Prevalence and patterns of youth responses to standard disability survey questions.

BACKGROUND: In 2011, the US Department of Health and Human Services adopted a minimum set of six standardized questions about disability to be used in population-based health surveys. These questions have been validated for self- and proxy-report use by adults, but how they perform for adolescents is unknown. OBJECTIVE: To describe how 8th grade students, 11th grade students, and young adults aged 18-24 years in Oregon answer these questions. METHODS: Cross-sectional study design. Data for the 8th and 11th grade students were derived from the Oregon Health Teens survey (OHT; 2017 and 2019); data for young adults aged 18-24 were from the Behavioral Risk Factor Surveillance System (BRFSS; 2017 and 2018). Unweighted counts, weighted proportions and 95% confidence intervals were calculated for socio-demographic characteristics, the six disability questions, and overall disability status (yes/no) among 8th graders (n = 14,396), 11th graders (n = 23,517), and young adults (n = 1112). RESULTS: Responses for 8th and 11th grade students were materially consistent for all six questions. Young adults were markedly less likely to report cognitive disability compared to 8th and 11th graders (17.2% vs. 24.9% and 27.0%, respectively) and somewhat less likely to report an independent living disability (6.5% vs. 8.6% and 9.8%, respectively). CONCLUSION: Differences in cognitive disabilities between adolescents and young adults may either be due to differences in underlying impairment or the result of youth interpreting this question differently than adults. Validation of the standardized disability identifiers for self-report in adolescents is needed.

Sexual Health Experiences Among High School Students With Disabilities.

PURPOSE: The purpose of this study was to investigate the sexual experiences of adolescents with and without disabilities. METHODS: Data were from the 2015 and 2017 Oregon Healthy Teens survey, a state-wide representative sample of 11th grade students. We compared teens with and without disabilities on whether or not they had ever had sexual intercourse (N = 20,812). Among those who had ever had intercourse (N = 8,311), we used multivariable Poisson regression to measure the association between disability status and the prevalence of five sexual experiences. RESULTS: After adjusting for sociodemographic characteristics, the prevalence of ever having had intercourse was 25% higher among teens with disabilities than among those without (adjusted prevalence ratio [aPR] 1.25, 95% confidence interval [CI]: 1.20-1.30). Among students who had had intercourse, the prevalence of having had intercourse before the age of 15 years (aPR 1.25, 95% CI: 1.14-1.47), having ≥ 2 lifetime sexual partners (aPR 1.13, 95% CI 1.07-1.19), having ≥ 2 sexual partners in the previous three months (aPR 1.23, 95% CI: 1.00-1.52), having used alcohol and/or drugs at the last intercourse (aPR 1.28, 95% CI: 1.10-1.48), and having condomless sex at the last intercourse (aPR 1.17, 95% CI: 1.08-1.27) was higher among students with disabilities than among students without disabilities. After accounting for sexual abuse, each of these associations was attenuated and most were no longer significant. CONCLUSIONS: Youth with disabilities are sexually active. Findings highlight the need for increased attention to sexual abuse prevention, sexual health promotion, and risk reduction efforts for this population.

Peer victimization as a mediator of the relationship between disability status and psychosocial distress.

BACKGROUND: Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown. OBJECTIVE: To determine whether the relationship between disability status and psychological distress was mediated by exposure to peer victimization, and if so, whether the mediation effects of peer victimization on psychosocial distress was moderated by sex. METHODS: This cross-sectional study involved a series of regressions to test for mediation and moderated mediation using complex survey data from 6664 Oregon 11th graders. RESULTS: Peer victimization partially mediated the relationship between disability status and psychosocial distress. Sex, however, did not significantly moderate the mediating effects of peer victimization on psychosocial distress. CONCLUSION: Exposure to peer victimization mediated the relationship between disability status and psychosocial distress; there was little support for sex as a moderator.

Aging with a disability: a systematic review of cardiovascular disease and osteoporosis among women aging with a physical disability.

Compared to men, women live longer but experience greater morbidity as they age. However, little is known about the rapidly growing population of women aging with disability. Women aging with disabilities may encounter barriers that increase risk of morbidity, including lack of access to medical care or inadequate assistance, equipment, or services. To evaluate risks of morbidity in this group, we conducted a systematic review focused on two important and prevalent conditions: cardiovascular disease (CVD) and osteoporosis. MEDLINE was searched for reports published between January 1, 1990 and August 6, 2010 and additional studies were identified through searches of bibliographies. 9156 abstracts and 93 articles were reviewed to identify empirical studies of women with physical disability who were 45 years or older and that reported CVD or osteoporosis as an outcome and not a cause of the disability. Articles meeting inclusion criteria were then critically appraised to exclude poor quality studies. In seven articles that evaluated CVD outcomes, we found limited evidence to support an increased risk of prevalence of CVD or risk factors for CVD in women aging with physical disabilities compared to non-disabled control populations. The literature is limited by small sample sizes that reduced statistical power to detect true differences. No articles meeting inclusion criteria were identified to evaluate osteoporosis risk in this group. This review is limited by the narrow focus on physical disabilities and two health outcomes. Additional high quality empirical research is necessary to understand the risks to health of women aging with disabilities.

Health disparities between women with and without disabilities: a review of the research.

As part of a women's health center project, we reviewed 16 years of research to examine health disparities between women with and without disabilities. We reviewed MEDLINE-indexed articles between 1990 and 2005 with data on women with and without physical, sensory, intellectual, developmental, or psychiatric disabilities. Our review found few articles examining health disparities in chronic disease, cancer, mental health and substance abuse, preventive screening, health-promoting behaviors, and health services utilization. Results reflect apparent health disparities between women with and without disabilities. Challenges for the field exist in standardizing disability definitions and determining a future course for health disparity research and policy.