People with SCI From Racial/Ethnic Minority Backgrounds Are At Increased Risk For Wheelchair Breakdowns

Research Objectives

To determine whether people from racial and ethnic minority backgrounds are at increased risk for wheelchair breakdowns and their negative consequences.

Design

Cross-sectional survey.

Setting

Eight SCI Model Systems (SCIMS) Centers.

Participants

Full-time wheelchair users (≥16 years old) with chronic SCI (duration of injury ≥1 year). Of the 734 survey respondents, n=541 had complete data on key measures and were included in this analysis.

Interventions

N/A.

Main Outcome Measures

The dependent variable, wheelchair breakdowns within the past 6 months, was measured with the following nominal categories: breakdowns, breakdowns without consequences, and breakdowns with consequences. The focal independent variable, race/ethnicity, included non-Hispanic Black, non-Hispanic White, and Hispanic subgroups. Multinomial regression models were used to estimate differences in risk of breakdown by race/ethnicity, controlling for financial strain (negative strain, no negative strain), employment (unemployed, employed), wheelchair type (manual, power), and wheelchair payer (private, self-pay, government).

Results

Individuals who were Hispanic reported more breakdowns without consequences relative to those who were non-Hispanic Whites (RRR: 2.4, 95%CI: 1.2-4.8, p=.015). Non-Hispanic Black (RRR: 2.1, 95%CI: 1.1-4.2, p=.033) and Hispanic participants (RRR: 2.6, 95%CI: 1.2-6.2, p=.028) reported more breakdowns with negative consequences relative to non-Hispanic White participants.

Conclusions

Wheelchair breakdowns are a frequent occurrence among people with spinal cord injury (SCI) and often lead to several immediate, negative consequences, such as injury; being stranded; and/or missing work, school, or medical appointments.1, 2 Previous studies have found disparities in wheelchair prescription based on race/ethnicity; namely, people with SCI from minority group backgrounds were less likely to receive higher-end, customizable chairs or have backup wheelchairs.3, 4 In this sample of wheelchair users with SCI, Hispanic and non-Hispanic Black participants had greater risk of one or more wheelchair breakdowns, and negative consequences from those breakdowns. Prior research has found that consequences from breakdowns is associated with poorer health outcomes.5 Further research is needed to determine why these relationships were observed and methods of preventing wheelchair breakdowns and their negative consequences.

Author(s) Disclosures

N/A