Examining inequalities in people with spinal cord injury through functioning

Area of Science:

• Health outcomes research
• Socioeconomic determinants of health
• Rehabilitation science

Background:

• Socioeconomic status significantly impacts health, but its effect on spinal cord injury (SCI) functioning remains under-researched.
• Understanding income's role is crucial for addressing health disparities in the SCI population.

Purpose of the Study:

• To investigate the association between income levels and overall functioning in individuals with traumatic spinal cord injury (SCI).
• To quantify income-related health disparities in functioning across different countries.

Main Methods:

• Cross-sectional analysis of data from the International Spinal Cord Injury Survey (InSCI) (2017-2019) across ten countries.
• Functioning assessed using the International Classification of Functioning, Disability and Health (ICF) core set for SCI.
• Income categorized by general population income deciles for international comparison.

Main Results:

• Individuals with lower incomes reported significantly poorer functioning compared to higher-income groups.
• Functioning score disparities between the highest and lowest income groups varied by country, ranging from 2 to 11 points.
• Age at injury onset exacerbated disparities, particularly in working-age and older adult populations.

Conclusions:

• Persistent income-related health disparities exist for individuals with SCI, with lower income correlating to reduced functioning.
• Interventions for SCI must consider and address economic and age-related factors to mitigate these disparities.
• Findings underscore the need for context-specific strategies to improve health outcomes for diverse SCI populations worldwide.