Background Loneliness is significantly related to health and wellbeing. However, there is little information on the prevalence of loneliness among people with disability or the association between disability, loneliness and wellbeing. Objective/hypothesis For a nationally representative sample of adults (age 16–64) with/without disability, to examine exposure to three indicators of low social connectedness (loneliness, low perceived social support, social isolation), and to evaluate the association between low social connectedness and wellbeing. To test whether disability status moderated the relationship between low social connectedness and wellbeing. Methods Secondary analysis of data from three annual rounds of the cross-sectional English Community Life Survey (CLS) 2016–19. Results People with disability experienced loneliness, low perceived social support and social isolation at significantly higher rates than people without disability. Effect sizes were significantly greater for loneliness. Disability was associated with lower wellbeing. With one exception, low social connectedness was associated with lower wellbeing. Again, effect sizes were significantly greater for loneliness. The prevalence of loneliness was highest among adults with disability who were younger, economically inactive, living in rented or other accommodation, living alone and with low levels of access to environmental assets. There was no evidence that disability status moderated the association between exposure to low social connectedness and low wellbeing. Conclusions Loneliness was a particularly significant driver of poor wellbeing among people with disability. The relative independence between different indicators of social connectedness suggests that interventions to reduce loneliness will need to do more than simply increase rates of social contact or social support.
Development of the World Health Organization’s International Classification of Health Interventions (ICHI) is currently underway. Once finalised, ICHI will provide a standard basis for collecting, aggregating, analysing, and comparing data on health interventions across all sectors of the health system. In this paper, we introduce the classification, describing its underlying tri-axial structure, organisation and content. We then discuss the potential value of ICHI for capturing information on met and unmet need for health interventions relevant to people with a disability, with a particular focus on interventions to support functioning and health promotion interventions. Early experiences of use of the Swedish National Classification of Social Care Interventions and Activities, which is based closely on ICHI, illustrate the value of a standard classification to support practice and collect statistical data. Testing of the ICHI beta version in a wide range of countries and contexts is now needed so that improvements can be made before it is finalised. Input from those with an interest in the health of people with disabilities and health promotion more broadly is welcomed.
Considering these basic questions is a pre-requisite to meaningful recording and measurement of functioning and disability. Future challenges include: incorporating environmental factors into measurement; setting thresholds on the disability spectrum; and combining the views of the person concerned with those of various professionals.
Objective: To develop a framework and indicators to monitor inequalities in health and the social determinants of health for Australians with disability. Methods: The development drew on existing frameworks and input from people with lived experience of disability. Results: The Disability and Wellbeing Monitoring Framework has 19 domains. Australian national data are available for 73% of the 128 indicators in these domains. Data gaps and limitations include the absence of national data and the absence of disability identifiers in some data sources. Conclusions: The framework will be used to report baseline data for people with and without disability and to monitor inequalities over time in Australia. It will also be used to locate policy priorities and focus efforts to address data gaps. Implications for public health: Inequality between people with and without disability in relation to health and the social determinants of health is a public health issue that warrants greater attention than it has received to date. The framework provides a robust, evidence‐informed tool to address the health inequalities of people with disability, inform the development of effective policy and practice responses, and monitor change over time.
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