Disadvantage in physically disabled adults: an assessment of the causation and selection hypotheses.

An area survey of West Beirut provided the opportunity to study whether disadvantage among people with physical disabilities is attributed to social class of origin (causation) or is due to the social consequences of disability (selection and drift). Adults who were disabled from poliomyelitis in childhood were compared to West Beirut residents and to age and sex matched sibling controls. The typical finding of a substantially greater proportion of disabled people in the lower social class groups was noted. Their fathers were also over-represented in the lower social classes but to a lesser extent in the skilled manual group. The occupational mobility processes, both inter-generational and intra-generational, pointed to a trend towards skilled labor for disabled groups from all social classes, a finding different from the general population trends. Selection (failure to reach or keep expected position) was noted in the lower social classes while the downward drift (movement from higher to lower social class) for the disabled persons was seen in the upper social classes. Both the causation and the selection-drift hypotheses were supported by the findings.

The nutritional status of children of displaced families in Beirut.

The nutritional status of children of displaced families in Greater Beirut was investigated in 1986 (a sample of 146 households) and in 1991 (137 households). Data on demographic variables, nutrient intake (calories, protein, and iron), and anthropometric measurements were collected. Iron intake was only 50-57% of the RDA for the 1-3 age group, and 35.6% and 32.0% of all children consumed < 60% of the RDA for iron in 1986 and 1991, respectively. Main sources of protein were dairy products, milk and eggs. The lower nutrient intake in 1991 compared to 1986 was negatively related to social class. Anthropometric measurements showed an increased past and recent undernutrition of the children in 1991 as compared to both the 1986 child sample and the NCHS standard child population. Severe inflation and marked increase in food prices were reflected in dietary intake and growth of the children. Food aid programmes, government subsidy of bread, and partial wage correction were possible stabilizing factors for the most destitute groups but not for the total population of displaced children.

PIP: 2 professors from the American University of Beirut analyzed 1986 and 1991 data on children of 283 displaced families in Greater Beirut, Lebanon, to examine their nutritional status and contributing socioeconomic factors. Between 1986 and 1991, while the civil war raged, inflation rates increased 2200% (food prices rose 900-6300%). The government subsidized bread, operated a food aid program for destitute families, and instituted partial wage correction. Mean caloric intake was within acceptable levels, but about 10% of the children received less than 60% of the recommended dietary allowance (RDA) for calories in both years. Mean caloric intake was less than the RDA for the 7-10 year old age group (88%) in 1986 and 94% in 1991). The mean iron intake for both years was very low for 1-3 year old children (50-57% of RDA). Further, 35.6% of children in 1986 and 32% in 1991 consumed less than 60% of the RDA for iron. Dairy products, eggs, and legumes accounted for most of the protein intake which tended to be adequate. Children of semiskilled and unskilled fathers consumed more nutrients than did those of other occupational groups, because poor families received more food aid (p .05). Children in 1991 exhibited more signs of undernutrition (e.g., poor growth) than did those in 1986. For example, 22.2% of 1-3 year old children weighed less than the 10th NCHS percentile in 1991 compared to 12% in 1986. Further, 16% of the same age children were in the 10th percentile for weight-by-height in 1991, while just 12% were in 1986. These results show that very high inflation rates and subsequent increases in food prices adversely affected dietary intake and growth patterns of the children of displaced families, even though the government subsidized bread and enacted wage correction. Furthermore, the food aid programs just helped the very poorest children.

Disadvantage as a measure of handicap: a paired sibling study of disabled adults in Lebanon.

In 1980 WHO defined disability as a functional limitation due to impairment, and handicap as the psychosocial disadvantage consequent to disability. This study was designed to investigate the advent of handicap in a group of adults physically disabled by poliomyelitis in childhood by comparing them to their age- and sex-matched siblings. An area survey was conducted in West Beirut and its Southern Suburb and 240 such disabled people and their siblings were identified and interviewed. Handicap was defined as disadvantage in six areas, namely, education, work, income, marital status, housing, and mental well-being. The differences between each disabled person and his/her sex-matched sibling were assessed. Significant differences were noted in employment (Odds ratio (OR) = 4.20, confidence interval (CI): 1.38-15.26), social class (OR = 2.67, CI: 1.11-6.79), income (OR = 2.88, CI: 5.57-113.3) and marital status for both the disabled people compared with their elder siblings (OR = 20.00, CI: 5.57-113.30) and for those disabled compared with their younger siblings (OR = 4.60, CI: 1.53-16.55). Multivariate analyses of the explanatory factors for each of these six areas of disadvantage among the disabled group showed that educational discrepancies cut across social class differences (OR = 1.90, CI: 1.00-3.61), income differences (OR = 1.44, CI: 0.97-2.14), and symptoms of depression (OR = 2.33, CI: 1.42-3.84). Marital-status disadvantage was related to lower income groups and disabled women (OR = 1.66, CI: 1.10-2.49; OR = 1.60, CI: 1.07-2.39).(ABSTRACT TRUNCATED AT 250 WORDS)