Environmental Problems by Impairment Type

IntroductionMan in wheelchair cant get up stairs

Environmental conditions affect people with impairments and ultimately, create
disability.  For example, someone who uses mobility equipment may have more difficulty with access barriers.  However, there is very little data about the lived experience of people with impairments and the barriers they encounter in their daily lives.

We used preliminary data from the Pain Interference Patterns Ecological Momentary Assessment (EMA) (n=116) to examine the relationship between impairment and an individual's experience within their environment. Time lagged effects were examined to look at predictors of participation based on existing environmental constraints such as crowds, perceptions of attitudes, lights, etc.

Sample

This EMA sample included 116 individuals age between 18 and 65 years old who were recruited from the population based Longitudinal Study sample.  For more information on EMA data collection methods and the sample please visit our Pain Interference Patterns EMA Sample section. The table below presents the number of respondents who reported each impairment type:
Number of Participants by Impairment

Within this sample 19 participants were deaf or had serious difficulty hearing, 10 participants were blind or had serious difficulty seeing even when wearing glasses, 50 participants had difficulty concentrating, remembering or making decisions, 82 participants had problems walking or climbing stairs, 39 participants had problems dressing or bathing, 47 participants had difficulty doing errands alone, and 61 participants reported having pain above a 4 on an 11 point scale.  The numbers for those who were deaf or hard of hearing and blind or have serious difficulty seeing are in red font because these subgroups are to small to have stable estimates

Demographics 

  • Average age = 52.8
  • 64.2% Female
  • 97.4% Caucasian
  • 49.6% Married
  • 23.3% HS or GED, 34.5% Some College, 23.3% Bachelor's degree, 9.5% Master degree or higher
  • 26.1% Live Alone
  • 50%  are between $20,0000-$30,000 in family income
  • 59.1% Not Employed, 13.9% Part-time Employment (30 hours per week or less), 27% Employed Full Time
  • 44.3% Receive Social Security Benefits

Measures

Environmental Problems

In addition to reporting on their location and type of activity, participants were asked to identify which of these problems bothered them since the last time they responded.

  • None 
  • Accessibility: such as lack of curbs cuts, ramps, appropriate signs
  • Allergens: such as pollen, animals, anything causing an allergic reaction
  • Air quality or smells: such as smoke, pollution, perfumes
  • Climate or weather: such as outside temperature, rain or snow, wind, seasonal variations
  • Crowds:  such as too many people, too much activity
  • Darkness: such as low light, lack of contrast
  • Lights: such as overly bright lights, flashing lights
  • Noisy or loud: such as loud background noise, music, voices, sounds
  • People’s attitudes: negative attitudes of friends, family, service providers and strangers, discrimination
  • Room temperature: such as indoor temperature too hot or too cold.
  • Traffic or parking: such as traffic congestion, lack of accessible spot, parking too far away
  • Transportation problems: such as car troubles, lack of a ride, bus problems

Results

Based on the impairments reported, results were both expected and unexpected. First, most everyone encountered environmental conditions that bothered them at some point during the study.  Many subjects reported problematic conditions more for more than half the time.

Time Periods without Constraints 

The graph shows a bimodal distribution wherein 16 of 123 respondents reported no barriers during any period while 23 of 123 reported barriers at every period. Accordingly, nearly 25% reported barriers in fewer than 20 percent of the observations while over 35% reported barriers at more than 80 percent of the observations. The distribution between 20 and 80 percent of the time periods is approximately normal.

 

Median Percentage of Periods with Problems

We examined the percentage of time periods when individuals reported they did not experience any problems by the impairments they reported.  These results indicated that the only impairment group that reported significantly more environmental problems compared with those not reporting the impairment were those individuals with cognitive impairments. They reported encountering problems nearly 50% of the time compared to less than 25% for those without cognitive impairment.

Median Percentage of Periods with Problems

 

Environmental Constraints by Impairment

To examine which environmental conditions were experienced  at greater or lesser rates based on impairment type, we calculated non-parametric tests for the share of time periods reported for each impairment type. For this analysis, we added two categories that are related to impairment: pain level and equipment use.  In the table below, we entered GT when the difference was experience more often for that impairment group and LT when it was less often.  Blank cells indicate no difference between people with and without the impairment listed. The RED cells indicate differences we hypothesized for an impairment group, but did not observe in the data.  For example, we thought people who indicated a walking impairment would indicate greater accessibility problems, but the data did not support that hypothesis. Rather, it was the subset of individuals who use equipment that report more access problems. Similarly, we anticipated that people with walking impairment, errands and those who use equipment would report higher rates of transportation problems, but this also was not the case.  

Differences in Environmental Problems by Impairment. Note: GT=Greater than; LT=Less than for differences with p < .05 Mann-Whitney U test. *Low statistical powe
Note: GT=Greater than; LT=Less than for differences with p < .05 Mann-Whitney U test. *Low statistical power

Discussion

Universal Design RampThese results indicate that the environment is problematic for people with various impairments, but not necessarily in the ways we might expect.  First, we noticed there is a lot of variability in people’s tendency to notice problems in the environment and this variance may be more related to other characteristics than simply impairment type. Second, while people may adapt their spatial travel patterns to minimize encountering problematic environments, they encounter them regularly. Future research may work toward understanding how environmental conditions affect the establishment and maintenance of community behavior.