Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Measures
2.2.1. Outcomes
2.2.2. Predictors
Individual Characteristics
Country-Level Characteristics
2.3. Statistical Analysis
3. Results
3.1. Partnership Status
3.2. Living Situation
4. Discussion
Strength and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Savage, A.; McConnel, D. The marital status of disabled women in Canada: A population-based analysis. Scand. J. Disabil. Res. 2016, 18, 295–303. [Google Scholar] [CrossRef] [Green Version]
- Crawford, D.; Ostrove, J.M. Representations of disability and the interpersonal relationships of women with disabilities. Women Ther. 2003, 26, 179–194. [Google Scholar]
- O’Toole, C. Sex, disability and motherhood: Access to sexuality for disables mothers. Disabil. Stud. Quart. 2002, 22, 81–101. [Google Scholar]
- Gerschick, T.J. The body, disability, and sexuality. In Handbook of the New Sexuality Studies; Seidman, S., Fischer, N., Meeks, C., Eds.; Routledge: New York, NY, USA, 2006; pp. 271–279. [Google Scholar]
- Nosek, M.A.; Howland, C.; Rintala, D.H.; Young, M.E.; Chanpong, G.F. National study of women with physical disabilities: Final report. Sex Disabil. 2001, 19, 5–40. [Google Scholar]
- Tumin, D. Marriage trends among Americans with childhood-onset disabilities, 1997–2013. Disabil. Health J. 2016, 9, 713–718. [Google Scholar] [PubMed]
- Liu, H.; Zhang, Z. Disability trends by marital status among older Americans: 1997–2010: An examination by gender and race. Popul. Res. Policy Rev. 2013, 32, 103–127. [Google Scholar]
- Clarke, H.; McKay, S. Disability, partnership and parenting. Disabil. Soc. 2014, 29, 543–555. [Google Scholar]
- Sandström, G.; Namatovu, F.; Ineland, J.; Larsson, D.; Ng, N.; Stattin, M. The persistence of high levels of living alone among adults with disabilities in Sweden, 1993–2011. Popul. Res. Policy. Rev. 2020. [Google Scholar] [CrossRef] [Green Version]
- MacInnes, M.D. Alter-bound? The effect of disability on the hazard of entry into first marriage. Int. J. Sociol. 2011, 41, 87–103. [Google Scholar]
- Singleton, P. Insult to injury: Disability, earnings, and divorce. J. Hum. Res. 2012, 47, 972–990. [Google Scholar]
- Kreuter, M. Spinal cord injury and partner relationships. Spinal Cord 2000, 38, 2–6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- DeVivo, M.J.; Hawkins, L.N.; Richards, J.S.; Go, B.K. Outcomes of post-spinal cord injury marriages. Arch. Phys. Med. Rehabil. 1995, 76, 130–138. [Google Scholar] [CrossRef]
- Karana-Zebari, D.; de Leon, M.B.; Kalpakjian, C.Z. Predictors of marital longevity after new spinal cord injury. Spinal Cord 2011, 49, 120–124. [Google Scholar] [CrossRef]
- Olsen, R.; Clarke, H. Parenting and Disability: Disabled Parents Experiences of Raising Children; Policy Press: Bristol, UK, 2003. [Google Scholar]
- Yeung, W.-Y.J.; Cheung, A.K.-L. Living alone: One-person households in Asia. Demogr. Res. 2015, 32, 1099–1112. [Google Scholar] [CrossRef] [Green Version]
- Genet, N.; Kroneman, M.; Boerma, W.G. Explaining governmental involvement in home care across Europe: An international comparative study. Health Policy 2013, 110, 84–93. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Brandt, M. Intergenerational help and public assistance in Europe–A case of specialization? Eur. Soc. 2013, 15, 26–56. [Google Scholar] [CrossRef]
