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Disability, environmental factors and non-fatal injury
  1. Marilyn Leff1,
  2. Lorann Stallones2,
  3. Huiyun Xiang3,
  4. Gale Whiteneck4
  1. 1Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado, USA
  2. 2Colorado School of Public Health, Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado, USA
  3. 3Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
  4. 4Craig Hospital, Englewood, Colorado, USA
  1. Correspondence to Dr Marilyn Leff, 616 S Pearl St, Denver, CO 80209, USA; marilyn.leff{at}


Background People with disabilities have high rates of non-fatal injury; they are also likely to experience environmental factors as barriers to functioning and participation in society. The reasons for the higher injury rates among those with disabilities have not been explained.

Objective To determine if problems with environmental factors influence the higher rates of injury among disabled compared with non-disabled.

Design Data from a population-based, random-digit dial cross-sectional telephone survey were analysed to evaluate whether environmental factors as measured by the Craig Hospital Inventory of Environmental Factors explained higher injury rates among those with disabilities compared with those without. A total of 2511 Colorado adults (1997 with no disability, 386 with moderate disability, and 128 with severe disability) were included in the sample. All rated their experience of environmental factors and reported injuries within the previous 12 months. Logistic regression analyses were conducted to evaluate whether environmental factors could be confounding factors in the association between disability and non-fatal injury.

Results Disability and environmental barriers were independently associated with higher rates of injury. Environmental factors did attenuate the increased odds of experiencing an injury among those with severe disabilities, but these people continued to have significantly higher rates of injury after adjustment for environmental factors. The natural environment, social attitudes and policies were ranked highly as problems by all injured persons.

Conclusion Injury prevention efforts need to focus on reducing disability-related injuries and reducing environmental barriers for all.

  • Disability
  • environment

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  • Funding This work was supported by Grant Number 5 R49 CE001 168 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Colorado State University and the Colorado Department of Public Health and Environment.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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