRR: 1.25, 95% CI: 1.10-1.41), and children without friends (aRR: 1.61, 95% CI: 1.16-2.23). Children experiencing frequent discrimination were substantially more likely to avoid others (aRR: 5.19, 95% CI: 3.48-7.74) and worry about how others act towards them (aRR: 4.05, 95% CI: 2.79-5.88).</p><p><strong>Conclusions: </strong>Children with disabilities in Lao PDR experience high levels of discrimination. Action is needed to reduce disability-related stigma and discrimination in line with the United Nations Convention on the Rights of Persons with Disabilities.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101963"},"PeriodicalIF":3.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092793","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":"Direct support professional perspectives on the value of virtual healthcare for adults with intellectual and developmental disabilities: Trends over four years.","authors":"Avra Selick, Sarah Ludmilla Bernier, Nicole Bobbette, Katharine Cardiff, Yona Lunsky","doi":"10.1016/j.dhjo.2025.101961","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101961","url":null,"abstract":"<p><strong>Background: </strong>Direct support professionals (DSPs) often play a critical role in supporting healthcare interactions for people with intellectual and developmental disabilities (IDD) but little is known about their experience supporting virtual healthcare.</p><p><strong>Objective: </strong>This study explored utilization of virtual care and DSP experiences of supporting virtual care at four time points in Ontario, Canada.</p><p><strong>Methods: </strong>DSPs in Ontario were invited to participate in an online survey in 2020 (n = 867), 2021 (n = 428), 2022 (n = 698) and 2023 (n = 603). This study focuses on the subset of questions related to DSP experience supporting virtual healthcare. Descriptive statistics were used to summarize quantitative data and content analysis was used to analyze open text responses.</p><p><strong>Results: </strong>Over the four surveys, reported utilization of phone-based care was consistently higher (53-60 %) than video-based care (20-30 %). DSPs were more likely to provide positive feedback for video-based care compared with phone-based care, however, there was a decline in positive feedback for both over the four surveys. Though video-based care in particular was identified as valuable for patients who struggle to attend in-person appointments, ongoing challenges were reported including technical issues and poor communication quality.</p><p><strong>Conclusions: </strong>Without the overwhelming concern of COVID transmission, for many patients, the benefits of virtual care may not outweigh the ongoing challenges. However, there appears to be a subset of people for whom virtual care can be critically important to support accessible care. DSPs require more training and resources to effectively support virtual healthcare visits.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101961"},"PeriodicalIF":3.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862549","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 limited role of sex education and contraception use in unintended pregnancy by disability status among young adults.","authors":"Darcy L Sullivan","doi":"10.1016/j.dhjo.2025.101960","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101960","url":null,"abstract":"<p><strong>Background: </strong>By examining young adult women with disabilities'(WWD) experiences with pregnancy, scholars have concluded that WWD are more likely to experience unintentional pregnancies compared to women without disabilities. Yet, the reasons for this increase in unintended pregnancy observed among WWD remains unclear. While WWD lack access to sexual health education and reproductive health care, they continue to engage in sexual behaviors and experience pregnancy at similar rates compared to able-bodied women.</p><p><strong>Objective: </strong>This study investigates if sexual health education and contraception use mediate the relationship between disability status and unintended pregnancy for women aged 15-24.</p><p><strong>Methods: </strong>Data come from 2011 to 2019 National Survey of Family Growth and include a sample of 6988 women. The sample is examined descriptively using chi-square tests and t-tests. Mediated path analysis within a structural equation modeling (SEM) framework is used to analyze the relationship between sexual health education, contraception use, disability status, and unintended pregnancy.</p><p><strong>Results: </strong>WWD were more likely to experience unintended pregnancy, less likely to receive sexual health education, and use less effective forms of contraception. No mediation effect of sexual health education or contraception use on the relationship between disability status and unintended pregnancy was found for this age group.</p><p><strong>Conclusion: </strong>Sexual health education and contraception use did not mediate the relationship between disability status and unintended pregnancy for young adult women with disabilities. More research is needed to adequately explore the mechanisms leading to increased unintended pregnancy among WWD, particularly across additional age groups.