- Bickenbach, J.; Officer, A.; Shakespeare, T.; von Groote, P. International Perspectives on Spinal Cord Injury; World Health Organization: Geneva, Switzerland, 2013. [Google Scholar]
- Stucki, G.; Bickenbach, J. The international spinal cord injury survey and the learning health system for spinal cord injury. Am. J. Phys. Med. Rehabil. 2017, 96, S2–S4. [Google Scholar] [CrossRef]
- Gross-Hemmi, M.H.; Post, M.W.; Ehrmann, C.; Fekete, C.; Hasnan, N.; Middleton, J.W.; Reinhardt, J.D.; Strom, V.; Stucki, G. Study protocol of the International Spinal Cord Injury (InSCI) community survey. Am. J. Phys. Med. Rehabil. 2017, 96, S23–S34. [Google Scholar] [CrossRef] [Green Version]
- Fekete, C.; Post, M.W.; Bickenbach, J.; Middleton, J.; Prodinger, B.; Selb, M.; Stucki, G. A Structured approach to capture the lived experience of spinal cord injury: Data model and questionnaire of the International Spinal Cord Injury community survey. Am. J. Phys. Med. Rehabil. 2017, 96, S5–S16. [Google Scholar] [CrossRef]
- Fekete, C.; Brach, M.; Ehrmann, C.; Post, M.W.; Stucki, G. Cohort profile of the International Spinal Cord Injury (InSCI) community survey. Arch. Phys. Med. Rehabil. 2020. [Google Scholar] [CrossRef]
- United Nations Educational, Scientific and Cultural Organization. International Standard Classification of Education (ISCED); UNESCO: Paris, France, 1997. [Google Scholar]
- Hagenaars, A.; De Vos, K.; Zaidi, M.A. Poverty Statistics in the Late 1980s: Research Based on Micro-Data; Publications Office of the European Union: Luxembourg, 1994. [Google Scholar]
- Human Development Index. Available online: http://hdr.undp.org/en/content/human-development-index-hdi (accessed on 27 August 2020).
- Hox, J.; Moerbeek, M.; van de Schoot, R. Multilevel Analysis. Techniques and Applications; Routledge: New York, NY, USA, 2018. [Google Scholar]
- White, I.R.; Royston, P.; Wood, A.M. Multiple imputation using chained equations: Issues and guidance for practice. Stat. Med. 2011, 30, 377–399. [Google Scholar] [CrossRef] [PubMed]
- Gill, C. Dating and relationship issues. Sex Disabil. 1996, 14, 183–190. [Google Scholar] [CrossRef]
- Gross-Hemmi, M.H.; Post, M.W.M.; Bienert, S.; Chamberlain, J.D.; Hug, K.; Jordan, X.; Scheel-Sailer, A.; Weiss, A.; Brinkhof, M.W.G. Participation in people living with spinal cord injury in Switzerland: Degree and associated factors. Arch. Phys. Med. Rehabil. 2019, 100, 1894–1906. [Google Scholar] [CrossRef] [PubMed]
- Lester, D. The impact of unemployment on marriage and divorce. J. Divorce Remarriage 1996, 25, 151–153. [Google Scholar] [CrossRef]
- González-Val, R.; Marcén, M. Unemployment, marriage and divorce. Appl. Econ. 2018, 50, 1495–1508. [Google Scholar] [CrossRef] [Green Version]
- Esteve, A.; Reher, D.S.; Treviño, R.; Zueras, P.; Turu, A. Living alone over the life course: Cross-national variations on an emerging issue. Popul. Dev. Rev. 2020, 46, 169–189. [Google Scholar] [CrossRef]
- Klinenberg, E. Going solo: The Extraordinary Rise and Surprising Appeal of Living Alone; Penguin Press: New York, NY, USA, 2012. [Google Scholar]
- Robles, T.F.; Slatcher, R.B.; Trombello, J.M.; McGinn, M.M. Marital quality and health: A meta-analytic review. Psychol. Bull. 2014, 140, 140–187. [Google Scholar] [CrossRef]
