Understanding disability and the ‘social determinants of health’: how does disability affect peoples’ social determinants of health?

Abstract

Purpose: The purpose of this study was to investigate how an individual’s social determinants of health are affected by the acquisition of physical disability in adulthood. The secondary aim was to report the described facilitators and barriers to living with a disability.

Method: This qualitative study used an exploratory, descriptive approach. Nine individuals with a neurologically derived disability were purposively recruited from a rehabilitation center in northern Queensland. Participation in the study involved semi-structured interviews. QSR NVivo was used for the data analysis process.

Results: Changes to social determinants of health resulting from the acquisition of disability had substantial flow-on consequences in all aspects of life for the individual and those close to them. Income had the greatest influence over the other social determinant of health. Following the acquisition of disability, the reduced inflow and increased outflow of finances had subsequent negative effects on housing, transport and social interactions, and also personal relationships.

Conclusions: When considering changes to the social determinants of health resulting from disability acquisition, it is impractical to view these changes and those affected in isolation. Consideration of this multidimensional effect on life associated with the acquisition of disability will be useful in disability research, advocacy and support services.

Implications for Rehabilitation

• Social determinants of health are known to have a direct influence on health status. As social determinants of health decrease, morbidity and mortality rates increase.

• Following the acquisition of disability, there is a decline in social determinants of health. This decline affects quality of life for individuals’ with a disability, and those closest to them.

• The effects of declining social determinants of health may inhibit the rehabilitation process. Thus, it is important to acknowledge the multifaceted impact the acquisition of disability has on peoples’ lives, and the consequences this may have for their rehabilitation.

Keywords:

• Social circumstances
• societal conditions
• socio-economic factors
• neurological conditions
• acquisition of disability
• research

Acknowledgements

Grateful acknowledgement and thanks are given to the Townsville rehabilitation center for allowing this study to be conducted within their facility. In addition, much gratitude is extended to interview participants for sharing their insights and personal experiences.

Disclosure statement

The primary researcher is a current employee at the rehabilitation center, and also lives with a neurologically derived disability. It is the belief of the primary researcher that these combined circumstances were advantageous to the study as familiarity and understanding of the topic were assured. However, the increased risk of coercion was acknowledged and close attention was paid to its mitigation as outlined in the methodology.