long-term conditions with functional limitations Roshini - - PowerPoint PPT Presentation
Risk of injury among Youth12 National Health and Wellbeing young New Zealenders Survey with disability and long-term conditions with functional limitations Roshini Peiris-John, Haya Al-Ani, Theresa (Terry) Fleming, on behalf of &
Theresa (Terry) Fleming, on behalf of & The Adolescent Health Research Group
Roshini Peiris-John, Haya Al-Ani, Terryann Clark, Theresa Flemming, Janie Sheridan, Arier Lee, Shanthi Ameratunga
Section of Epidemiology and Biostatistics, School of Population Health
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In New Zealand, one in four people identified as disabled (Disability Survey 2013)
11% of children <15 years (n=95,000)
International research suggests people living with disabilities are known to:
experience poorer levels of health not have equal access to healthcare Have higher risk of injuries
Limited population-based information on injury risks among young New Zealanders with disabilities
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To investigate the risk of injury and associated healthcare interactions among adolescents living with disabling conditions in New Zealand
International Classification of Functioning
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Youth’12 survey National secondary school student survey N=8,500 (response rate - 68%) Self-administered questionnaire using touch screen tablets Students responded to a broad range of questions including: Socio-demographic information Risk and protective factors in home, school and community Health and healthcare interactions
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Disabling conditions defined as: Any disability (lasting six months or more) OR Any health problem (lasting six months or more) with functional limitations
Difficulty/ inability to carry out every day activities/
could do Difficulty/ inability communicate, mix or socialise
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Analysis Data were weighted and the variance of estimates adjusted. Logistic regression models (controlling for age, gender, ethnicity, home locale and indicators of socioeconomic status) investigated associations between disabling condition and
risky behaviour related to road use
injury risk: injury requiring healthcare cause of injury problems seeking healthcare for injury
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Theresa (Terry) Fleming, on behalf of & The Adolescent Health Research Group
Students with disabling conditions (n=1,267) (15%) Reference population (n=7,233) (85%)
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Results (cont.)
Demographic characteristics of study participants
Students with disabling conditions Reference population Chi2 (p-value) n %(95%CI) n %(95%CI) Age <13 221 12.7(11.0-14.4) 1508 87.3(85.6-89.0) 14.571 (0.006) 14 282 15.4(13.9-17.0) 1541 84.6(83.0-86.1) 15 281 16.7(15.0-18.4) 1405 83.3(81.6-85.0) 16 257 16.8(14.4-19.3) 1259 83.1(80.7-85.6) >17 225 16.3(14.0-18.6) 1154 83.7(81.4-86.0) Gender Male 530 14.3(13.1-15.5) 3168 85.7(84.5-86.9) 7.815 (0.005) Female 737 16.6(15.2-17.9) 3706 83.4(82.1-84.7) Prioritised ethnicity Maori 255 15.7(13.8-17.5) 1371 84.3(82.4-86.2) 32.706 (<0.001) Pacific island 140 12.4(9.6-15.2) 994 87.6(84.8-90.4) Asian 113 11.4(9.1-13.6) 883 88.6(86.4-90.8) Other 82 16.9(13.1-20.6) 398 83.1(79.4-86.9) European 676 17.3(16.1-18.4) 3221 82.7(81.6-83.9)
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Results (cont.)
Socioeconomic characteristics of study participants
Students with disabling conditions Reference population Chi2 (p-value) n %(95%CI) n %(95%CI) NZ deprivation1 Lower (Decile 1-3) 405 15.3(14.0-16.6) 2233 84.7(83.4-86.0) 0.952 (0.621) Medium (Decile 4-7) 460 15.9(14.4-17.4) 2415 84.1(82.5-85.6) Higher (Decile 8-10) 382 15.1(12.8-17.3) 2153 84.9(82.7-87.1) Worry about not having enough money for food Often/ all the time 211 24.0(20.5-27.6) 658 76.0(72.4-79.5) 56.111 (<0.001) Never/ occasionally 988 14.5(13.4-15.5) 5830 85.5(84.4-86.6) Moved home > twice 113 19.5(16.5-22.4) 472 80.5(77.6-83.4) 6.752 (0.009) <= twice 1153 15.2(14.2-16.3) 6396 84.8(83.7-85.8)
1NZ Deprivation index 2006
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Results (cont.)
*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group
N (%) Adjusted OR (95%CI)* Students with disabling conditions Reference population Risky behaviour related to road use Always wear a helmet while cycling (among those who cycle) 347(37.0) 1709(34.0) 0.87 (0.75-1.01) Always wear a seatbelt 915(72.3) 5118(74.6) 1.12 (0.94-1.35) Risk taking as a driver Driving within two hours of taking >two glasses of alcohol 27(4.2) 115(3.6) 1.03(0.62-1.70) Driving when high on alcohol 26(4.1) 134(4.2) 0.87(0.54-1.39) Driving dangerously 62(9.9) 317(10.0) 0.99 (0.70-1.41) Risk taking as a passenger in a vehicle Driver who was drinking alcohol 272(21.6) 1206(17.6) 1.16(0.96-1.39) Driver was drunk/ taken drugs 151(11.9) 549(8.0) 1.32 (1.04-1.66) Driver driving dangerously 394(23.4) 1124(16.4) 1.43 (1.23-1.66)
Risky behaviour related to road use
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N (%) Adjusted OR (95%CI)* Students with disabling conditions Reference population Accessed healthcare for injury (previous 12 months) 807(63.9) 3767(55.0) 1.36 (1.22-1.51) Causes of injury requiring healthcare Road traffic crash 70(5.5) 215(3.1) 1.70(1.24-2.35) Fall 311(24.5) 1187(17.2) 1.46(1.23-1.72) Near drowning 21(1.7) 32(0.5) 3.24(1.83-5.74) Work-related injury 36(2.8) 129(1.9) 1.36(0.98-1.91) Sport or recreation-related injury 517(41.0) 2582(37.7) 1.10(0.98-1.24) Assault 53(4.2) 117(1.7) 2.42(1.67-3.52) Attempted self-harm 87(6.9) 91(1.3) 4.89(3.48-6.86) Difficulty in accessing healthcare for injury 187(15.5) 700(10.8) 1.55(1.29-1.85)
Results (cont.)
*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group
Healthcare utilisation for injury
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Adolescents with disabling conditions in New Zealand, attending mainstream schools (cf. with their peers) are at greater odds of: being a passenger in a motor vehicle driven dangerously or by someone who was drunk or taken drugs intentional and unintentional injury experience greater difficulty accessing healthcare for injury when needed More work is needed to identify the physical and social barriers that exist The risks identified require particular attention of healthcare providers, public health workers and policy makers
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For more detailed information please see our website www.youthresearch.auckland.ac.nz
The Youth’12 project was funded by the Ministries of Youth Development, Social Development, Health, Education and Justice, the Department of Labour, the Families Commission and the Health Promotion Agency (HPA) Thanks to all the schools and students who participated
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