- Robles, T.F.; Kiecolt-Glaser, J.K. The physiology of marriage: Pathways to health. Physiol. Behav. 2003, 79, 409–416. [Google Scholar] [CrossRef]
- Kiecolt-Glaser, J.K. Marriage, divorce, and the immune system. Am. Psychol. 2018, 73, 1098–1108. [Google Scholar] [CrossRef]
Categorical Variables (% Missing Values in Total Population) | Total |
---|---|
N (%) | |
Partnership status (0.7) | |
Single | 5119 (41.0) |
Having a partner | 7380 (59.0) |
Living situation (1.6) | |
Living alone | 2351 (19.0) |
Living with others | 9630 (77.7) |
Living in an institution | 413 (3.3) |
Gender (0.3) | |
Female | 3393 (27.0) |
Male | 9165 (73.0) |
Age at time of survey in years (0.6) | |
16–30 years | 1323 (10.6) |
31–45 years | 3193 (25.5) |
46–60 years | 4325 (34.6) |
61 years or older | 3672 (29.4) |
Employment status (0) | |
Paid work | 3880 (30.8) |
No paid work | 8711 (69.2) |
Injury severity (4.3) | |
Incomplete paraplegia | 4155 (34.5) |
Complete paraplegia | 3381 (28.1) |
Incomplete tetraplegia | 3284 (27.3) |
Complete tetraplegia | 1225 (10.2) |
Etiology (1.6) | |
Traumatic | 9990 (80.6) |
Non-traumatic | 2399 (19.4) |
Time since injury in years (2.7) | |
0–5 years | 4209 (34.4) |
6–15 years | 4153 (33.9) |
16–25 years | 2006 (16.4) |
26 years or more | 1880 (15.4) |
Human development index a (0) | |
Lowest quartile | 2661 (21.1) |
2nd lowest quartile | 2109 (16.8) |
2nd highest quartile | 2225 (17.7) |
Highest quartile | 5596 (44.4) |
Continuous variables | Mean (SD); median (IQR) |
Age in years (0.6) | 51.3 (15.3); 52 (40–63) |
Time since injury in years (2.7) | 13.1 (11.9); 9 (4–19) |
Education in years (6.1) | 12.2 (5.2); 12 (9–15) |
Individual and Country-level Characteristics | Being Single | |
---|---|---|
Model 1 | Model 2 | |
OR (95% CI) | OR (95% CI) | |
Sociodemographic characteristics | ||
Gender | ||
Male | Reference | Reference |
Female | 1.21 (1.11–1.31) | 1.16 (1.05–1.28) |
p-value | <0.001 *** | 0.005 ** |
Age (in years) | 0.96 (0.96–0.96) | 0.95 (0.94–0.95) |
p-value | <0.001 *** | <0.001 *** |
Education (in years) | ||
Lowest quartile | Reference | Reference |
2nd lowest quartile | 1.05 (0.95–1.17) | 0.99 (0.87–1.12) |
2nd highest quartile | 1.04 (0.93–1.16) | 0.95 (0.83–1.08) |
Highest quartile | 1.18 (1.06–1.31) | 1.12 (0.98–1.28) |
p-value | 0.025 * | 0.064 |
Net-equivalent household income | ||
Lowest quartile | Reference | Reference |
2nd lowest quartile | 0.57 (0.51–0.64) | 0.61 (0.54–0.69) |
2nd highest quartile | 0.52 (0.47–0.64) | 0.55 (0.48–0.62) |
Highest quartile | 0.48 (0.43–0.53) | 0.53 (0.47–0.61) |
p-value | <0.001 *** | <0.001 *** |
Employment status | ||
No paid work | Reference | Reference |
Paid work | 0.90 (0.83–0.98) | 0.68 (0.61–0.76) |
p-value | 0.010 * | <0.001 *** |
Characteristics of the spinal cord injury | ||
Injury severity | ||
Incomplete paraplegia | Reference | Reference |
Complete paraplegia | 1.20 (1.09–1.33) | 1.06 (0.95–1.19) |
Incomplete tetraplegia | 1.06 (0.96–1.17) | 1.15 (1.02–1.29) |
Complete tetraplegia | 1.87 (1.63–2.14) | 1.51 (1.29–1.78) |
p-value | <0.001 *** | <0.001 *** |
Etiology | ||
Non-traumatic | Reference | Reference |
Traumatic | 1.27 (1.15–1.4) | 0.89 (0.78–1.01) |
p-value | <0.001 *** | 0.066 |
Time since injury (in years) | 1.00 (1.00–1.01) | 1.02 (1.02–1.03) |
