Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults.

PURPOSE There is a need for empirical support of the association between the built environment and disability-related outcomes. This study explores the associations between community and neighborhood land uses and community participation among adults with acquired physical disability. METHODS Cross-sectional data from 508 community-living chronically disabled adults in New Jersey were obtained from among participants in national Spinal Cord Injury Model Systems database. Participants' residential addresses were geocoded to link individual survey data with Geographic Information Systems data on land use and destinations. The influence of residential density, land use mix, destination counts, and open space on four domains of participation were modeled at two geographic scales-the neighborhood (i.e., half mile buffer) and community (i.e., five mile) using multivariate logistic regression. All analyses were adjusted for demographic- and impairment-related differences. RESULTS Living in communities with greater land use mix and more destinations was associated with a decreased likelihood of reporting optimum social and physical activity. Conversely, living in neighborhoods with large portions of open space was positively associated with the likelihood of reporting full physical, occupational, and social participation. CONCLUSIONS These findings suggest that the overall living conditions of the built environment may be relevant to social inclusion for persons with physical disabilities.