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101960"},"PeriodicalIF":3.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859848","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":"Differences in substance use treatment receipt, perceived treatment need, and barriers to receiving treatment among US adults with and without disabilities, 2022-2023.","authors":"Roberto Abadie, Manuel Cano","doi":"10.1016/j.dhjo.2025.101934","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101934","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities (PWD) are at higher risk of experiencing substance use (SU) disorders than those without a disability. While treatment for SU reduces mortality and morbidity, currently there are no national-level studies comparing US adults with and without disabilities in terms of SU treatment receipt, perceived need, and barriers.</p><p><strong>Objective: </strong>To examine differences between US adults with and without disabilities in terms of SU treatment receipt, perceived need for treatment, and barriers to receiving treatment.</p><p><strong>Methods: </strong>This cross-sectional study examined National Survey on Drug Use and Health (NSDUH) 2022-2023 data (n = 89,167 adults) on self-reported disability and past-year substance use disorder (SUD), SU treatment, unmet treatment need, and treatment barriers. Analyses included weighted prevalence estimates, chi-squared tests (corrected for the survey design), and binomial logistic regression.</p><p><strong>Results: </strong>An estimated 10.0 % of adults with a disability, versus 3.9 % without a disability, reported receiving past-year SU treatment. For adults with a past-year SUD who did not receive treatment, reporting a disability was associated with 70 % higher odds (Adjusted Odds Ratio [AOR] 1.70; 95 % Confidence Interval [CI], 1.27-2.28) of \"unmet need\" for SU treatment (after adjusting for demographics). Among adults who reported an \"unmet need\" for SU treatment, barriers related to cost and stigma were reported more frequently in those with, compared to those without, a disability.</p><p><strong>Conclusions: </strong>Findings highlight elevated SU treatment need and barriers for PWD. Understanding the intersection of disability with the cascade of care, from screening to diagnosis and treatment of SU, is critical in improving health outcomes.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101934"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795918","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}
Amr Abdelwahed, Xindong Zhao, Daad Fouad, Ebrahim Amer, Maha Abo Gendia
{"title":"Intersecting Inequalities: Non-Partner violence against poor women with disabilities in Egypt.","authors":"Amr Abdelwahed, Xindong Zhao, Daad Fouad, Ebrahim Amer, Maha Abo Gendia","doi":"10.1016/j.dhjo.2025.101935","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101935","url":null,"abstract":"<p><strong>Background: </strong>Non-partner violence (NPV) against women with disabilities remains underexamined, particularly in resource-limited settings like Egypt. Intersecting vulnerabilities-gender, disability, and poverty-amplify risks. Structural inequalities and social marginalization further heighten violence, limit access to support systems, and exacerbate the vulnerabilities of women with disabilities, creating significant gaps in intervention and support.</p><p><strong>Objective: </strong>This study investigates the prevalence and determinants of NPV among poor women with disabilities in Egypt, with a focus on how sociodemographic and disability-related factors shape risk.</p><p><strong>Methods: </strong>Using data from the 2020 Violence Against Women With Disability Survey, this cross-sectional study analyzes 5616 women with physical, hearing, visual, or multiple disabilities. Descriptive statistics and logistic regression models were employed to examine lifetime and past-year experiences of NPV and associated characteristics.</p><p><strong>Results: </strong>Nearly half (47.8 %) of women reported experiencing NPV since age 15, and 25.3 % experienced it in the past year. Higher risk was observed among younger women, unmarried, those living in Upper Egypt, those with early-onset or multiple disabilities, and those with lower educational attainment. Notably, employed women faced increased odds of NPV, possibly reflecting exposure in public or workplace settings.</p><p><strong>Conclusions: </strong>The findings emphasize the urgent need for disability-sensitive interventions that address structural inequality, stigma, and social exclusion. Interventions should prioritize inclusive legal protections, caregiver oversight, and access to accessible services, especially in underserved and rural regions. Targeted policies are essential to ensure safety, dignity, and justice for women with disabilities in Egypt.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101935"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849384","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":"Editorial transition at DHJO","authors":"Monika Mitra (DHJO Co-Editor-in-Chief)","doi":"10.1016/j.dhjo.2025.101936","DOIUrl":"10.1016/j.dhjo.2025.101936","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101936"},"PeriodicalIF":3.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812550","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}
