Disability discrimination and well-being in the United Kingdom: a prospective cohort study

Abstract

ObjectivesDisability discrimination is linked with poorer well-being cross-sectionally. The aim of this study was to explore prospective associations between disability discrimination and well-being.DesignProspective cohort study.SettingThe United Kingdom Household Longitudinal Study.ParticipantsData were from 871 individuals with a self-reported physical, cognitive or sensory disability.Primary outcome measuresDepression was assessed in 2009/10. Psychological distress, mental functioning, life satisfaction and self-rated health were assessed in 2009/10 and 2013/14.ResultsData were analysed using linear and logistic regression with adjustment for age, sex, household income, education, ethnicity and impairment category. Perceived disability discrimination was reported by 117 (13.4%) participants. Cross-sectionally, discrimination was associated with depression (OR=5.40, 95% CI 3.25 to 8.97) fair/poor self-rated health (OR=2.05; 95% CI 1.19 to 3.51), greater psychological distress (B=3.28, 95% CI 2.41 to 4.14), poorer mental functioning (B=−7.35; 95% CI −9.70 to −5.02) and life satisfaction (B=−1.27, 95% CI −1.66 to −0.87). Prospectively, discrimination was associated with increased psychological distress (B=2.88, 95% CI 1.39 to 4.36) and poorer mental functioning (B=−5.12; 95% CI −8.91 to −1.34), adjusting for baseline scores.ConclusionsPerceived disability-related discrimination is linked with poorer well-being. These findings underscore the need for interventions to combat disability discrimination.

Racial discrimination and health: a prospective study of ethnic minorities in the United Kingdom

“…Those who reported other (non-racial) forms of discrimination were not included in the analysis. This measure has been used in previous investigations to look at the link between perceived discrimination and health outcomes [ 28 , 31 , 32 ].…”

“…We included 3 mental health measures at waves 1 (2009/10) and 3 (2011/12). Psychological distress was assessed using the General Health Questionnaire (GHQ)-12 [ 33 ], in line with previous studies [ 31 , 32 ]. This tool has been validated as a screening tool to detect psychological distress in community samples [ 34 ].…”

“…The 12-item short-form health survey (SF-12) mental component summary score was used to measure limitations caused by emotional, mental health and social functioning issues [ 35 ], in keeping with previous studies [ 31 , 32 ]. This tool has been validated for use as a measure of mental functioning in community samples [ 35 , 36 ].…”

“…One item was used to assess participants’ life satisfaction by asking them how satisfied they were with their “life overall”, on a scale from 1 (completely dissatisfied) to 7 (completely satisfied) [ 38 ]. Single item measures of life satisfaction are widely used in survey studies [ 39 ] This measure has been used in previous investigations to assess the link between discrimination and life satisfaction [ 31 , 32 ].…”

“…A single item was used to assess self-rated health: “ Would you say your health is … poor/fair/good/very good/excellent?” In keeping with earlier work [ 31 , 32 , 42 ] self-rated health was dichotomised with 0 being “good/very good/excellent” and 1 being “poor/fair”. This single item measure has been shown to have good predictive validity for health outcomes [ 42 ].…”