Dataset Information

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

ABSTRACT: OBJECTIVES:Disability 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. DESIGN:Prospective cohort study. SETTING:The United Kingdom Household Longitudinal Study. PARTICIPANTS:Data were from 871 individuals with a self-reported physical, cognitive or sensory disability. PRIMARY OUTCOME MEASURES:Depression was assessed in 2009/10. Psychological distress, mental functioning, life satisfaction and self-rated health were assessed in 2009/10 and 2013/14. RESULTS:Data 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. CONCLUSIONS:Perceived disability-related discrimination is linked with poorer well-being. These findings underscore the need for interventions to combat disability discrimination.

SUBMITTER: Hackett RA

PROVIDER: S-EPMC7069317 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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

Hackett Ruth A RA Steptoe Andrew A Lang Raymond P RP Jackson Sarah E SE

BMJ open 20200312 3

<h4>Objectives</h4>Disability 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.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>The United Kingdom Household Longitudinal Study.<h4>Participants</h4>Data were from 871 individuals with a self-reported physical, cognitive or sensory disability.<h4>Primary outcome measures</h4>Depression was assessed in 2009/10. Psyc ...[more]

PMID: 32169928

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Project description:BACKGROUND:Racism has been linked with poor health in studies in the United States. Little is known about prospective associations between racial discrimination and health outcomes in the United Kingdom (UK). METHODS:Data were from 4883 ethnic minority (i.e. non-white) participants in the UK Household Longitudinal Study. Perceived discrimination in the last 12?months on the basis of ethnicity or nationality was reported in 2009/10. Psychological distress, mental functioning, life satisfaction, self-rated health, physical functioning and reports of limiting longstanding illness were assessed in 2009/10 and 2011/12. Linear and logistic regression analyses adjusted for age, sex, income, education and ethnicity. Prospective analyses also adjusted for baseline status on the outcome being evaluated. RESULTS:Racial discrimination was reported by 998 (20.4%) of the sample. Cross-sectionally, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (odds ratio (OR)?=?1.78, 95% confidence interval (CI) 1.49; 2.13) and fair/poor self-rated health (OR?=?1.50; 95% CI 1.24; 1.82) than those who did not report racial discrimination. Racial discrimination was associated with greater psychological distress (B?=?1.11, 95% CI 0.88; 1.34), poorer mental functioning (B?=?-?3.61; 95% CI -4.29; -?2.93), poorer physical functioning (B?=?-?0.86; 95% CI -1.50; -?0.27), and lower life satisfaction (B?=?-?0.40, 95% CI -0.52; -?0.27). Prospectively, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (OR?=?1.31, 95% CI 1.01; 1.69) and fair/poor self-rated health (OR?=?1.30; 95% CI 1.00; 1.69), than those who did not report racial discrimination. Racial discrimination was associated increased psychological distress (B?=?0.52, 95% CI 0.20; 0.85) and poorer mental functioning (B?=?-?1.77; 95% CI -2.70; -?0.83) over two-year follow-up, adjusting for baseline scores. CONCLUSIONS:UK adults belonging to ethnic minority groups who perceive racial discrimination experience poorer mental and physical health than those who do not. These results highlight the need for effective interventions to combat racial discrimination in order to reduce inequalities in health.

Project description:BackgroundDigital health devices, such as health and well-being smartphone apps, could offer an accessible and cost-effective way to deliver health and well-being interventions. A key component of the effectiveness of health and well-being apps is user engagement. However, engagement with health and well-being apps is typically poor. Previous studies have identified a list of factors that could influence engagement; however, most of these studies were conducted on a particular population or for an app targeting a particular behavior. An understanding of the factors that influence engagement with a wide range of health and well-being apps can inform the design and the development of more engaging apps in general.ObjectiveThe aim of this study is to explore user experiences of and reasons for engaging and not engaging with a wide range of health and well-being apps.MethodsA sample of adults in the United Kingdom (N=17) interested in using a health or well-being app participated in a semistructured interview to explore experiences of engaging and not engaging with these apps. Participants were recruited via social media platforms. Data were analyzed with the framework approach, informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework, which are 2 widely used frameworks that incorporate a comprehensive set of behavioral influences.ResultsFactors that influence the capability of participants included available user guidance, statistical and health information, reduced cognitive load, well-designed reminders, self-monitoring features, features that help establish a routine, features that offer a safety net, and stepping-stone app characteristics. Tailoring, peer support, and embedded professional support were identified as important factors that enhance user opportunities for engagement with health and well-being apps. Feedback, rewards, encouragement, goal setting, action planning, self-confidence, and commitment were judged to be the motivation factors that affect engagement with health and well-being apps.ConclusionsMultiple factors were identified across all components of the COM-B model that may be valuable for the development of more engaging health and well-being apps. Engagement appears to be influenced primarily by features that provide user guidance, promote minimal cognitive load, support self-monitoring (capability), provide embedded social support (opportunity), and provide goal setting with action planning (motivation). This research provides recommendations for policy makers, industry, health care providers, and app developers for increasing effective engagement.

Dataset Information

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

Publications

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

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