p-value | 0.008 ** | <0.001 *** |
Country-level characteristics | ||
Human Development Index (1–21, 1 = highest, 21 = lowest HDI) | 1.02 (0.98–1.06) | 0.99 (0.95–1.03) |
p-value | 0.204 | 0.598 |
Individual and Country-level Characteristics | Living Alone | |
---|---|---|
Model 1 | Model 2 | |
OR (95% CI) | OR (95% CI) | |
Sociodemographic characteristics | ||
Gender | ||
Male | Reference | Reference |
Female | 1.00 (0.86–1.15) | 0.81 (0.69–0.96) |
p-value | 0.975 | 0.020 * |
Age (in years) | 1.04 (1.04–1.05) | 1.04 (1.04–1.05) |
p-value | <0.001 *** | <0.001 *** |
Education (in years) | ||
Lowest quartile | Reference | Reference |
2nd lowest quartile | 0.91 (0.76–1.09) | 0.96 (0.77–1.18) |
2nd highest quartile | 0.76 (0.62–0.92) | 0.83 (0.66–1.05) |
Highest quartile | 0.98 (0.81–1.19) | 1.03 (0.82–1.30) |
p-value | 0.026 * | 0.245 |
Net-equivalent household income | ||
Lowest quartile | Reference | Reference |
2nd lowest quartile | 0.74 (0.61–0.89) | 0.76 (0.61–0.94) |
2nd highest quartile | 1.29 (1.07–1.56) | 1.36 (1.10–1.68) |
Highest quartile | 1.91 (1.57–2.32) | 2.11 (1.68–2.65) |
p-value | <0.001 *** | <0.001 *** |
Employment status | ||
No paid work | Reference | Reference |
Paid work | 0.92 (0.80–1.06) | 0.92 (0.77–1.11) |
p-value | 0.268 | 0.392 |
Characteristics of the spinal cord injury | ||
Injury severity | ||
Incomplete paraplegia | Reference | Reference |
Complete paraplegia | 1.12 (0.95–1.33) | 1.19 (0.97–1.46) |
Incomplete tetraplegia | 0.79 (0.67–0.94) | 0.79 (0.64–0.98) |
Complete tetraplegia | 0.63 (0.51–0.79) | 0.75 (0.58–0.98) |
p-value | <0.001 *** | <0.001 *** |
Etiology | ||
Non-traumatic | Reference | Reference |
Traumatic | 0.78 (0.65–0.94) | 0.93 (0.73–1.17) |
p-value | 0.008 ** | 0.513 |
Time since injury (in years) | 1.02 (1.01–1.03) | 1.00 (1.00–1.01) |
p-value | <0.001 *** | 0.285 |
Country-level characteristics | ||
Human Development Index (1–21, 1 = highest, 21 = lowest HDI) | 0.84 (0.81–0.87) | 0.85 (1.00–1.01) |
p-value | <0.001 *** | <0.001 *** |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Fekete, C.; Arora, M.; Reinhardt, J.D.; Gross-Hemmi, M.; Kyriakides, A.; Le Fort, M.; Patrick Engkasan, J.; Tough, H. Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics? Int. J. Environ. Res. Public Health 2020, 17, 7002. https://doi.org/10.3390/ijerph17197002
Fekete C, Arora M, Reinhardt JD, Gross-Hemmi M, Kyriakides A, Le Fort M, Patrick Engkasan J, Tough H. Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics? International Journal of Environmental Research and Public Health. 2020; 17(19):7002. https://doi.org/10.3390/ijerph17197002
Chicago/Turabian StyleFekete, Christine, Mohit Arora, Jan D. Reinhardt, Mirja Gross-Hemmi, Athanasios Kyriakides, Marc Le Fort, Julia Patrick Engkasan, and Hannah Tough. 2020. "Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics?" International Journal of Environmental Research and Public Health 17, no. 19: 7002. https://doi.org/10.3390/ijerph17197002
APA StyleFekete, C., Arora, M., Reinhardt, J. D., Gross-Hemmi, M., Kyriakides, A., Le Fort, M., Patrick Engkasan, J., & Tough, H. (2020). Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics? International Journal of Environmental Research and Public Health, 17(19), 7002. https://doi.org/10.3390/ijerph17197002