Longitudinal perspective of secondary conditions and community accessibility in a predominantly African American group of women with mobility disability

Secondary conditions can have a substantial negative impact on the health and well being of people with mobility disabilities. The purposes of this study were to: a) identify the type and prevalence of secondary conditions in a predominantly African American group of women with mobility disabilities; and b) examine the temporal sequence of secondary conditions in relation to community accessibility (e.g., transportation, built/natural environment, policies, etc.) over a 12-month period. 217 subjects living in a large urban setting were surveyed over the phone on community accessibility (i.e., number of access barriers reported in the community) and secondary conditions at baseline, 6 months, and 12 months. The majority of subjects (M age = 56.4+12.8 yr.) were female (71%), African American (76%), had a high school education or less (54%), were not employed (92%), had an annual income less than $10,000 (52%) and were obese (M BMI =36.3+12.9 kg/m2). The most commonly reported secondary conditions included pain (84%), muscular weakness (80%), fatigue (74%), difficulty leaving the home or getting around (63%), problem sleeping (63%), falls (60%), and weight problems (56%). Nearly half of the subjects also reported depressive symptoms (49%), social isolation (49%), and anxiety (45%). At baseline, there was no relationship between community accessibility and secondary conditions (r=0.08, p=0.26). However, across time, people who reported improved community accessibility also reported a lower number of secondary conditions. More research is needed to better understand the nature of secondary conditions with respect to community accessibility. (Funded by NIH Grant #R01HD052891)