Megan Morris, Steve Lockhart, Kori Eberle, Jennifer Oshita
{"title":"Incentivizing, enforcing and improving disability accessible health care: Current gaps and potential solutions.","authors":"Megan Morris, Steve Lockhart, Kori Eberle, Jennifer Oshita","doi":"10.1016/j.dhjo.2025.101933","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101933","url":null,"abstract":"<p><strong>Background: </strong>Despite federal requirements for health care organizations (HCOs) to provide accessible care to patients with disability, care often remains inaccessible.</p><p><strong>Objective: </strong>To explore stakeholders' perspectives of the effectiveness of federal requirements and factors motivating HCOs to provide accessible care to patients with disability.</p><p><strong>Methods: </strong>We conducted 55 interviews with key informants (e.g., Disability Coordinators, researchers, policymakers, professional organizations, advocates) between May 2019 and August 2020. All interviews were conducted by qualitatively trained researchers and analyzed using content analysis methodology.</p><p><strong>Results: </strong>We identified 3 themes: 1) existing laws are necessary, but not sufficient; 2) education is needed for health care organizations on disability as an equity issue; 3) health care is motivated by cost, quality and competition.Interview participants reported legal mandates as a major mechanism incentivizing healthcare organizations to invest in accessible care for patients with disability. These mandates, enforced through patient lawsuits and complaints, have been ineffective in driving systemic change.Additionally, organizational leaders lack knowledge on their legal obligations to provide equitable access to healthcare and the needs of patients with disability. Participants identified a need for research demonstrating that accessible care improves outcomes and costs. Finally, participants expressed a desire for methods to facilitate competition amongst healthcare organizations to encourage provision of accessible care.</p><p><strong>Conclusion: </strong>Federal requirements are necessary but insufficient in ensuring accessibility. Alternative solutions are needed which educate leadership and align with cost, quality and competition incentives. Diversifying the levers which incentivize accessible care could drive meaningful change in equitable healthcare for patients with disability.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101933"},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765729","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":"Unequal impact of housing, food, and healthcare hardships on depression among persons with disabilities: A quantile regression approach.","authors":"Gum-Ryeong Park, Mihi Parikh, Jiya Patel","doi":"10.1016/j.dhjo.2025.101932","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101932","url":null,"abstract":"<p><strong>Background: </strong>While material hardships have been widely studied, less is known about whether baseline psychological health mitigates these hardships-or how its role varies by type of essential good or service (e.g., housing, food, healthcare) among persons with disabilities.</p><p><strong>Objective: </strong>This study examines how different types of material hardship-specifically housing, food, and healthcare hardships-affect psychological health across different points in the depressive symptom distribution among people with disabilities.</p><p><strong>Methods: </strong>This study used data from the Disability and Life Dynamic Panel (DLDP) survey (2018-2020). Individual level fixed effects models were conducted to estimate within-individual differences in depressive symptoms in relation to housing, food, and healthcare hardships. Quantile regression was used to examine how the effects of material hardships vary across the distribution of depressive symptoms, allowing us to assess whether individuals with relatively better or worse psychological health are differently impacted.</p><p><strong>Results: </strong>Individuals with mental disabilities and those categorized with brain lesion disorders reported higher levels of depressive symptoms and greater difficulties related to housing, food, and healthcare. Quantile regression results indicate that the association between these material hardships and depressive symptoms is more pronounced among individuals with higher baseline levels of depression.</p><p><strong>Conclusions: </strong>This study highlights the impact of material hardship on depression in individuals with disabilities, emphasizing the need for policies and support systems that address both material and psychological health needs.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101932"},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718964","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}